Dr. Rena Malik - Board-Certified Urologist & YouTube Educator (3M+ Subscribers) | What Your Sexual Health Reveals About Your Overall Health

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When you look at the blood vessels to the penis, they are about half the size of the blood vessels to the heart.

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So anything that's going to affect the health of the blood vessels, you're going to see first in terms of erection quality, long before you start having high blood pressure, high cholesterol.

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Today's guest is Dr. Reena Malik, a board-certified urologist, pelvic surgeon, and health educator.

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She is known for making complex medical topics easier to understand through her educational content and online platforms.

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In this episode, we explore health, wellness, medical misconceptions, and the importance of understanding the human body.

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That's the first thing I think of when I think you can't get an erection.

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It must be a testosterone problem.

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Testosterone has some really good marketing, but it's the sole cause of a**tile dysfunction in like 3% to 6% of guys.

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The other thing that I think people get wrong that actually scares me is that it causes a**tility, and people don't know that.

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your customer info insights and next steps are there when you need them try the starter plan for ten dollars a month learn more at hubspot.com the average high performer what are they missing what are they not paying attention to when all they care about is work is getting to the next level and that's like their main focus

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So I think a lot of high performers, they do do a good job of thinking about, oh, I need to stay fit because I need to be high performing.

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I need to sleep well to high perform.

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I need to eat well to high perform.

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But then that's sort of it.

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Like they don't think about the other aspects of health, which include sort of how stress affects your life and quite significantly in terms of both sexual health and health.

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And so a lot of times they don't realize that they're constantly in this go, go, go.

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And they're constantly bombarded with, inundated with like pings and notifications.

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And I got to do this.

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I forgot to do this.

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Let me do this right now.

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And there's no like shut off time, right?

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And so then when they want to be intimate with their partner, they are often like just can't get into the mind state to really turn that off.

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And then they'll start having some difficulties.

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And then that's catastrophic, right?

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Because they're like, oh my God, like what happened?

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And, you know, am I broken?

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And they're like, now they've had that stressful experience and they're still thinking about it the next time and they're thinking about the next time.

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And it's just getting worse and worse and worse because when you need to be intimate with a person, when you need to get aroused and for a man get an erection, you need to be in a rest and digest state.

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Your body needs to be in the parasympathetic nervous system to be able to get an erection properly.

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And so when you're constantly stressed and you're not really focusing on like calming your nervous system down, de-stressing, you can't get an erection.

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And then the next time you go and you try to have an erection, you're stressed about that last time.

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And you're like, is it going to happen?

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Is it going to happen?

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Is it going to happen?

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Yeah.

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And then because you're stressed, you still can't.

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And now it's just worse and worse.

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You're getting this vicious cycle.

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And so that's one type of high performer.

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The other type of high performer who is just so focused on success in terms of ambition for their career that they are really negating the other aspects of health.

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Like you could probably relate to this.

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I could sit at my computer for like eight hours and just work.

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And then I'd be like, I haven't moved my body.

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I haven't, you know, maybe I haven't even drank enough water.

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Maybe I haven't eaten a meal.

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Like, I don't know.

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Like, I'm just, if I'm in the zone, you don't know what's going to happen.

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And so those kind of people, and I'm guilty of it at times too, you have to like prompt yourself to do the health beneficial behaviors and...

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And, you know, I think the other issue is a lot of high performers can work on less.

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Like part of the reason that you are successful is because you're able to work when you're tired, when you're maybe lacking sleep.

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I mean, as a resident, when I was training, we would work for, you know, 36 hours straight.

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And you would just keep and you'd be making life and death decisions.

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Right.

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It's not like you're doing like emails, like you're doing real things.

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And so and but you got it done and you took care of people and you saved lives.

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And so you are capable of so much.

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And because you know that, you will sometimes put your body and your health in the back.

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You'll be like, I'll take care of it later.

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Like, I'll deal with that later.

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And so that may be eating junk food.

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That may be not getting exercise.

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That may be not getting sleep.

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And so those are really sort of the big issues that I often see.

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And then the other one is like, you may look really healthy and you may be doing all the right things, but

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But because maybe bad luck, genetics, you have other health conditions like high blood pressure, high cholesterol, or prediabetes or even diabetes.

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And you're just like, you're like, but I feel great.

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I look great.

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And you're like, this is just a number.

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And you're just, you can't focus on that.

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And you're like, but I'm doing all the right things.

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And so, but those things continue to progress over time if you don't really give them the attention they deserve.

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And that's going to affect your sexual function long before you get a heart attack or a stroke.

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Right.

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And I don't think people even understand.

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So I was reading some of your work and listening to some other podcasts and like sexual function is this leading indicator that there's something broken.

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And I don't think anybody really thinks of it that way.

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They just think of maybe they're aware that they can't shut off from work or maybe they're whatever it is.

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And they're like, I'm not focused on this.

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So this is the reason why I don't have a good sex life with my partner.

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It could be that or it could be something much more insidious and they have no idea and they don't have the bandwidth to figure it out.

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Usually like health issues are like, I don't have the time to figure this shit out right now.

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Or we just don't go to the doctor because we're like, I don't have the time to make the appointment.

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Right?

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Like, I keep putting it off.

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Or like, man, I made this appointment and something else came up and now I have to move the appointment.

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And so, like, you won't go get your screening.

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You won't go get your doctor's appointment.

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And it just keeps getting pushed off.

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So you're really delaying it.

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And so the good thing about having sexual problems, the only good thing that comes from it, is that it's an opportunity to say, like, look, this is important to me.

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And now because I'm having a problem, it is, oh, I need to go to the doctor.

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And what needs to happen then is that you need to investigate your overall health.

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Because as you mentioned, it's sort of like a check engine light.

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It's like, hey, something's wrong here.

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And the reason is because when you look at the blood vessels to the penis, they are about half the size of the blood vessels to the heart.

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So anything that's going to affect the health of the blood vessels...

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you're going to see first in terms of erection quality long before you start having high blood pressure, high cholesterol, chest pain, shortness of breath, any of those things that would be like, oh, oh my God, I'm really ill. Like I really need to do something.

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And so if you take that opportunity, you find out what's wrong, you do the work to fix it, you follow the four pillars that we talk about in The Hard Truth, you will not only have good sex, but you will be protecting yourself from illness down the road.

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Is this why Brian Johnson measures his erections every single night?

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Yeah, absolutely.

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And so, you know, morning erections...

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So let's talk about nighttime erections for a second.

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So overnight, every guy will have three to five erections, a healthy guy.

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And so this is your body's way of, like, protecting you.

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So if...

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Normally your penis is at sort of a low oxygen state.

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And when you have an erection, you get good, healthy, oxygenated blood flow into the tissues.

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So it keeps it flexible.

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It keeps it healthy.

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If you stop having erections at all, meaning none at night, none during the day, you start actually getting scar tissue in the penis.

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And so it's called fibrosis.

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And so your penis gets the scar tissue.

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It can't expand as well.

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It may shrink a little bit.

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And so it's really important that you have these nighttime erections because it's keeping your genitals healthy.

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Okay.

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And so when you're having them, it's basically a marker that things are working pretty well.

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Like you're getting good blood flow to the penis.

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Your hormones are giving you the signals necessary to get blood flow down there.

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Your nerves are giving you the appropriate signals to get blood flow down there.

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And, you know, you're and so this is like just a marker that things are OK and things are working well.

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And so if you measure your erections, which you can do, or you just say like, yeah, I'm consistently waking up with a morning erection as I often do, and they're still quite as firm as they used to be, that's a really good sign.

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And also can be a sign that like, hey, maybe I need to pay more attention if like, I'm, you know, I don't remember the last time I woke up with a morning erection or, you know, and my erections are getting a little less robust than they used to be.

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That could be a sign where like, hey, let's be proactive and let's sort of use this as a marker to see.

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how things are going.

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So I guess the question to start with is, how do you isolate which variables actually contributing to the thing that's stressing you out, which is lack of great sex, probably?

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Because you want to figure out, is it health-related?

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Is it stress-related?

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And I think just starting to work through that

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So a good way to delineate if it's stress-related versus an organic or medical problem, one is the nighttime erections.

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If you wake up with these really strong erections every day, that means that things are really working well.

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And that's a good sign.

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In fact, that is one of the tests that we used to do back in the day.

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You would do these tests to see what are people's nighttime erections like to see, okay, that helps us delineate.

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Now, it's not be all end all.

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The other thing I would encourage guys to do is like, well, when you're by yourself and you're self stimulating, do you get a strong erection?

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Do you have any issues there?

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Because obviously having another person in the room, like having some expectation of what that's going to go like either for you or what you think your partner might expect adds a level of stress.

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And so if you're doing fine by yourself, that does say that, yeah, maybe there's some psychological component there.

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Right.

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Regardless, I think every guy has some psychological component, right?

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If you're having trouble with an erection, you are stressed about it.

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It doesn't matter if it's a medical problem or not.

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There is going to be a psychological component.

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So I'd say I would still encourage every guy, even if you don't go see a urologist, go see your primary care doctor.

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And say, look, I am concerned about my erections and I want to get an evaluation.

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And what that would include be check your blood pressure, check your cholesterol, check if you're diabetic.

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So you can get a hemoglobin A1C blood test.

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And those are the big ones that you want to check.

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And then you go down the rabbit hole, like if any of those things are raised flags, then there's other testing that can be done.

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But I think it's – think of it as like, okay –

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And now you can do a lot of blood testing at home.

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Like for busy entrepreneurs, like you can get a blood test.

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You can pay for one at Quest or LabCorp or through a home company.

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They'll come to your house now.

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Like there's so many options.

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And so if you're super busy, at least get some blood tests.

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Get your cholesterol panel.

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Get your hemoglobin A1C.

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You can check your blood pressure at CVS or like buy a blood pressure cuff and bring it to your home.

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Like it's not – it's really manageable.

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Of course, I would love if you would go see a doctor.

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But if you can't and you're just so busy, then at least do those few things.

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And then after you, that will start to indicate what you should pay attention to.

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That will indicate if it's, and am I right in assuming that it could be like a testosterone?

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And your testosterone.

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You should also get your hormones.

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check.

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So what we usually do, what the guidelines would recommend is to get just a total testosterone.

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And then if that's low, you go on to get a second set.

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Now, I don't think you can just get a full set of like a male hormone panel, which would be like a testosterone, a sex hormone binding glibulin, a free testosterone, an FSH, LH, a prolactin, a thyroid hormone, and an estradiol.

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And so you can get those tests as well.

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Because...

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Hormone problems do cause erectile dysfunction, but they are a very small portion of what causes erectile dysfunction alone.

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So it's interesting.

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Sorry.

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It's okay.

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I'm just so interested because that's the first thing I think of when I think you can't get an erection.

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It must be a testosterone problem.

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Testosterone has some really good marketing.

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It has really good marketing.

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It has really, really good marketing.

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Look, testosterone is great.

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I mean, everyone needs to have a sufficient amount of testosterone to function and to perform and to have good cognitive function, good sexual function, good mood, and physical function, right?

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So there is a value in checking your testosterone.

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And as you mentioned earlier, testosterone is declining.

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And we do see that on average that testosterons are declining, but testosterone.

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It's the sole cause of erectile dysfunction in like 3% to 6% of guys.

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Now, it may contribute.

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Like you may have multiple reasons and it may contribute to it.

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But the only reason being, no, not usually.

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And, you know, I'm grateful for it because there was a lot of...

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fear around testosterone before about it being related to heart health, you know, cardiovascular disease, causing cardiovascular disease or prostate cancer, which has now been largely debunked.

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And so I'm glad that people who need it are getting it.

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What really worries me about today's society is that people are looking at testosterone and saying, I need this number.

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I need to be this number.

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And I was like, you can't possibly know what you need individually because I don't know what you need individually.

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Unless you were to tell me like, hey, I got my blood tested when I was in my 20s and I checked my testosterone a few times and this is where my baseline is.

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And then I may know, okay, when you're feeling great, your testosterone is XYZ and you may need that amount to feel great again.

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And that helps me.

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But some people, because the reality is individuals are different, right?

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And so everyone has a different number of testosterone receptors in their body, which testosterone attaches to.

208
00:14:07.163 --> 00:14:09.726
And those receptors have different sensitivities.

209
00:14:10.127 --> 00:14:16.074
So what that means is that the testosterone may attach to the receptor, and it may work really, really well.

210
00:14:17.415 --> 00:14:22.117
Or in some cases, it may be less than this, so it might need a little more testosterone to attach to it to work the same way.

211
00:14:22.717 --> 00:14:27.799
And that differentiation, we don't have commercial lab testing available to look at that yet.

212
00:14:28.159 --> 00:14:32.160
And so I have guys who come in with testosterone of 350 and they feel fine.

213
00:14:32.200 --> 00:14:33.240
They have no symptoms.

214
00:14:33.261 --> 00:14:33.921
They're great.

215
00:14:34.321 --> 00:14:35.601
And so they don't need more.

216
00:14:35.961 --> 00:14:37.542
But if they feel like they are...

217
00:14:38.082 --> 00:14:43.504
I have guys who come in with 450 and they actually have a really low free testosterone

218
00:14:43.904 --> 00:14:46.427
And they actually feel pretty crummy.

219
00:14:46.507 --> 00:14:49.409
And when we replace them, they see the differences.

220
00:14:49.429 --> 00:14:54.574
And I think the reality is you have to look at like what is the benefit if you decide to try testosterone.

221
00:14:55.115 --> 00:14:56.676
Are you seeing a benefit from it?

222
00:14:56.716 --> 00:15:04.844
Now, every guy is going to see a muscular health benefit because even when your testosterone receptors throughout your whole body are saturated, the muscle will continue to grow.

223
00:15:05.244 --> 00:15:05.504
But...

224
00:15:06.585 --> 00:15:10.509
At some point, you will get to a point where you're now getting, there's obviously risk with everything.

225
00:15:10.549 --> 00:15:14.613
So the risk-benefit ratio is seesawing the other way.

226
00:15:14.713 --> 00:15:16.195
So there's more risks than benefits.

227
00:15:16.495 --> 00:15:18.777
You could end up getting a thickening of your blood.

228
00:15:18.797 --> 00:15:19.858
You could get a blood clot.

229
00:15:20.359 --> 00:15:21.860
And these are serious things, right?

230
00:15:21.900 --> 00:15:26.404
And so you have to really, hormones are not just like willy-nilly something we play with.

231
00:15:26.444 --> 00:15:30.068
It is a very serious treatment that you need serious monitoring with.

232
00:15:30.348 --> 00:15:33.769
And that's the issue when testosterone has a really good marketing department.

233
00:15:33.889 --> 00:15:34.149
Exactly.

234
00:15:34.169 --> 00:15:35.289
People are just trying to hit a number.

235
00:15:35.449 --> 00:15:35.989
And they're frustrated.

236
00:15:36.009 --> 00:15:38.149
They're like, I'm not, why is no one telling me?

237
00:15:38.189 --> 00:15:39.830
Like no one's giving me an answer of why.

238
00:15:39.970 --> 00:15:41.730
Maybe they think it's for erectile dysfunction.

239
00:15:41.770 --> 00:15:43.190
No one's telling me why I feel this way.

240
00:15:43.510 --> 00:15:44.951
Or no one's telling me why I feel exhausted.

241
00:15:44.971 --> 00:15:45.811
There's no other answer.

242
00:15:45.831 --> 00:15:46.971
It has to be testosterone.

243
00:15:47.191 --> 00:15:50.011
And my doctor won't give it to me, so I'll go somewhere else and get it.

244
00:15:50.111 --> 00:15:52.032
And so that's where the challenge is.

245
00:15:52.312 --> 00:15:58.813
The other thing that I think people get wrong that actually scares me is that it causes infertility.

246
00:15:59.393 --> 00:16:00.554
And people don't know that.

247
00:16:00.634 --> 00:16:13.601
And we have younger and younger guys on testosterone because they think it's their looks maxing or they're doing all sorts of things without really understanding that they may be causing themselves to become infertile.

248
00:16:14.021 --> 00:16:16.782
Usually that will get reversed, but it will take time.

249
00:16:17.703 --> 00:16:21.925
And sometimes if you're on it for too long, like it won't be reversible.

250
00:16:22.245 --> 00:16:23.906
How does it affect your fertility?

251
00:16:24.224 --> 00:16:28.488
So when you're getting outside testosterone, right, your brain just sees testosterone.

252
00:16:28.508 --> 00:16:30.029
They don't know that it's coming from outside.

253
00:16:30.310 --> 00:16:31.931
So it thinks that you're making enough.

254
00:16:32.352 --> 00:16:37.797
And so it stops sending signals to the testicles to make testosterone and it affects sperm production.

255
00:16:38.077 --> 00:16:49.167
So for all these guys jumping on TRT, because some guys do it for the right reasons, some guys just want to look better and they're trying to hit a number like we were talking about before, right?

256
00:16:50.744 --> 00:16:52.806
How do you preserve fertility?

257
00:16:53.106 --> 00:16:56.509
So there are some protocols on how to do this, right?

258
00:16:56.790 --> 00:17:02.515
Depending on how long, if you need it medically, then how long is it until you want to be fertile?

259
00:17:02.815 --> 00:17:11.383
So then you can add things like Clomid and HCG, which is another injectable medication that essentially rev up your body's production of testosterone.

260
00:17:11.423 --> 00:17:12.224
So there are ways to do this properly?

261
00:17:12.264 --> 00:17:23.008
There are ways to do this and there's protocols to do it, but you need to know that you need to give yourself leeway so that you can start producing sperm again or do that from the beginning if you know you're fertile.

262
00:17:23.028 --> 00:17:26.429
This is also the reason why you should be working with a doctor to do this and not just self-medicating.

263
00:17:26.589 --> 00:17:27.189
Exactly.

264
00:17:27.449 --> 00:17:34.752
Are there any protocols that you even see doctors prescribe that are sort of scary?

265
00:17:35.572 --> 00:17:35.992
Of course.

266
00:17:36.112 --> 00:17:37.673
I mean, I think there's people...

267
00:17:37.693 --> 00:17:39.614
I feel like everybody's offering TRT now.

268
00:17:39.674 --> 00:17:40.034
It's like...

269
00:17:40.742 --> 00:17:45.823
There's a lot of times people will do things outside their scope, right?

270
00:17:45.843 --> 00:17:51.125
Like I've seen certain doctors where they really have no business doing men's health.

271
00:17:51.465 --> 00:17:57.006
Like maybe they're a woman's health doctor or maybe they're, you know, a foot doctor or a chiropractor or something.

272
00:17:57.046 --> 00:18:00.067
You know, like just they're not even in the realm of that.

273
00:18:00.527 --> 00:18:02.248
And yes, anyone can learn.

274
00:18:02.448 --> 00:18:06.569
I'm not saying that they may be very skilled and they may have learned it.

275
00:18:06.929 --> 00:18:09.930
But I think that any doctor who's prescribing something should...

276
00:18:10.510 --> 00:18:15.853
very much know the complications and very much know what to do if those complications arise.

277
00:18:16.273 --> 00:18:16.453
Right?

278
00:18:16.473 --> 00:18:25.898
Like if you don't know what to do and you're like, oh, now if you don't counsel the patient, if you go to a doctor and they say, this is the best thing since sliced bread, take it, you'll be fine.

279
00:18:26.238 --> 00:18:28.580
And they don't tell you a single risk factor.

280
00:18:28.960 --> 00:18:33.502
That's a red flag because everything has a risk and it can cause breast enlargement.

281
00:18:33.602 --> 00:18:34.723
And sometimes it can cause

282
00:18:35.443 --> 00:18:36.885
shrinkage of the testicles.

283
00:18:37.205 --> 00:18:39.027
You want to check your blood pressure while you're on it.

284
00:18:39.047 --> 00:18:40.288
Sometimes it can cause swelling.

285
00:18:40.669 --> 00:18:53.482
Like I actually think my job with patients is like, I want to make sure they know every single side effect before I tell them the benefits because I need them to know, like, okay, I want this despite these potential side effects, right?

286
00:18:53.502 --> 00:18:58.107
You would recommend TRT and testosterone is like a last resort.

287
00:18:58.767 --> 00:18:59.969
After you do all the other stuff.

288
00:18:59.989 --> 00:19:02.011
I think you should always try lifestyle things.

289
00:19:02.071 --> 00:19:14.267
But for some people, like when they are really low, like they are so like exhausted and fatigued and like true, like truly low that they they really may need it just to be able to do the lifestyle things.

290
00:19:14.447 --> 00:19:14.948
You know what I mean?

291
00:19:14.988 --> 00:19:16.850
So I think it's there's a balance there.

292
00:19:18.142 --> 00:19:19.123
And that's what's tough.

293
00:19:19.563 --> 00:19:20.164
People have to figure...

294
00:19:20.184 --> 00:19:22.386
So this is where the recommendation is, go talk to a doctor first.

295
00:19:22.406 --> 00:19:23.026
Yes, yes.

296
00:19:23.107 --> 00:19:35.139
I mean, always work on lifestyle because the true thing is about the testosterone blood test is that it's so variable that I can take your blood today and that's why we have you check it twice based on the guidance because the variability is on average 18%.

297
00:19:36.720 --> 00:19:38.400
So like, it's pretty big.

298
00:19:38.701 --> 00:19:43.782
And so that's why we need to check it a few times to make sure you're truly like, you know, in that range.

299
00:19:43.802 --> 00:19:47.543
And like, say you're having a stressful moment in your life, like it may be really low.

300
00:19:47.983 --> 00:19:50.904
And so you may want to get out of that and then recheck it.

301
00:19:50.944 --> 00:19:52.344
And so I don't think you should act in.

302
00:19:52.364 --> 00:19:53.165
Check it on vacation versus.

303
00:19:53.205 --> 00:19:53.365
Yeah.

304
00:19:53.385 --> 00:19:56.486
I mean, I think you should, you should give it, you know, give it a moment.

305
00:19:56.546 --> 00:20:00.267
Like, like people I think are so eager to like, oh, I need this to make me better.

306
00:20:00.287 --> 00:20:05.048
That like, they're not really letting their body like figure it out for themselves.

307
00:20:05.448 --> 00:20:11.593
I was looking at some of the stories in the book, and in The Hard Truth, one of the stories is about Patrick.

308
00:20:11.633 --> 00:20:13.014
He's a gym franchise owner.

309
00:20:14.395 --> 00:20:16.256
Really good, in-shape guy.

310
00:20:17.197 --> 00:20:18.758
Works out nonstop.

311
00:20:18.798 --> 00:20:21.480
He was having erection problems.

312
00:20:21.660 --> 00:20:23.021
It wasn't a testosterone thing.

313
00:20:23.041 --> 00:20:23.622
So this is the...

314
00:20:24.202 --> 00:20:25.443
Exactly.

315
00:20:26.243 --> 00:20:31.746
So tell me about this story and what happened when you were speaking to him and what you recognized about sort of his lifestyle.

316
00:20:31.806 --> 00:20:35.387
So he was just so focused on work, right?

317
00:20:35.487 --> 00:20:36.568
And he was very successful.

318
00:20:36.608 --> 00:20:39.289
Like he was doing, he had so many gym franchises.

319
00:20:39.309 --> 00:20:40.089
He was doing great.

320
00:20:40.489 --> 00:20:44.191
He, he was, but like, he was like, yeah, there's always stress in my life.

321
00:20:44.191 --> 00:20:46.533
Like, of course, like there's always things going on.

322
00:20:46.553 --> 00:20:47.874
You know, there's financial issues.

323
00:20:47.894 --> 00:20:48.675
There's this, there's that.

324
00:20:48.695 --> 00:20:50.617
I'm always thinking about it.

325
00:20:50.797 --> 00:20:52.879
And he just didn't like and he was healthy.

326
00:20:52.899 --> 00:20:54.380
He was doing all the right things.

327
00:20:54.460 --> 00:20:59.304
But like we talked about earlier, he was really stressed and he was like, I need to fix this problem.

328
00:20:59.444 --> 00:21:03.468
And like many entrepreneurs, he was like, I'm going to figure out how to fix this problem.

329
00:21:03.508 --> 00:21:03.688
Right.

330
00:21:03.708 --> 00:21:05.330
Like I can fix any problem.

331
00:21:06.190 --> 00:21:11.114
But he wouldn't really look at his lifestyle as contributing, right?

332
00:21:11.154 --> 00:21:12.695
He's like, no, I can't stop.

333
00:21:12.735 --> 00:21:13.776
I can't change.

334
00:21:13.876 --> 00:21:26.645
And the reality is if you don't make the changes necessary to live in a healthy way, that includes reducing stress and figuring that out and like sleeping and doing the things necessary, you...

335
00:21:26.945 --> 00:21:28.687
you're going to pay the price at some point.

336
00:21:28.707 --> 00:21:30.989
You're going to have to slow down then, right?

337
00:21:31.249 --> 00:21:42.641
So you might as well take it and incorporate it into your life now so that you don't have to make an abundance of time and take weeks off because you had a heart attack or whatever the case might be, right?

338
00:21:43.081 --> 00:21:45.804
Say somebody is listening to this advice.

339
00:21:46.905 --> 00:21:48.286
They understand that...

340
00:21:49.027 --> 00:21:50.868
They have to get all these blood panels done.

341
00:21:51.368 --> 00:21:51.928
They do.

342
00:21:52.788 --> 00:21:53.688
It looks normal.

343
00:21:54.248 --> 00:21:55.569
They're still having problems.

344
00:21:56.269 --> 00:21:56.849
What does that mean?

345
00:21:57.349 --> 00:22:02.090
So then we talk about, OK, there's probably a psychological component too, right?

346
00:22:02.110 --> 00:22:06.612
Because if everything else appears normal, then you would assume that it's likely psychological.

347
00:22:07.032 --> 00:22:10.213
In those cases, you can talk to, there's a few options, right?

348
00:22:10.233 --> 00:22:11.733
You can talk to a sex therapist.

349
00:22:12.173 --> 00:22:14.894
Again, I understand entrepreneurs, like I don't have time for that, right?

350
00:22:15.694 --> 00:22:18.736
Like I tell my patients all the time, I wish they would all see a sex therapist.

351
00:22:18.776 --> 00:22:19.237
Right.

352
00:22:19.617 --> 00:22:21.418
But you can now do it on virtually telemedicine.

353
00:22:21.458 --> 00:22:22.419
There's lots of options.

354
00:22:22.839 --> 00:22:26.202
So to work on thoughts and like how you're thinking about your performance.

355
00:22:26.222 --> 00:22:28.343
I don't like the word performance, but how you think about.

356
00:22:28.663 --> 00:22:29.344
Why not?

357
00:22:29.524 --> 00:22:32.246
Because it puts a pressure on somebody.

358
00:22:32.266 --> 00:22:33.667
Like I have to go perform.

359
00:22:34.207 --> 00:22:39.172
Women don't feel like I have to go perform, but men feel like I have to go perform, right?

360
00:22:39.192 --> 00:22:46.598
So you are now like showing up to do something with the expectation that you have this like outcome that's going to happen, right?

361
00:22:46.658 --> 00:22:52.684
And so sex should be fun, playful, like, okay, so if you don't have an erection one time, like...

362
00:22:53.104 --> 00:22:54.245
it's not the end of the world.

363
00:22:54.285 --> 00:23:01.912
Let's focus on other things that are fun and playful and like have intimacy and like be close and be physical and like enjoy other parts of our bodies.

364
00:23:01.932 --> 00:23:05.756
Like it doesn't have to be this one outcome that we all ascribe it to.

365
00:23:05.776 --> 00:23:06.537
Of course, it's great.

366
00:23:06.557 --> 00:23:07.077
It's wonderful.

367
00:23:07.377 --> 00:23:13.243
But like, okay, if that happens, like let's not like catastrophize and let's enjoy, still enjoy being with each other.

368
00:23:13.743 --> 00:23:15.585
And so that's why I don't like the word performance.

369
00:23:15.905 --> 00:23:19.028
So if the blood panel is good, then yeah.

370
00:23:19.448 --> 00:23:21.630
So if you can talk to a sex therapist, that can be helpful.

371
00:23:21.650 --> 00:23:25.834
The other thing is sometimes I will see guys and I will say, okay, I understand that you're feeling stressed.

372
00:23:25.854 --> 00:23:27.055
Like there's a lot going on.

373
00:23:27.355 --> 00:23:36.663
Why don't we do a trial like a low dose of Cialis or Tadalafil daily so that it helps you just like get a little – it becomes easier to get an erection.

374
00:23:36.683 --> 00:23:36.923
Yeah.

375
00:23:36.943 --> 00:23:42.031
And when it becomes easier, now you can get the confidence back that like, oh, yeah, this is all working fine.

376
00:23:42.311 --> 00:23:45.777
And then you can decide whether you want to stay on the medication, go off it, no big deal.

377
00:23:46.057 --> 00:23:46.197
Right.

378
00:23:46.237 --> 00:23:48.761
But it's just helps you sort of bridge that gap a little bit.

379
00:23:48.801 --> 00:23:52.247
And there's no there's no issue staying on these drugs like long term?

380
00:23:52.441 --> 00:23:54.523
Well, so every medication has side effects.

381
00:23:54.583 --> 00:23:55.043
For sure.

382
00:23:55.083 --> 00:23:58.725
This is a very safe medication in terms of like there are few side effects.

383
00:23:58.745 --> 00:23:59.966
Some people get muscle aches.

384
00:24:00.026 --> 00:24:03.989
Some people do get a stuffy head cold sort of type symptoms.

385
00:24:04.009 --> 00:24:07.952
But usually on the low dose medications, these issues don't happen very often.

386
00:24:08.292 --> 00:24:16.098
I can count on my like literally I think I can think of two patients my entire life who've had a side effect that was so bothersome with a low dose to Delphyl.

387
00:24:16.118 --> 00:24:19.040
And you can imagine I prescribed this to thousands of patients.

388
00:24:19.440 --> 00:24:21.002
So it's pretty safe.

389
00:24:21.342 --> 00:24:25.387
Now, in terms of long term, this is something that people have been using for years.

390
00:24:25.427 --> 00:24:27.249
I mean, the medication's been out for a long time.

391
00:24:27.269 --> 00:24:29.331
People have been using it for years without issue.

392
00:24:29.371 --> 00:24:33.436
Now, can I tell you that if you use it for 40 years, like, is it going to be fine?

393
00:24:33.516 --> 00:24:34.757
Probably, but I don't know.

394
00:24:34.977 --> 00:24:36.219
I don't know that we have that data.

395
00:24:36.279 --> 00:24:37.020
It hasn't even been...

396
00:24:37.820 --> 00:24:39.021
It hasn't been around for 40 years.

397
00:24:39.061 --> 00:24:42.505
It's like if someone started at 60 and they live to 100, like, I don't know.

398
00:24:42.605 --> 00:24:42.845
Right.

399
00:24:43.505 --> 00:24:45.888
But likely it's quite safe.

400
00:24:46.288 --> 00:24:48.090
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418
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If you look at...

419
00:26:08.622 --> 00:26:10.384
your job and the work you do.

420
00:26:11.545 --> 00:26:16.910
Is it like 50% medical issue, 50% psychological issue?

421
00:26:16.950 --> 00:26:19.693
Is it like, are you like more therapist than doctor?

422
00:26:19.793 --> 00:26:23.317
I call my sister, we joke that we're like, you're a psychologist because-

423
00:26:23.997 --> 00:26:28.981
Because I spend a lot of time talking about these things because the reality is it's intermingled.

424
00:26:29.001 --> 00:26:30.402
There's not one without the other.

425
00:26:30.422 --> 00:26:32.163
We call it biopsychosocial, right?

426
00:26:32.263 --> 00:26:34.305
Sex is just biopsychosocial.

427
00:26:34.345 --> 00:26:36.066
Like, it incorporates everything.

428
00:26:36.447 --> 00:26:42.611
And I think the hard part for Ben is, like, they don't want to think that anything is wrong with the way they're thinking about things, right?

429
00:26:42.631 --> 00:26:43.512
They're like, I want to...

430
00:26:43.732 --> 00:26:49.921
Fix this physical issue that I can fix with a medication or fix with a treatment or some action.

431
00:26:50.261 --> 00:26:52.725
But when it's like, oh, I got to think about what I'm thinking about now.

432
00:26:52.845 --> 00:26:53.526
I don't want to do that.

433
00:26:53.606 --> 00:26:53.826
Right.

434
00:26:54.207 --> 00:26:55.529
And so it is challenging.

435
00:26:55.589 --> 00:26:58.513
But I will tell you that once you build, I mean, I've taken care of.

436
00:26:58.873 --> 00:27:06.699
So many men that like once I build a rapport with them, like they, you know, it's they understand, like you get it right when I tell you like it's definitely something you're thinking about.

437
00:27:06.719 --> 00:27:07.399
Yeah, you're right.

438
00:27:07.619 --> 00:27:09.300
Like you are completely right.

439
00:27:09.320 --> 00:27:10.461
But it's like you have to get there.

440
00:27:10.481 --> 00:27:18.787
You have to like bring your mind to think that, yes, this is something that I need to address and think about because it is affecting me in the background and that.

441
00:27:19.247 --> 00:27:22.508
I think for high performers, the thing is that these things, you will move past it.

442
00:27:22.528 --> 00:27:23.708
You'll be like, okay, I got to get back to work.

443
00:27:23.728 --> 00:27:24.608
I got to focus on this.

444
00:27:24.888 --> 00:27:27.569
But it will always be there sort of nagging you in the background.

445
00:27:27.889 --> 00:27:43.613
And if you don't give it the attention it deserves, it will seep into other areas of your life because you will start thinking like you will have a little bit of self-doubt or you have a little bit of stress about it or, you know, a little bit of anxiety about it that will creep into other areas, whether it's in your relationship or the way you show up at work.

446
00:27:43.653 --> 00:27:44.673
And so it...

447
00:27:45.153 --> 00:27:50.298
Not only for your health, which is the most important thing, like for your heart health, your overall health, you should be addressing it.

448
00:27:50.639 --> 00:28:03.171
But because you're a high performer and you want to show up and be the best version of yourself, that's another reason to just take the time and take care of it and get addressed and talk about it and find the right doctor for you and do the work.

449
00:28:03.472 --> 00:28:06.615
Why do you think it's so hard for guys to speak about this stuff?

450
00:28:07.385 --> 00:28:09.086
I can only talk from anecdote, right?

451
00:28:09.126 --> 00:28:10.007
I can't give you data on that.

452
00:28:10.027 --> 00:28:14.589
But I will say that society makes it very difficult for men to be vulnerable.

453
00:28:15.609 --> 00:28:23.033
And I think that it is really, it's been expected of men to show up, do the work, get things done.

454
00:28:23.413 --> 00:28:30.457
And so I think because of that, it also is very difficult for men to show that they have some challenges they're working on.

455
00:28:30.797 --> 00:28:38.492
But I think that the average guy is not going to, is not, I mean, they're not even honest with their partner, let alone themselves.

456
00:28:38.894 --> 00:28:39.194
Oh, yeah.

457
00:28:39.474 --> 00:28:40.795
I mean, there's actually some data on this.

458
00:28:40.835 --> 00:28:44.278
So Cleveland Clinic does a study called the Mention Study, and they'll ask questions to guys.

459
00:28:44.298 --> 00:28:48.401
And like only 48 percent of guys will share their health issues with their partner.

460
00:28:48.861 --> 00:28:51.063
Like sometimes they will just keep them to themselves.

461
00:28:51.543 --> 00:28:54.966
And most guys would rather do chores than see a doctor.

462
00:28:55.406 --> 00:29:00.109
And like they would rather do they would wait until something is so serious, like 60.

463
00:29:00.229 --> 00:29:05.053
I think it was 66 percent of guys will wait till something is so serious before they actually go see a doctor.

464
00:29:06.077 --> 00:29:13.063
What do you say to somebody who comes in to, and hopefully people listening will hear this and it will resonate with them.

465
00:29:13.444 --> 00:29:16.326
What do you say to somebody to get them more comfortable?

466
00:29:17.007 --> 00:29:18.248
Because you said half your job is.

467
00:29:18.488 --> 00:29:19.890
Yeah.

468
00:29:20.030 --> 00:29:21.351
So how do you get somebody to open up?

469
00:29:21.666 --> 00:29:23.127
Well, first I listen, right?

470
00:29:23.227 --> 00:29:25.608
I ask questions without judgment, right?

471
00:29:25.648 --> 00:29:28.430
And I say like, well, what does sex look like for you?

472
00:29:28.690 --> 00:29:30.031
What do you want it to look like?

473
00:29:30.511 --> 00:29:36.915
And when they start talking about that, and usually they're like grateful someone's actually asked them, right?

474
00:29:36.935 --> 00:29:42.119
Like to be honest, so like someone's actually cares about what I want and is willing to ask me about it.

475
00:29:42.679 --> 00:29:46.381
And they've already worked up so much to come to see me, right?

476
00:29:46.401 --> 00:29:48.062
Like they've probably seen other doctors.

477
00:29:48.082 --> 00:29:50.364
They've probably, you know, been like...

478
00:29:51.024 --> 00:29:53.145
stressed about this issue for some time.

479
00:29:53.205 --> 00:29:55.506
So they're coming in being like, I need to deal with this.

480
00:29:55.546 --> 00:29:57.026
So I'm going to talk about it.

481
00:29:57.347 --> 00:30:00.448
And because I've, I mean, part of it is like, I've talked about it a lot online.

482
00:30:00.468 --> 00:30:03.269
So people come, some of my patients come and know who I am, right?

483
00:30:03.309 --> 00:30:03.969
And some don't.

484
00:30:04.009 --> 00:30:05.350
But I think the reality is like,

485
00:30:06.370 --> 00:30:08.733
I'm like, tell me what's going on.

486
00:30:08.773 --> 00:30:09.914
Let's actually talk about it.

487
00:30:09.934 --> 00:30:13.097
Because usually what happens is the guy goes in and says, I have erection problems.

488
00:30:13.137 --> 00:30:14.358
Here's your medication.

489
00:30:14.418 --> 00:30:15.099
See you later, sir.

490
00:30:15.259 --> 00:30:15.439
Right?

491
00:30:15.679 --> 00:30:17.201
There's no other conversation.

492
00:30:17.241 --> 00:30:19.123
So when someone's like, well, what happened?

493
00:30:19.143 --> 00:30:20.964
Like, what's going on exactly?

494
00:30:21.485 --> 00:30:23.387
And let's talk about it.

495
00:30:23.427 --> 00:30:25.308
And let's ask all the questions.

496
00:30:25.729 --> 00:30:27.651
I think they're like, wow, someone actually cares.

497
00:30:27.671 --> 00:30:27.931
Yeah.

498
00:30:27.991 --> 00:30:33.852
But that's scary, though, that they could go to a doctor, say that to their GP, and then GP prescribes.

499
00:30:35.813 --> 00:30:40.494
They're called PD5 inhibitors, like Viagra, Cialis, Levitra.

500
00:30:40.514 --> 00:30:42.155
Yeah, these are the drugs you're talking about.

501
00:30:42.175 --> 00:30:50.197
They're very safe, but there's no red flag that the doctor thinks about that could be like, oh, there could be a heart issue with this person.

502
00:30:50.417 --> 00:30:50.517
Yeah.

503
00:30:50.537 --> 00:30:51.677
And you sort of send them on their way.

504
00:30:51.997 --> 00:30:52.257
Yeah.

505
00:30:52.397 --> 00:31:03.325
And I mean, usually, like, it's tough because, I mean, I empathize with physicians, too, because we like a lot of people are working and they're not incentivized to spend more time with patients.

506
00:31:03.365 --> 00:31:07.188
So if you go to your primary care doctor, they want to make sure you've had all your screening.

507
00:31:07.228 --> 00:31:08.589
So whether that's a colonoscopy.

508
00:31:09.789 --> 00:31:11.870
a chest x-ray, whatever it is, right?

509
00:31:11.890 --> 00:31:14.711
They're making sure that your health is in tip-top order.

510
00:31:15.131 --> 00:31:17.192
And so they're like, let's go through all these big things.

511
00:31:17.612 --> 00:31:22.873
And then usually the patient's like, oh, I'm also having trouble with erections at the end of the appointment, right?

512
00:31:23.093 --> 00:31:25.074
And so they're like, okay, here's a prescription.

513
00:31:25.114 --> 00:31:26.094
I got to go.

514
00:31:26.194 --> 00:31:31.896
And so it's like, it's tough because there's no incentive to spend time talking to patients.

515
00:31:31.936 --> 00:31:36.258
I think the other issue that you have with a smart audience and a...

516
00:31:37.263 --> 00:31:43.769
like a lot of people listen to this, is that they choose to sort of opt out of the traditional system and self-medicate.

517
00:31:43.969 --> 00:31:45.210
That's happening more and more.

518
00:31:45.431 --> 00:31:49.294
Especially now with AI, you feel like you can just talk to AI and it'll tell you what to do.

519
00:31:49.334 --> 00:31:51.636
And you get all the answers and it's telling you exactly what to do.

520
00:31:51.937 --> 00:31:53.538
And some of the advice is actually not bad.

521
00:31:53.738 --> 00:31:53.918
Yeah.

522
00:31:53.958 --> 00:31:56.100
So you say that like...

523
00:31:56.681 --> 00:31:56.981
I mean...

524
00:31:57.322 --> 00:31:59.163
So the point is, but if you go to your GP...

525
00:32:00.144 --> 00:32:04.927
and all they give you is Cialis or Viagra.

526
00:32:05.907 --> 00:32:07.148
And then you're like, well, this is silly.

527
00:32:07.428 --> 00:32:10.050
So then you start looking at, okay, how do I get testosterone?

528
00:32:10.290 --> 00:32:11.590
And then you start going on through a rabbit hole.

529
00:32:11.610 --> 00:32:15.853
It's not even self-medicating per se, it's just like- This desire for knowledge.

530
00:32:16.373 --> 00:32:18.574
And that's actually why I started my channel.

531
00:32:18.654 --> 00:32:23.136
I was realizing over and over again, these guys were coming to me with problems.

532
00:32:23.656 --> 00:32:25.597
And it was not just sexual problems.

533
00:32:25.617 --> 00:32:26.857
It was like bladder problems.

534
00:32:26.897 --> 00:32:31.779
I'd have somebody wait in the waiting room, park in the parking lot, come to see me.

535
00:32:32.099 --> 00:32:34.980
And I'd have to see 40 patients that day because that's what was booked for me.

536
00:32:35.481 --> 00:32:38.122
And they would come in and I'd be like, okay, you're peeing a lot.

537
00:32:38.142 --> 00:32:38.942
Drink less water.

538
00:32:39.162 --> 00:32:40.083
Reduce your caffeine.

539
00:32:40.123 --> 00:32:43.264
Things I could tell them they could have learned online.

540
00:32:44.084 --> 00:32:45.906
And I'd be like, do you want a medication?

541
00:32:45.926 --> 00:32:46.367
They'd be like, no.

542
00:32:46.387 --> 00:32:47.368
I'd be like, okay.

543
00:32:47.548 --> 00:32:49.269
And then we would move on right to the next thing.

544
00:32:49.650 --> 00:32:51.572
And it would just be like the same thing over and over again.

545
00:32:51.612 --> 00:32:55.455
And then the guys would come in and they would be like, I have erectile dysfunction.

546
00:32:55.475 --> 00:32:57.137
I'd be like, okay, well, we have these medications.

547
00:32:57.437 --> 00:33:02.042
And I realized they were just really frustrated because they wanted to know, like, why is this happening to me?

548
00:33:02.142 --> 00:33:05.826
Like, what's going on with my body that I can't get an erection?

549
00:33:05.866 --> 00:33:06.847
How can I fix this?

550
00:33:06.887 --> 00:33:08.008
I don't want to take a pill.

551
00:33:08.488 --> 00:33:13.633
And so I was like, people want to understand why we are doing these things.

552
00:33:13.973 --> 00:33:26.686
And the reality is in 30 minutes or 15 minutes, whatever time you have with the patient, it's very difficult to get all that information, get their history, do an exam and give them the treatment and give them the backstory of why this all makes sense.

553
00:33:27.106 --> 00:33:27.526
And so...

554
00:33:28.607 --> 00:33:30.389
And it's really like people just want to know.

555
00:33:30.409 --> 00:33:32.411
And once they know, they're happy to do it, right?

556
00:33:32.431 --> 00:33:37.055
Like guys want to take testosterone because they know all the benefits of testosterone, right?

557
00:33:37.075 --> 00:33:39.277
They understand that testosterone has had great marketing.

558
00:33:39.898 --> 00:33:41.479
And so they know it's a household thing.

559
00:33:41.499 --> 00:33:43.381
People know the benefits of testosterone.

560
00:33:43.681 --> 00:33:51.489
But like they don't necessarily know that your heart health is linked with your penis health and your brain health is linked with your heart health and your penis health.

561
00:33:51.509 --> 00:33:52.650
And they're all interconnected.

562
00:33:53.228 --> 00:34:02.671
One more question just on, I guess, the psychological hurdle that people have talking about this.

563
00:34:03.111 --> 00:34:05.032
How many men have issues?

564
00:34:05.432 --> 00:34:07.213
Like, do you have like data sets on?

565
00:34:07.353 --> 00:34:08.273
I do, I do.

566
00:34:08.373 --> 00:34:10.013
It's like the norm, I'm assuming.

567
00:34:10.133 --> 00:34:20.877
So in terms of erectile dysfunction, let's say, which is the most common sexual problem that men face, 52% of guys over 50 will have some erectile dysfunction.

568
00:34:21.537 --> 00:34:25.181
60% of 60-year-olds, 70% of 70-year-olds, and so on.

569
00:34:25.242 --> 00:34:27.684
And so it is extremely common.

570
00:34:27.764 --> 00:34:31.689
Think of a room of 50-year-olds, one in two guys is going to have a problem.

571
00:34:32.310 --> 00:34:35.813
And it is a problem because people don't link these...

572
00:34:36.374 --> 00:34:39.137
problems that you have no symptoms with, like high blood pressure, high cholesterol.

573
00:34:39.157 --> 00:34:39.757
You feel fine.

574
00:34:39.817 --> 00:34:40.999
You're like, ah, I'm fine.

575
00:34:41.019 --> 00:34:43.061
I don't need to do anything about these things.

576
00:34:43.701 --> 00:34:48.666
And these things that are sort of very obscure, they don't link those things with their erections.

577
00:34:48.706 --> 00:34:50.548
And so they're not really treating those things.

578
00:34:50.968 --> 00:34:54.372
And so when they're not treating them appropriately, those are worsening.

579
00:34:54.412 --> 00:34:57.495
The blood vessels are getting less and less healthy and the erections are getting worse.

580
00:34:57.895 --> 00:35:04.337
And so what oftentimes I'll see is guys are like, well, I'm going to take Viagra or Cialis, which is really a Band-Aid, right?

581
00:35:04.357 --> 00:35:06.518
It's just giving you an erection in the moment.

582
00:35:06.558 --> 00:35:08.459
It's not fixing the underlying problem.

583
00:35:08.759 --> 00:35:13.921
And so as the underlying problem progresses, now Viagra or Cialis doesn't work as well.

584
00:35:13.981 --> 00:35:15.021
Or like you need a higher dose.

585
00:35:15.041 --> 00:35:16.862
And like, well, these medications are not working.

586
00:35:17.382 --> 00:35:24.305
And it's not like no one's ever making the link with like, well, I need to look under the hood and see like what is actually going on and fix that.

587
00:35:24.885 --> 00:35:30.133
And even at 50 or 60, there should be no age where this is normal.

588
00:35:30.513 --> 00:35:30.573
No.

589
00:35:30.613 --> 00:35:35.981
So, like, obviously, if somebody, like, is, like, 30 years old, they feel like, oh, this is off.

590
00:35:36.441 --> 00:35:40.067
But a 50 or 60-year-old may just assume, well, this is just aging.

591
00:35:40.167 --> 00:35:41.769
And it's not just aging.

592
00:35:42.089 --> 00:35:46.051
If you are a healthy person, you should be able to get erections well into your 90s.

593
00:35:46.071 --> 00:35:46.651
And it's interesting.

594
00:35:46.691 --> 00:35:51.953
I think I wrote about him in the book, but there was like a 90-year-old patient who came in to me for prostate problems.

595
00:35:52.473 --> 00:35:56.775
And I was like, I ask everyone about sexual function, whether they come to me for something else.

596
00:35:57.335 --> 00:35:58.776
And so I was like, oh, how are your erections?

597
00:35:58.896 --> 00:35:59.656
And he's like, great.

598
00:36:00.117 --> 00:36:03.278
And his girlfriend was there, her wife or partner, I don't remember.

599
00:36:03.818 --> 00:36:05.539
And she was sort of like smirking in the corner.

600
00:36:05.899 --> 00:36:07.540
And I was like, that's amazing.

601
00:36:07.660 --> 00:36:08.100
I love it.

602
00:36:08.260 --> 00:36:08.480
Like,

603
00:36:08.760 --> 00:36:09.020
Great.

604
00:36:09.080 --> 00:36:09.641
Good for you.

605
00:36:09.661 --> 00:36:10.101
Good for you.

606
00:36:10.121 --> 00:36:10.922
Good for you.

607
00:36:10.942 --> 00:36:11.902
Good for you.

608
00:36:12.002 --> 00:36:15.224
It's not normal just to have a shitty sex life just because you're older.

609
00:36:15.465 --> 00:36:16.185
Right.

610
00:36:16.325 --> 00:36:24.771
And when I was a resident, I did a study looking at how urology residents, how much we think older people are having sex.

611
00:36:24.871 --> 00:36:26.772
And we were so underreporting.

612
00:36:26.832 --> 00:36:30.355
How much people thought how much older people have sex.

613
00:36:30.395 --> 00:36:33.977
And so everybody wants to have great sex when they're older.

614
00:36:34.037 --> 00:36:37.159
Nobody wants to be like, oh, I'm just going to stop when I'm 80.

615
00:36:37.199 --> 00:36:37.980
Nobody wants that.

616
00:36:38.000 --> 00:36:41.781
Well, this is this whole conversation about not just like what it's not.

617
00:36:43.002 --> 00:36:44.302
Oh, not lifespan.

618
00:36:44.322 --> 00:36:45.003
It's healthspan.

619
00:36:45.583 --> 00:36:45.783
Right.

620
00:36:45.803 --> 00:36:47.784
It's like living a good life until.

621
00:36:48.064 --> 00:36:48.284
Yeah.

622
00:36:48.664 --> 00:36:49.484
Until it's over.

623
00:36:49.604 --> 00:36:55.366
Not just living this life that's, you know, plagued with all these medical issues and health issues.

624
00:36:55.426 --> 00:36:59.868
And not only can you not have sex, but you can't go for a walk or play with your grandkids.

625
00:36:59.888 --> 00:37:01.269
Like you want to live a good life.

626
00:37:01.309 --> 00:37:02.309
You got to do the work.

627
00:37:02.389 --> 00:37:04.950
And you got to you got to do the work sooner than later.

628
00:37:05.130 --> 00:37:05.590
Right.

629
00:37:05.730 --> 00:37:12.192
And the beauty of it is the work that you do for your sexual health is the same work that you're going to do for your overall health.

630
00:37:12.272 --> 00:37:17.734
And so when you make sex a priority, which I think sometimes people feel like, oh, this is an extracurricular thing.

631
00:37:17.774 --> 00:37:19.094
I can't make it a priority.

632
00:37:19.434 --> 00:37:20.535
It's not that important.

633
00:37:20.795 --> 00:37:27.997
But when you make your sex life a priority, not only are you going to have great sex, but you're also going to live longer and you're going to live healthier.

634
00:37:28.482 --> 00:37:33.687
So the book organizes sort of the basics into fuel, strength, environment, and confidence.

635
00:37:34.048 --> 00:37:36.250
So we spoke a little bit about confidence.

636
00:37:36.590 --> 00:37:42.116
When you look at fuel, strength, and environment, can you explain what those mean for the average person?

637
00:37:42.196 --> 00:37:42.677
Yes.

638
00:37:42.817 --> 00:37:43.818
And I'm curious because…

639
00:37:46.063 --> 00:37:52.088
Those four categories, where does what we were just talking about, where does heart health fall into this?

640
00:37:52.108 --> 00:37:57.212
Well, so these are all the things that you're going to do to prevent any problems with, you know what I mean?

641
00:37:57.272 --> 00:37:59.094
We're not talking about once you have a problem.

642
00:37:59.114 --> 00:38:02.917
This is like the foundation that you have to build for your sexual house.

643
00:38:02.937 --> 00:38:06.520
So if you're building a house, you need to have a really strong foundation.

644
00:38:06.560 --> 00:38:10.283
So these are the things that are non-negotiable you have to do to have great sex.

645
00:38:10.303 --> 00:38:10.463
Right.

646
00:38:10.823 --> 00:38:12.644
So fuel is you are what you eat, right?

647
00:38:12.684 --> 00:38:15.725
And what you eat translates to how you perform in the bedroom.

648
00:38:16.165 --> 00:38:26.530
So we know that there are certain things, certain rules that you need to follow to maintain an overall good body weight and to also maintain good muscular health, maintain good gut health.

649
00:38:26.870 --> 00:38:29.131
And those things are all really important for sexual health.

650
00:38:29.791 --> 00:38:34.573
And when you look at the data in terms of diet, the Mediterranean diet consistently outperforms everything else.

651
00:38:34.633 --> 00:38:44.017
So when you take a Mediterranean diet and compare it to guys who don't have a regular standard American diet, guys who follow a Mediterranean diet have a 20% lower risk of erectile dysfunction.

652
00:38:44.917 --> 00:38:48.378
And in the book, I also talk about, like, all these superfoods that you'll hear about.

653
00:38:48.398 --> 00:38:54.700
Because, you know, you've heard about beetroot juice or watermelon or blueberries.

654
00:38:54.780 --> 00:38:56.600
And so you're like, well, what's the science behind these?

655
00:38:56.660 --> 00:38:58.520
And there is science behind a lot of these things.

656
00:38:58.581 --> 00:39:04.642
For example, blueberries, consuming blueberries might reduce your – in similar studies, they've looked at, like, these individual foods.

657
00:39:04.982 --> 00:39:07.303
And they found that blueberries also reduced your risk by, like, 22%.

658
00:39:08.723 --> 00:39:10.546
And so, and there's a reason behind it.

659
00:39:10.566 --> 00:39:11.568
There's antioxidants.

660
00:39:11.588 --> 00:39:14.732
There's different things that are also basically good for your blood vessels.

661
00:39:15.634 --> 00:39:16.755
And so I talk about them.

662
00:39:16.795 --> 00:39:23.425
I want you to know the science, but I also want you to like figure out what you like and don't like, but don't force yourself to eat something you don't like.

663
00:39:23.445 --> 00:39:24.865
Yeah, it just makes smarter choices in general.

664
00:39:24.885 --> 00:39:25.185
Right, right.

665
00:39:25.245 --> 00:39:26.546
And so we talk about that in Fuel.

666
00:39:26.806 --> 00:39:34.087
But really the important part is like, especially for high performers, is that we get stuck in this rut of like, oh, I got to eat quick food.

667
00:39:34.127 --> 00:39:35.407
I might be on the go.

668
00:39:35.467 --> 00:39:36.607
I might be traveling a lot.

669
00:39:36.627 --> 00:39:47.109
And so you still have to really make those intentional choices to eat healthy when you're traveling and you're not home and you don't have access to your kitchen or your foods that you've bought from the grocery store.

670
00:39:47.469 --> 00:39:50.550
And so you have to figure out how to do that in those circumstances.

671
00:39:50.570 --> 00:39:51.370
The next one is strength.

672
00:39:51.530 --> 00:39:51.870
Strength.

673
00:39:51.971 --> 00:39:54.853
So strength, I'm sure many of your listeners know.

674
00:39:54.913 --> 00:40:00.198
We talk about cardiovascular training and resistance training.

675
00:40:00.559 --> 00:40:11.689
Now, cardiovascular training, a lot of people don't know this, is that when you do moderate intensity aerobic activity, and I find that this is sometimes in guys, they will definitely do the resistance training, but they will avoid the cardiovascular training.

676
00:40:11.709 --> 00:40:12.430
That happens sometimes.

677
00:40:12.490 --> 00:40:27.497
And so this is how I motivate people is like when you do about 150 to 160 minutes of cardiovascular workouts every week at moderate intensity, you will see an improvement in erectile function as good as if you took a Viagra.

678
00:40:27.697 --> 00:40:28.017
Really?

679
00:40:28.157 --> 00:40:28.317
Yeah.

680
00:40:28.337 --> 00:40:35.180
So when you compare the magnitude of improvement in erectile function based on these surveys, it's the same as if you were to take a Viagra.

681
00:40:35.772 --> 00:40:36.532
That's insane.

682
00:40:36.612 --> 00:40:36.852
Yes.

683
00:40:37.152 --> 00:40:39.453
So it's very powerful because it's good for your blood vessels.

684
00:40:39.633 --> 00:40:41.194
Like all these things are good for your blood vessels.

685
00:40:41.274 --> 00:40:49.436
I've read that the two biggest indicators of how long you're going to live is your VO2 max and your ability to like lift heavy shit up.

686
00:40:49.876 --> 00:40:53.977
And if you can have a great VO2 max and you can lift some heavy weights and you're good.

687
00:40:54.057 --> 00:40:55.138
But I think that a lot of guys.

688
00:40:56.098 --> 00:40:57.858
because they just, oh, I look good enough.

689
00:40:58.118 --> 00:41:02.780
I don't have to go for a jog or I don't have to go on the stair mass or whatever.

690
00:41:03.180 --> 00:41:07.061
So this is actually very, very important, obviously, not just for your heart health, but for everything.

691
00:41:07.521 --> 00:41:23.744
And then resistance training is important because it helps with testosterone and hormonal health, especially doing large volume, large heavy weights on the largest muscle group, so your lower extremities, which sometimes male listeners tend to not focus on.

692
00:41:23.945 --> 00:41:25.985
And compound movements are also very helpful.

693
00:41:26.365 --> 00:41:31.608
Why every single interview you've ever done, you speak about pelvic floor.

694
00:41:31.848 --> 00:41:33.309
So this is where it comes in.

695
00:41:33.349 --> 00:41:34.570
It's also about strength.

696
00:41:34.870 --> 00:41:45.115
Your pelvic floor is a bowl of muscles that we need to pay attention to and men need to pay attention to as well for their sexual function and health.

697
00:41:45.715 --> 00:41:48.797
And so the pelvic floor is like this bowl of muscles that sits here.

698
00:41:49.097 --> 00:41:50.478
It's always working in the background.

699
00:41:50.618 --> 00:41:54.040
with every step you take, with every breath you take, is contracting and relaxing.

700
00:41:54.400 --> 00:41:56.802
Now, how does it work with sexual function?

701
00:41:57.222 --> 00:42:04.706
When you are having an orgasm, these muscles will rhythmically contract at a rate of 0.8 seconds.

702
00:42:04.786 --> 00:42:09.949
And so part of that intensity you feel is that rhythmic feeling from those muscles.

703
00:42:10.009 --> 00:42:14.352
And so when these muscles are functioning appropriately, you will have nice, strong orgasms.

704
00:42:14.672 --> 00:42:19.835
Your ejaculate, when it propels, part of that is the propulsion from the pelvic floor muscles pushing it out.

705
00:42:20.095 --> 00:42:25.241
And so when you want to have a more forceful ejaculate, you want to have nice, strong pelvic floor muscles.

706
00:42:25.722 --> 00:42:28.264
And so most guys don't think about them and they're fine.

707
00:42:28.284 --> 00:42:30.447
I've never heard of them until I found you.

708
00:42:30.507 --> 00:42:30.767
Yes.

709
00:42:31.488 --> 00:42:38.796
And then when you, but the real issue, and I think especially for high performers, is that you can have high tone pelvic floor.

710
00:42:39.517 --> 00:42:47.347
Just like people get TMJ and they clench their jaw, TMJ dysfunction, sorry, TMJ dysfunction, they clench their jaw and they wake up with headaches.

711
00:42:47.628 --> 00:42:51.713
And this is common in high performers because they're stressed and they grind their teeth.

712
00:42:52.414 --> 00:42:54.056
The same thing can happen with your pelvic floor.

713
00:42:54.096 --> 00:42:58.101
The pelvic floor can get tense, turned on and tight and not relax.

714
00:42:58.441 --> 00:43:01.604
And when that happens, you start having a lot of problems.

715
00:43:01.964 --> 00:43:03.065
Some of them can be sexual.

716
00:43:03.085 --> 00:43:04.086
Some of them can be not.

717
00:43:04.406 --> 00:43:09.290
So I've seen guys with urgency, frequency, going to the bathroom all the time, waking up at night.

718
00:43:09.731 --> 00:43:12.493
I see guys with constipation, really bad constipation.

719
00:43:12.813 --> 00:43:18.438
I see guys with pain with erectile erections, pain with ejaculation, scrotal pain.

720
00:43:18.918 --> 00:43:21.901
And then sometimes when it's really tight, the blood flow can't get in as well.

721
00:43:21.941 --> 00:43:23.923
So they may also have weaker erections.

722
00:43:24.603 --> 00:43:26.844
And it can affect your stamina.

723
00:43:26.924 --> 00:43:29.546
So some people will have premature ejaculation.

724
00:43:29.966 --> 00:43:34.309
And so a lot of it is in this pelvic floor and learning how to relax it.

725
00:43:34.349 --> 00:43:37.170
And so in the book, I have some exercises that can help relax it.

726
00:43:37.510 --> 00:43:45.275
But also, you know, if you really feel like this is an issue, you should go see a pelvic floor physical therapist or a urologist to get evaluated.

727
00:43:45.655 --> 00:43:54.697
Because it is really something that once your body learns that it's tight and contracted, it becomes very difficult to unlearn and you have to really work at it.

728
00:43:55.260 --> 00:44:09.211
So how would somebody know if, because again, like I've been into bodybuilding for years of my life and I've played sports most of my life and I've never heard of this muscle group ever, ever really focused on it.

729
00:44:09.651 --> 00:44:14.255
So how does somebody know sort of what state their pelvic floor is in?

730
00:44:14.275 --> 00:44:16.957
Because it seems to be very important for a whole bunch of sexual...

731
00:44:17.237 --> 00:44:18.879
One is like, are you having any of those symptoms?

732
00:44:18.919 --> 00:44:20.581
If you're not having any of those symptoms, great.

733
00:44:20.621 --> 00:44:22.042
That's a good starting point.

734
00:44:22.603 --> 00:44:25.045
Because people are like, oh, I should just do Kegels because it's good for me.

735
00:44:25.305 --> 00:44:28.509
But if you do Kegels and you have this issue, it's going to become worse.

736
00:44:28.689 --> 00:44:32.533
So say you start doing Kegels so you think everything's fine and you're like, oh, my God, something's changed.

737
00:44:32.573 --> 00:44:33.193
It's not good.

738
00:44:33.514 --> 00:44:34.394
That may be a sign.

739
00:44:34.414 --> 00:44:34.515
Yeah.

740
00:44:35.135 --> 00:44:42.638
Also, if you feel like, I mean, you can actually sort of evaluate your pelvic floor in terms of like you can put your hand underneath the scrotum.

741
00:44:42.679 --> 00:44:47.721
So in the perineum or taint area, and you can actually do like a deep breath and you should feel it move.

742
00:44:47.741 --> 00:44:51.963
You should feel like the muscle relax and contract when you take a deep breath.

743
00:44:52.123 --> 00:45:01.047
If it's not moving or it's like just like sort of flickering and like it's uncomfortable or painful, that may be a sign as well.

744
00:45:01.487 --> 00:45:10.711
But again, I think if you're ever concerned, the best thing is to get an evaluation because really the way we can feel the muscles is through like an exam, through like a rectal exam.

745
00:45:10.731 --> 00:45:14.053
That's where we can actually feel the muscles and be like, are they tense and tight?

746
00:45:14.993 --> 00:45:17.454
And so we can tell you, yes, they do feel tense and tight.

747
00:45:17.774 --> 00:45:20.495
But also you could do the exercises in my book for relaxation.

748
00:45:20.535 --> 00:45:21.416
They're super easy.

749
00:45:21.536 --> 00:45:24.537
It's like a figure four stretch or happy baby pose.

750
00:45:24.557 --> 00:45:25.537
They take a few minutes.

751
00:45:25.557 --> 00:45:27.018
Like you can just start doing them.

752
00:45:27.058 --> 00:45:28.639
And so in the book, I have like a,

753
00:45:29.579 --> 00:45:33.480
a whole plan for people who've never worked out or who want to change up their plan.

754
00:45:33.600 --> 00:45:41.182
And so in it, we have like a pelvic floor strengthening day and a pelvic floor relaxation day because it's something that you can actually incorporate into your workout.

755
00:45:41.202 --> 00:45:42.422
It doesn't take that long.

756
00:45:43.282 --> 00:45:53.044
When you're thinking about things you should go to your doctor and speak about after listening to this, you just mentioned one of them should be the pelvic floor.

757
00:45:53.604 --> 00:45:57.125
Because I'm thinking about guys who, you know,

758
00:45:58.495 --> 00:46:03.242
put off having a prostate exam or a colonoscopy because that's for like old people.

759
00:46:03.903 --> 00:46:04.684
Please don't put it off.

760
00:46:05.004 --> 00:46:05.906
But everybody does.

761
00:46:05.986 --> 00:46:07.848
Like you know people put it off for forever.

762
00:46:08.329 --> 00:46:08.549
So,

763
00:46:10.983 --> 00:46:22.029
Just to leave people with like the most important thing to talk to their doctor about, what are the other types of exams or things they should ask their doctor next time they go in?

764
00:46:22.329 --> 00:46:24.791
So pelvic floor, it's probably not going to be your GP that's going to do this either.

765
00:46:24.811 --> 00:46:25.811
They're not going to do that, yeah.

766
00:46:25.932 --> 00:46:35.357
You'll need to go to a urologist who has some expertise in pelvic floor or a pelvic floor physical therapist if you have one near you that can actually do a proper exam.

767
00:46:35.537 --> 00:46:37.078
Are there other things that they should be asking?

768
00:46:37.098 --> 00:46:37.278
Yeah.

769
00:46:37.541 --> 00:46:45.370
Yeah, so I mean, I think in terms of sexual health, you know, you don't absolutely need a... Like a prostate exam is anxiety provoking.

770
00:46:45.631 --> 00:46:47.553
So you don't always need a prostate exam.

771
00:46:47.573 --> 00:46:52.238
In fact, like I think a lot of people will be like, oh, I don't want to get my prostate cancer screening because I'm worried about...

772
00:46:53.239 --> 00:46:53.799
that exam.

773
00:46:54.179 --> 00:46:55.720
And so I'll tell you, you don't have to.

774
00:46:55.760 --> 00:47:00.101
You can just get a blood test called a PSA, which will do your screening for prostate cancer.

775
00:47:00.141 --> 00:47:02.222
And if you don't want to do the rectal exam, that's okay.

776
00:47:02.562 --> 00:47:04.543
We have other ways to look at the prostate.

777
00:47:05.363 --> 00:47:07.924
And if, you know, if that comes back as concerning.

778
00:47:08.304 --> 00:47:11.285
And so please don't delay for that reason.

779
00:47:11.305 --> 00:47:19.448
Like, honestly, exams are really important, but like less and less people are losing the skill of doing physical exams because we're just like,

780
00:47:20.048 --> 00:47:21.728
We're so telemedicine.

781
00:47:21.808 --> 00:47:26.329
It's just like there's very few physical exam doctors left.

782
00:47:26.369 --> 00:47:30.370
And so I think, I mean, they will still be trained to do physical exams.

783
00:47:30.430 --> 00:47:33.051
But it's okay if you can't get an exam.

784
00:47:33.131 --> 00:47:34.191
I would love you to.

785
00:47:34.551 --> 00:47:36.532
But also do your own exam as a guy.

786
00:47:36.692 --> 00:47:39.312
Do a testicular exam, especially if you're a young guy.

787
00:47:39.352 --> 00:47:41.733
And if you see something abnormal, please don't delay.

788
00:47:41.753 --> 00:47:41.953
Mm-hmm.

789
00:47:42.533 --> 00:47:53.180
For example, testicular cancer is really treatable and it's really like it can be very easily treated and you can live a long, healthy life, even if you were unfortunate enough to get testicular cancer.

790
00:47:53.200 --> 00:47:55.722
But if you delay, it becomes more difficult.

791
00:47:55.862 --> 00:48:01.086
And so I would just say that, like, whenever you see something abnormal, you know.

792
00:48:01.706 --> 00:48:05.948
like especially for you high performers listening who will like put it off because you've got work.

793
00:48:06.308 --> 00:48:08.009
Like just don't delay.

794
00:48:08.149 --> 00:48:15.652
Take the little bit of time to get the evaluation because otherwise if it is something real, you're going to be taken off a lot longer.

795
00:48:16.072 --> 00:48:18.093
What do we know about prostate?

796
00:48:18.433 --> 00:48:25.456
What should this audience know about for people that are trying to figure out, okay, is my prostate in good health?

797
00:48:25.516 --> 00:48:25.916
Is it not?

798
00:48:27.697 --> 00:48:28.397
What's your advice?

799
00:48:28.950 --> 00:48:29.110
Yes.

800
00:48:29.170 --> 00:48:32.974
So one is, you know, get screened for prostate cancer at an age-appropriate time.

801
00:48:33.234 --> 00:48:38.019
So in terms of prostate cancer screening, 55 unless you have risk factors.

802
00:48:38.039 --> 00:48:50.250
So risk factors are you're African-American, you have family history, like a first-degree relative father or brother, you have a BRCA1, BRCA2, some genetic mutation that puts you at a higher risk.

803
00:48:50.290 --> 00:48:51.371
Those people want to start at 45.

804
00:48:52.312 --> 00:48:53.012
You want to get one.

805
00:48:53.293 --> 00:49:02.037
And there is some, so there's different guidelines, but there's some guidelines that would say getting one at baseline, like in your 40s, at any point, just to have a baseline is a good idea.

806
00:49:02.077 --> 00:49:07.759
Because PSA is emitted by your prostate, and it can be more if you have an enlarged prostate.

807
00:49:07.779 --> 00:49:09.060
And so it's nice to have a baseline.

808
00:49:09.960 --> 00:49:16.243
And so then you get it every two years if it's within normal and sometimes every year depending on what your results are.

809
00:49:16.663 --> 00:49:21.025
And so that's important because it screens for prostate cancer and prostate cancer is very common.

810
00:49:21.125 --> 00:49:23.526
One in eight guys will get prostate cancer in their lifetime.

811
00:49:23.606 --> 00:49:24.147
One in eight?

812
00:49:24.707 --> 00:49:24.987
Mm-hmm.

813
00:49:25.518 --> 00:49:26.599
Oh, I didn't realize it was that.

814
00:49:26.739 --> 00:49:27.379
It's really high.

815
00:49:27.419 --> 00:49:27.859
That high.

816
00:49:27.999 --> 00:49:28.340
Yeah.

817
00:49:29.320 --> 00:49:30.141
And so that's important.

818
00:49:30.681 --> 00:49:36.844
Now, in terms of the other big issue that men face is an enlarged prostate.

819
00:49:37.324 --> 00:49:43.688
And so if you look at 80-year-olds and you did autopsy studies, 80% of guys have an enlarged prostate.

820
00:49:44.028 --> 00:49:47.253
So it is very, very common to have an enlarged prostate.

821
00:49:47.293 --> 00:49:53.021
Now, not everyone has symptoms, but the symptoms to look out for are you have more trouble emptying your bladder.

822
00:49:53.061 --> 00:49:54.202
You might be straining.

823
00:49:54.222 --> 00:49:55.624
Your stream might be weaker.

824
00:49:56.025 --> 00:50:00.571
You might have to wait for your stream to start or it'll stop and start throughout the week.

825
00:50:01.692 --> 00:50:02.733
So that's one sign.

826
00:50:02.793 --> 00:50:07.137
Another sign could be that you're going very often, very frequently, very urgently.

827
00:50:07.397 --> 00:50:10.200
You're waking up a lot at night to urinate.

828
00:50:10.360 --> 00:50:13.783
And so those are issues that you're having in large prostate.

829
00:50:13.803 --> 00:50:18.547
Now, these sound like maybe not a big deal, but they are actually huge impacts on quality of life.

830
00:50:19.267 --> 00:50:22.468
And when you're a high performer, you don't want to be looking for a bathroom everywhere.

831
00:50:22.508 --> 00:50:24.249
Like you want to be focused on what you're doing.

832
00:50:24.609 --> 00:50:28.990
And so I would say that this is another thing that I find that people wait a long time to get help with.

833
00:50:29.270 --> 00:50:31.231
Now, there are lifestyle things you can do.

834
00:50:31.571 --> 00:50:37.293
So even just walking two hours a week has been shown to be potentially beneficial for prostate health.

835
00:50:37.573 --> 00:50:42.855
And a lot of the things like we've talked about already, like vegetables actually have been shown to be beneficial for prostate health.

836
00:50:43.135 --> 00:50:46.137
So like there are certain things that are potentially beneficial.

837
00:50:46.197 --> 00:50:47.759
Now, some of it's out of your control.

838
00:50:48.099 --> 00:50:50.741
Like it is a genetic, there's a genetic component to it.

839
00:50:50.761 --> 00:50:58.026
So if you know that your dad had symptoms like that when he was younger, you may get them younger, like even in your 40s sometimes.

840
00:50:59.227 --> 00:51:02.510
And so the thing to know is, yes, there are lifestyle things.

841
00:51:02.570 --> 00:51:04.071
There are medications that can help.

842
00:51:04.111 --> 00:51:14.139
In fact, the medication that we talked about earlier, Cialis, Tadalafil, you can take daily and will also help relax the prostate muscles so that you can – the muscles around the prostate so you can pee better.

843
00:51:14.199 --> 00:51:15.360
And so that may be an option.

844
00:51:15.420 --> 00:51:18.442
And really what I want people to take away is, one, you don't have to suffer.

845
00:51:18.943 --> 00:51:23.707
And two, you do want to treat it because it can be transformative for your life.

846
00:51:23.987 --> 00:51:25.768
And so what I would say to people is just take –

847
00:51:26.849 --> 00:51:33.861
Go ahead, talk to your urologist, even your primary care doctor, and get help with it because it may help you.

848
00:51:34.282 --> 00:51:37.587
And it may help you just live a better quality of life.

849
00:51:37.647 --> 00:51:39.270
The last piece of this is environment.

850
00:51:39.971 --> 00:51:40.993
So what does environment mean?

851
00:51:41.294 --> 00:51:43.235
So environment encompasses a lot of different things.

852
00:51:43.335 --> 00:51:49.698
People automatically think environment means, oh, I need to avoid endocrine disrupting chemicals, which you should try your best to do.

853
00:51:49.998 --> 00:51:51.458
But they are really ubiquitous.

854
00:51:51.498 --> 00:51:54.320
We are exposed to endocrine disrupting chemicals all the time.

855
00:51:54.680 --> 00:52:03.684
And so it's trying to do your best in terms of avoiding plastics in the environment, not heating up food on plastics, try to drink out of glass and metal rather than plastic.

856
00:52:03.724 --> 00:52:07.085
Those sorts of things are easy to do and can be done.

857
00:52:07.105 --> 00:52:11.087
And then there are, you know, we just don't know yet, like, what are the big things that

858
00:52:11.547 --> 00:52:19.531
Ideally, trying to dust regularly to avoid, you know, build up in the environment, things like that, that really do play a role that you can do easily.

859
00:52:20.031 --> 00:52:23.653
But I don't want people to get down this rabbit hole where they're like, oh, my God, what?

860
00:52:23.753 --> 00:52:25.254
Like, I can't do anything, right?

861
00:52:25.294 --> 00:52:26.875
Because it's literally everywhere.

862
00:52:28.155 --> 00:52:35.076
But we also talk about environment in terms of stress, which we've talked about, sleep, which is so important.

863
00:52:35.377 --> 00:52:38.417
And this is for our high performers because they don't sleep always.

864
00:52:38.817 --> 00:52:50.979
And so I will give you this data is that when they look at guys who sleep seven hours or more a night and they take those same guys and they have them sleep five hours or less a night, their testosterone drops by 15% just from sleep.

865
00:52:50.999 --> 00:52:52.780
That's a huge amount.

866
00:52:53.920 --> 00:52:56.321
So we need to be prioritizing sleep.

867
00:52:56.401 --> 00:53:02.743
You have to wind down, get away from your computer for that last hour before bed, and you need to prioritize it.

868
00:53:02.763 --> 00:53:03.763
Like this is important.

869
00:53:03.783 --> 00:53:08.505
You want to be a high performer not just today but well into the future, so prioritize sleep.

870
00:53:08.805 --> 00:53:10.686
What else does lack of sleep do to you?

871
00:53:11.427 --> 00:53:17.370
So lack of sleep is, one, you can think that when you have lack of sleep, you are cranky, right?

872
00:53:17.430 --> 00:53:21.092
And so that's going to affect your performance.

873
00:53:21.152 --> 00:53:24.454
And we know that there's so much data on how sleep affects performance the next day.

874
00:53:24.474 --> 00:53:30.296
So if you want to nail your meeting the next day or whatever it is you got, what you're working on, you need to get that sleep in.

875
00:53:30.677 --> 00:53:35.479
So there, it also affects, like we said, testosterone production.

876
00:53:35.959 --> 00:53:37.000
It affects...

877
00:53:37.340 --> 00:53:43.722
you know, if you are sleep deprived, you now have sort of less in reserve for everything else, right?

878
00:53:43.742 --> 00:53:49.765
Because during sleep, you're like, there's so much like cleansing of your body that happens, so to speak.

879
00:53:50.105 --> 00:53:51.425
And so you just have less reserve.

880
00:53:51.445 --> 00:53:56.387
Like you will eat poorly because you've slept less and your cravings will be stronger.

881
00:53:56.407 --> 00:54:00.469
And so there's a lot of factors that go in with good sleep.

882
00:54:00.829 --> 00:54:03.630
And we know like there's links with less sleep and dementia.

883
00:54:03.950 --> 00:54:06.631
The other thing about sleep I will add is if you are snoring,

884
00:54:07.211 --> 00:54:09.353
it may be a sign that you have sleep apnea.

885
00:54:09.893 --> 00:54:14.077
And sleep apnea is a condition where you basically stop breathing for short periods of time.

886
00:54:14.097 --> 00:54:18.560
And it's often because of large neck muscles that are compressing on your airway.

887
00:54:18.580 --> 00:54:23.184
But some people can have, because of brain issues, they can have this too, called central sleep apnea.

888
00:54:23.644 --> 00:54:26.727
And so when this happens, this is a huge...

889
00:54:27.347 --> 00:54:27.947
health issue.

890
00:54:28.247 --> 00:54:29.828
One, it affects erection quality.

891
00:54:29.868 --> 00:54:32.629
We know that guys who have sleep apnea have worse erections.

892
00:54:32.969 --> 00:54:40.231
We know that guys who have sleep apnea, once it's treated, their testosterone increases by like 200 nanograms per deciliter.

893
00:54:40.611 --> 00:54:53.155
It's a small study, but it's impressive because, again, sleep is so important that when you treat that issue, you are not only getting better sleep and feeling better, but you are improving your testosterone.

894
00:54:53.975 --> 00:54:57.196
And you're improving your brain health because now your brain's getting oxygen throughout the night.

895
00:54:57.236 --> 00:54:58.956
And, you know, we want to protect our brains.

896
00:54:59.256 --> 00:55:00.656
So those are really important things.

897
00:55:01.256 --> 00:55:06.117
So that's a really important diagnosis that is underdiagnosed.

898
00:55:06.577 --> 00:55:09.578
And a lot of guys will maybe not even really notice it.

899
00:55:10.078 --> 00:55:12.978
But most guys, if you're a male, like you're already at risk.

900
00:55:13.058 --> 00:55:22.020
And then you add, like, if you have an exocupference of, I believe it's like 17 inches or 16 and a half inches, larger than that, you're also at risk for sleep apnea.

901
00:55:22.140 --> 00:55:49.739
bigger guys or even muscular guys especially and so it's really important to get that tested and now you can do it at home you can literally get an at-home sleep test done you know you can go to telemedicine company you can see a sleep doctor they'll send you your sleep medicine your sleep test at home and get it done you can even just buy the sleep test and just do that you don't have to see the doctor but you know that way you get the answer right do i have sleep apnea and yes people are like i don't want to try this sleep machine but there are other options but

902
00:55:50.199 --> 00:55:51.221
Really, they make a difference.

903
00:55:51.241 --> 00:55:55.629
Like people sleep so much better once they get that treated.

904
00:55:55.690 --> 00:55:59.417
And then the next day, your cognitive performance, I'm assuming, increases.

905
00:55:59.597 --> 00:56:00.118
So much.

906
00:56:00.158 --> 00:56:01.641
Like so much better.

907
00:56:02.097 --> 00:56:13.104
You know, the issue that I keep thinking about is what happens with, again, like I'm just going to use myself as a case study, especially for lack of sleep.

908
00:56:14.265 --> 00:56:14.825
Don't get sleep.

909
00:56:15.165 --> 00:56:16.726
And then the next day I'm tired.

910
00:56:17.026 --> 00:56:24.171
So I'll find like a nootropic or a peptide or way too much caffeine and just try and self-medicate that way.

911
00:56:24.191 --> 00:56:24.951
And I'll be like, you know what?

912
00:56:25.352 --> 00:56:26.853
I'll figure out my sleep eventually.

913
00:56:26.873 --> 00:56:27.233
Yeah.

914
00:56:27.393 --> 00:56:35.723
But then like the next day happens and then you just end up doing the same thing again and again because you can medicate in the short term.

915
00:56:35.943 --> 00:56:36.684
It's a problem.

916
00:56:36.724 --> 00:56:38.366
And like I said, it's because we can.

917
00:56:38.466 --> 00:56:40.629
It's because we can function on little sleep.

918
00:56:41.110 --> 00:56:42.311
And so we just do.

919
00:56:42.892 --> 00:56:45.355
And then you just like you just keep going.

920
00:56:45.655 --> 00:56:50.318
But again, if you don't make the intention now, you will suffer later, right?

921
00:56:50.338 --> 00:56:51.959
Like it will catch up to you.

922
00:56:52.040 --> 00:56:53.320
You are not superhuman.

923
00:56:53.501 --> 00:56:57.904
Everyone here who's listening, if you don't prioritize sleep, it will catch up to you.

924
00:56:57.924 --> 00:57:01.466
And as someone who's been working on it recently, I will say it's transformative.

925
00:57:01.766 --> 00:57:02.447
It is so good.

926
00:57:02.987 --> 00:57:03.988
Sleep is so beautiful.

927
00:57:04.288 --> 00:57:15.731
I used to try and do like five, six hours, and lately also, like eight hours, go to bed early, and there's not a single Red Bull in the world that's gonna make you feel like a- I know.

928
00:57:16.012 --> 00:57:20.653
And I will say sometimes these trackers are actually helpful, especially for people who really like to look at data.

929
00:57:20.873 --> 00:57:43.954
the aura or like yeah or whoop and like like just knowing one having a number of how you slept but then getting a score and we're we we gotta we gotta get a's right so like it does help for for those of us who are way too competitive in that way um but but don't get obsessed with it but like it is nice to be like okay like i and then to see like yeah i did perform better today because i got a 92 percent or whatever it is you know

930
00:57:44.234 --> 00:57:47.756
Every company has that one process only one person knows.

931
00:57:48.196 --> 00:57:52.758
Someone new joins, asks that person, gets walked through it, none of it's written down.

932
00:57:53.038 --> 00:57:55.820
Then that person's out for a week and nobody knows what to do.

933
00:57:56.100 --> 00:57:57.820
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934
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935
00:58:04.884 --> 00:58:11.387
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936
00:58:11.747 --> 00:58:16.208
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937
00:58:16.529 --> 00:58:20.890
Admins enforce that across the team, and nothing gets published until a person reviews it.

938
00:58:21.210 --> 00:58:27.292
GuideMe gives people real-time guidance inside the actual tool they're using, shows them exactly where to click.

939
00:58:27.592 --> 00:58:34.114
And for AI agents, Scribe gives them real context for how your company does things, not generic knowledge off the internet.

940
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941
00:58:36.295 --> 00:58:38.757
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942
00:58:39.118 --> 00:58:41.960
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943
00:58:42.260 --> 00:58:49.926
Learn more at scribe.how slash success and mention success for your first month of Scribe Capture free on Select Plans.

944
00:58:50.246 --> 00:58:54.870
That's S-C-R-I-B-E dot how slash success.

945
00:58:55.450 --> 00:58:57.411
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946
00:58:57.792 --> 00:59:03.615
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947
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948
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949
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950
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951
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952
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953
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954
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955
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956
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957
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958
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959
00:59:53.039 --> 00:59:57.222
Also, how do you tell if you're stressed if that just becomes your life?

960
00:59:57.982 --> 00:59:59.123
That's what I've thought about a lot.

961
00:59:59.444 --> 01:00:01.125
I've been thinking about this a lot myself.

962
01:00:01.765 --> 01:00:03.926
And I think, you know, it is really tough.

963
01:00:03.966 --> 01:00:20.795
But if you realize that you haven't stopped, like you literally haven't taken a moment to yourself to do anything that is restorative, which means like you are literally constantly sending emails or when you do have downtime, you're scrolling the internet or having a glass of wine.

964
01:00:21.115 --> 01:00:22.956
That's how you think you're de-stressing.

965
01:00:23.316 --> 01:00:25.717
You're actually never dealing with the root cause.

966
01:00:25.777 --> 01:00:26.837
cause of your stress.

967
01:00:26.877 --> 01:00:29.358
You're not actually doing anything to decline stress.

968
01:00:29.759 --> 01:00:31.719
Sex actually decreases stress.

969
01:00:31.779 --> 01:00:39.722
Being intimate with another human being, there's data on this where like doing a prolonged intimate contact with a partner.

970
01:00:39.762 --> 01:00:48.466
So the Gottmans popularized the six second kiss and the 20 second hug where you, you know, you sort of like, you stand on your own

971
01:00:49.026 --> 01:00:52.850
You stand on your own two feet and your partner stand on their own ground and you hug for 20 seconds.

972
01:00:53.290 --> 01:00:59.136
And it feels like you're like, oh, this is sort of weird because we're not like there's nothing's happening.

973
01:00:59.156 --> 01:01:00.597
But it actually makes a huge difference.

974
01:01:00.617 --> 01:01:03.901
Like try it and you will actually feel significantly better.

975
01:01:04.361 --> 01:01:09.022
Like just after 20 seconds or like a six second kiss where there's no intention to like go make out.

976
01:01:09.042 --> 01:01:10.203
You're literally just kissing.

977
01:01:10.703 --> 01:01:13.104
It just tells your brain like you're in a safe space.

978
01:01:13.464 --> 01:01:14.204
You're okay.

979
01:01:14.544 --> 01:01:20.006
And so I think doing those small things can be really tangible for someone who's a high performer.

980
01:01:20.026 --> 01:01:21.186
Like I can do that.

981
01:01:21.326 --> 01:01:22.867
I can take a deep breath.

982
01:01:22.967 --> 01:01:26.188
I can like listen to music and dance around my office for a few minutes.

983
01:01:26.388 --> 01:01:27.088
Whatever it is.

984
01:01:27.128 --> 01:01:30.629
But these sort of things, they're just telling your brain that you're in a safe space.

985
01:01:30.649 --> 01:01:31.709
That you can take a deep breath.

986
01:01:31.729 --> 01:01:33.270
You don't need to run away from the tiger.

987
01:01:34.010 --> 01:01:36.992
If you constantly feel like you've got to go, go, go.

988
01:01:37.492 --> 01:01:39.213
And you know, like, I think people know this.

989
01:01:39.253 --> 01:01:41.934
You know, like, I can't fall asleep because I'm thinking about all the things I have to do.

990
01:01:42.375 --> 01:01:44.756
I am like, I wake up thinking about what I got to do.

991
01:01:44.776 --> 01:01:45.856
I wake up checking my email.

992
01:01:46.157 --> 01:01:48.698
Whatever it is, you know, like, everyone knows.

993
01:01:48.898 --> 01:01:50.619
Like, they may say they don't know, but they know.

994
01:01:50.799 --> 01:01:52.700
Like, you know, because you can't turn it off.

995
01:01:53.220 --> 01:01:54.981
And so you need to be able to be intentional.

996
01:01:55.001 --> 01:02:00.184
And it'll help you sleep better if you can learn how to turn it off and get yourself in that calm state.

997
01:02:00.364 --> 01:02:01.865
That's what Seth's stressed about this.

998
01:02:02.025 --> 01:02:02.185
Yeah.

999
01:02:02.965 --> 01:02:11.791
But I have because my my life is so chaotic sometimes that it doesn't like it doesn't present itself as stress.

1000
01:02:11.811 --> 01:02:17.914
I don't feel stressed about working from like, you know, seven in the morning till two.

1001
01:02:18.915 --> 01:02:21.297
at night and definitely not afternoon, two in the morning.

1002
01:02:21.757 --> 01:02:25.641
I don't feel stressed, but I know that it's like just always on, can't be healthy.

1003
01:02:25.861 --> 01:02:27.562
And then you wonder about like the long-term side effects.

1004
01:02:27.582 --> 01:02:28.903
Your body will show you too.

1005
01:02:29.084 --> 01:02:33.227
Like that's why pelvic floor dysfunction is something that your body does on its own.

1006
01:02:33.387 --> 01:02:35.429
People clench their jaw, they get jaw.

1007
01:02:35.649 --> 01:02:37.310
Like your body will start showing you.

1008
01:02:37.491 --> 01:02:39.252
And then, and finally it catches up with you.

1009
01:02:39.332 --> 01:02:40.413
And that, and you know,

1010
01:02:42.095 --> 01:02:47.196
I think for the average person, it turns into like a really bad cold when your body forces you to shut down.

1011
01:02:47.596 --> 01:02:49.476
And so that's the other part of it.

1012
01:02:49.516 --> 01:02:51.177
And then also the company you keep.

1013
01:02:51.237 --> 01:02:56.678
So really being around people who hold the same values as you when it comes to sexual health.

1014
01:02:56.718 --> 01:03:01.718
Like if you're around a bunch of couples where they've like just resigned themselves to like sex is not a big deal.

1015
01:03:01.798 --> 01:03:04.839
Like you're going to probably fall into that same category.

1016
01:03:05.659 --> 01:03:11.040
And so you want to be in a place where people value their partners and they value that romantic connection with them.

1017
01:03:11.780 --> 01:03:15.223
And that they're like, you know, that they're all they're open to that.

1018
01:03:15.323 --> 01:03:20.367
And because good sex with a relationship, which is actually part of confidence, takes work.

1019
01:03:20.927 --> 01:03:22.368
And we can talk a little bit about that.

1020
01:03:22.388 --> 01:03:28.112
But the last part of environment, which is what a lot of guys are concerned about and find out is your sexual environment.

1021
01:03:28.493 --> 01:03:31.455
So masturbation and pornography and how that plays a role.

1022
01:03:31.995 --> 01:03:37.702
And what I want people to really take away is that those things are fine to use for the large majority of people.

1023
01:03:37.722 --> 01:03:40.485
They masturbate, they use pornography, and they have no issues.

1024
01:03:40.806 --> 01:03:50.637
There are a small subset of people who have issues with these, and so I talk about that in the book, so they can self-identify and potentially course-correct if they find themselves in that area.

1025
01:03:51.078 --> 01:03:51.758
I'm curious.

1026
01:03:52.319 --> 01:04:03.363
Does somebody who has an obsessive personality, who puts everything towards work, do they have a higher likelihood of being obsessed with these other sort of hedonistic?

1027
01:04:03.583 --> 01:04:05.664
I think it really comes down to a few things.

1028
01:04:05.704 --> 01:04:08.585
So one is, what is their baseline view on these things?

1029
01:04:08.625 --> 01:04:16.348
So sometimes when people feel like this is bad, like this is a sinful thing or this is a bad thing, then they are actually more likely to have problems with it.

1030
01:04:16.408 --> 01:04:17.048
Because if...

1031
01:04:17.148 --> 01:04:24.555
invariably they'll come across it, they'll use it, then they'll feel such immense guilt around that, that then they really need to not feel guilt.

1032
01:04:24.595 --> 01:04:28.979
So then they might go back to use it again, because it gives them that initial, like hit of feeling pleasure.

1033
01:04:29.340 --> 01:04:31.241
And then they sort of get into this vicious cycle.

1034
01:04:31.261 --> 01:04:34.104
So that's one type of person that tends to have problems.

1035
01:04:34.725 --> 01:04:38.848
And the other type of person is when they start using it to cope with negative feelings.

1036
01:04:38.969 --> 01:04:40.830
So they are doing it because they

1037
01:04:42.071 --> 01:04:43.333
They're trying to not feel bad.

1038
01:04:43.353 --> 01:04:44.534
They're trying to not feel sad.

1039
01:04:44.594 --> 01:04:47.776
They're trying to avoid maybe boredom.

1040
01:04:47.796 --> 01:04:49.758
They're just using it for not purposes of pleasure.

1041
01:04:50.138 --> 01:04:55.403
And so then that becomes like they're self-medicating in a different way instead of dealing with the issue.

1042
01:04:55.543 --> 01:04:56.243
Stress release.

1043
01:04:56.384 --> 01:04:56.764
Correct.

1044
01:04:57.104 --> 01:04:58.966
And so this is how they're now self-medicating.

1045
01:04:59.246 --> 01:05:02.609
And so that's another kind of person that we can see where it becomes problematic.

1046
01:05:02.629 --> 01:05:02.729
Yeah.

1047
01:05:02.849 --> 01:05:10.400
So in that case, I guess, how do you know if you have a problem with, I guess, what is it?

1048
01:05:10.701 --> 01:05:12.423
Watching pornography, masturbation.

1049
01:05:12.443 --> 01:05:14.426
How do you know if you have this problem?

1050
01:05:14.546 --> 01:05:17.310
But also, how does that impact your sex life with your partner?

1051
01:05:17.731 --> 01:05:24.953
So the people who have problems is like they can't, they would rather watch porn or masturbate than be with their partner.

1052
01:05:25.013 --> 01:05:26.174
They would rather do that.

1053
01:05:26.434 --> 01:05:28.314
And they start saying like, oh, I'm doing that so they're going to work.

1054
01:05:28.534 --> 01:05:32.876
So often it's not like the high, high performers because they're like, well, I need to go to work.

1055
01:05:34.576 --> 01:05:38.257
But like that's when you're like, okay, this is, they're starting to have relationship conflict.

1056
01:05:38.397 --> 01:05:40.177
It's starting to really invade in their life.

1057
01:05:40.697 --> 01:05:48.139
Now, the other time it becomes a problem is when they're noticing that like they're having struggles with their partner when they're with them intimately.

1058
01:05:48.259 --> 01:05:50.000
And there's a couple of reasons that can happen.

1059
01:05:50.540 --> 01:05:55.581
One is they've now become accustomed to this one way or one stimuli.

1060
01:05:55.921 --> 01:06:02.944
So they're either accustomed to masturbating a certain way, which they can't replicate with a vagina, a mouth, an anus.

1061
01:06:03.144 --> 01:06:04.044
They just can't, right?

1062
01:06:04.064 --> 01:06:07.526
Like it's either very firm grip or they're doing it against a hard surface.

1063
01:06:07.886 --> 01:06:10.087
And now they can't do that with their partner.

1064
01:06:10.147 --> 01:06:13.528
And so they can't climax or they can't get there, right?

1065
01:06:13.548 --> 01:06:15.189
And so they're just like frustrated.

1066
01:06:15.569 --> 01:06:20.611
The other type of person is like, I watch the same type of pornography every single time.

1067
01:06:20.711 --> 01:06:22.172
And this is what gets me aroused.

1068
01:06:22.612 --> 01:06:24.913
And nothing else can really come close to that.

1069
01:06:25.313 --> 01:06:30.255
And so they just have a hard time mentally getting aroused because that's what they've gotten used to.

1070
01:06:30.455 --> 01:06:33.737
And so then they have to break the pattern and be like, OK, we have to try different things.

1071
01:06:33.757 --> 01:06:36.418
We have to take a break from that specific type of stimuli.

1072
01:06:36.658 --> 01:06:45.042
We have to masturbate in a different way and sort of relearn that we can be aroused and turned on and climax to multiple different things.

1073
01:06:45.382 --> 01:06:53.126
I think also I'm just thinking of like issues with long term relationships is people love newness and pornography creates newness.

1074
01:06:53.146 --> 01:07:02.010
So it creates an escape is a wrong word, but it really is like an accurate word, an escape from the the sameness, the routine.

1075
01:07:02.511 --> 01:07:05.432
Well, so that's what actually confidence, we didn't talk about it so much.

1076
01:07:05.512 --> 01:07:06.933
Actually not about- We can go back into confidence, yeah.

1077
01:07:06.973 --> 01:07:09.293
It's not actually about yourself being confident.

1078
01:07:09.553 --> 01:07:13.515
It's about understanding what's required to please your partner.

1079
01:07:13.555 --> 01:07:15.095
And novelty is one of those things.

1080
01:07:15.155 --> 01:07:18.576
So novelty and to maintain pleasure in a relationship.

1081
01:07:18.637 --> 01:07:23.358
And so when you're with a long-term partner, often we fall into routines.

1082
01:07:23.378 --> 01:07:24.639
We're like, this works for us.

1083
01:07:25.179 --> 01:07:26.259
We both have orgasms.

1084
01:07:26.299 --> 01:07:26.919
We feel great.

1085
01:07:26.959 --> 01:07:28.380
This is always the way you do it.

1086
01:07:29.040 --> 01:07:32.722
But if you eat chicken and broccoli every day, at some point, you're going to get really bored.

1087
01:07:32.882 --> 01:07:34.403
And so it's the same thing with sex.

1088
01:07:34.423 --> 01:07:36.305
You need to have a little bit of novelty.

1089
01:07:36.745 --> 01:07:37.886
And then people are like, oh, my God, what?

1090
01:07:37.906 --> 01:07:41.448
I have to go buy whips and chains and like do something crazy.

1091
01:07:41.768 --> 01:07:43.709
No, it can be so minor.

1092
01:07:43.809 --> 01:07:45.490
It can be doing it in a different room.

1093
01:07:45.530 --> 01:07:51.514
It can be literally like instead of having your body facing this way on the bed, it can be facing horizontal.

1094
01:07:51.574 --> 01:07:52.275
Like just.

1095
01:07:52.295 --> 01:07:52.635
Really?

1096
01:07:52.735 --> 01:07:54.276
I was going to say, like, go on vacation.

1097
01:07:54.296 --> 01:07:55.897
Like vacation sex is always the best.

1098
01:07:55.917 --> 01:07:56.017
Yeah.

1099
01:07:56.297 --> 01:08:02.840
And that's actually a great barometer of like, is this, is, is, is the issues in my sex life stress related?

1100
01:08:02.860 --> 01:08:08.303
Because when you're on vacation, if everything's great, okay, you know that like there's a stress component, right?

1101
01:08:08.323 --> 01:08:10.244
Because vacation is like, there's no stress.

1102
01:08:10.264 --> 01:08:11.445
You have, you have planned.

1103
01:08:11.465 --> 01:08:12.745
You're like, I know I'm going on vacation.

1104
01:08:12.765 --> 01:08:13.606
Everything's got to be done.

1105
01:08:13.646 --> 01:08:14.206
Don't call me.

1106
01:08:14.546 --> 01:08:14.726
Right.

1107
01:08:14.746 --> 01:08:17.488
You know, you know, like I'm going away and I don't need to work.

1108
01:08:17.888 --> 01:08:20.149
And so that is like the ultimate test.

1109
01:08:20.469 --> 01:08:24.471
How many people truly have healthy sex lives with their partner?

1110
01:08:24.890 --> 01:08:25.470
Oh my gosh.

1111
01:08:26.391 --> 01:08:28.411
I don't know the number, but I'm certain it's quite low.

1112
01:08:29.232 --> 01:08:29.532
Really?

1113
01:08:29.792 --> 01:08:30.072
Yeah.

1114
01:08:30.812 --> 01:08:32.293
I mean, I don't know.

1115
01:08:32.393 --> 01:08:37.414
I'm biased because I see people who don't have healthy sex lives for a living.

1116
01:08:40.055 --> 01:08:53.080
But I think a lot of people, and this is of course observational, I think a lot of people will put sex on the back burner for some point in their life and never get back to it.

1117
01:08:53.780 --> 01:08:55.281
It'll never be the way it was.

1118
01:08:55.902 --> 01:09:03.107
And not that it has to be the way it was, but they will just accept that, like, it is what it is.

1119
01:09:03.587 --> 01:09:05.289
And I hear about it a lot.

1120
01:09:05.389 --> 01:09:08.351
I obviously see patients come in and tell me about that.

1121
01:09:09.392 --> 01:09:16.417
But, like, when I have people who are committed to maintaining their sex life and are willing to do the work,

1122
01:09:17.677 --> 01:09:19.318
Because it's work.

1123
01:09:19.398 --> 01:09:20.098
That's the reality.

1124
01:09:20.318 --> 01:09:24.579
You want to have a long, vibrant sex life with your partner, you have to work at it.

1125
01:09:24.859 --> 01:09:26.419
And people don't want to work at sex.

1126
01:09:26.459 --> 01:09:27.859
They want it to be natural.

1127
01:09:27.899 --> 01:09:30.860
They want it to be something that is spontaneous all the time.

1128
01:09:31.280 --> 01:09:34.521
And the reality is that's just not going to work.

1129
01:09:35.021 --> 01:09:41.362
We need to have sex be a part of the mainstream conversation.

1130
01:09:42.062 --> 01:09:49.772
And be allowed to prioritize sex without feeling like it's something dirty or something that we have to hush about behind closed doors.

1131
01:09:50.233 --> 01:09:57.036
And I think there's something about being vulnerable and intimate with another human being that is valuable for overall health.

1132
01:09:57.516 --> 01:10:00.397
Like loneliness is a real problem.

1133
01:10:01.057 --> 01:10:11.701
And being sexually intimate with someone allows you to feel like connected and bonded with someone in a way that you can't get in any other way.

1134
01:10:12.321 --> 01:10:12.521
Right.

1135
01:10:12.581 --> 01:10:14.642
And so it makes you feel like you belong.

1136
01:10:15.403 --> 01:10:19.104
And that's a really valuable part of life that people are missing out on.

1137
01:10:19.722 --> 01:10:23.688
So when you speak about confidence, explain, just go a level deeper.

1138
01:10:23.708 --> 01:10:24.288
What does that mean?

1139
01:10:24.349 --> 01:10:26.151
You said confidence in what your partner needs?

1140
01:10:26.732 --> 01:10:34.202
Confidence in that you know that you have the knowledge necessary to provide pleasure to your partner.

1141
01:10:34.483 --> 01:10:36.625
The knowledge necessary to provide pleasure to your partner.

1142
01:10:36.686 --> 01:10:36.906
Okay.

1143
01:10:37.403 --> 01:10:45.965
So that would mean understanding their anatomy, understanding how to communicate with your partner, because we don't know how to talk about sex.

1144
01:10:46.005 --> 01:10:47.485
No one taught us, right?

1145
01:10:47.505 --> 01:10:49.246
And it's very uncomfortable.

1146
01:10:49.586 --> 01:10:53.066
I've been on so many interviews where people are like, well, what do I do?

1147
01:10:53.446 --> 01:10:54.107
How do I know?

1148
01:10:54.187 --> 01:10:56.707
And I was like, you ask, you talk.

1149
01:10:57.207 --> 01:10:59.508
And they look at me like I can just see it in their eyes.

1150
01:10:59.528 --> 01:11:00.168
They're like, really?

1151
01:11:00.208 --> 01:11:00.728
I have to?

1152
01:11:02.124 --> 01:11:03.805
And I was like, you have to.

1153
01:11:04.725 --> 01:11:05.585
Talking is sexy.

1154
01:11:05.606 --> 01:11:06.706
You have to talk about it.

1155
01:11:07.206 --> 01:11:09.807
But it's uncomfortable because we just don't know how to.

1156
01:11:10.347 --> 01:11:14.709
And so talking about it, understanding that there is more than just genitals.

1157
01:11:14.729 --> 01:11:17.831
There's a whole body of erogenous zones that you can stimulate.

1158
01:11:17.871 --> 01:11:23.473
And there's actually a certain frequency to how you caress them that stimulates pleasure centers in the brain that really...

1159
01:11:23.833 --> 01:11:29.094
like can be helpful and can help make sex from good to great, right?

1160
01:11:29.114 --> 01:11:35.216
When you incorporate these things and like how do certain positions help stimulate your female partner better?

1161
01:11:35.296 --> 01:11:44.278
And so there's a whole host of things in that chapter that's really on just understanding what gives pleasure and how to incorporate that in your relationship.

1162
01:11:44.298 --> 01:11:49.799
I don't think anybody really, like it's just, there's no school for this.

1163
01:11:49.859 --> 01:11:51.059
This is the school for it.

1164
01:11:51.139 --> 01:11:51.339
Yeah.

1165
01:11:51.620 --> 01:11:53.600
And I think that people just try and navigate it themselves.

1166
01:11:54.180 --> 01:11:57.381
And there is some like intuition, like, oh, this feels good.

1167
01:11:57.401 --> 01:11:58.521
Let me do more of it.

1168
01:11:58.861 --> 01:12:04.283
But the challenge is that we don't even know, like, we feel like sex has to be so serious.

1169
01:12:04.883 --> 01:12:08.424
And like, it has to, we have to get to the orgasm and it has to work this way.

1170
01:12:08.684 --> 01:12:13.385
And it's like, why don't we just have fun, explore, luxuriate in the experience, give it time.

1171
01:12:13.826 --> 01:12:19.747
Like, give it the time it deserves, you know, and enjoy each other because it's supposed to be playful.

1172
01:12:20.147 --> 01:12:21.848
Like, as adults, when do we play?

1173
01:12:22.668 --> 01:12:23.228
We don't.

1174
01:12:23.509 --> 01:12:25.450
Sex is supposed to be our playground.

1175
01:12:25.610 --> 01:12:25.850
Yeah.

1176
01:12:26.170 --> 01:12:27.411
But no one uses it like that.

1177
01:12:27.671 --> 01:12:34.695
When you are so busy and you're always on, what's your advice so that you don't become disconnected from your partner?

1178
01:12:34.735 --> 01:12:37.977
Like we spoke about intimacy is for sure.

1179
01:12:38.137 --> 01:12:38.937
Sex is one part.

1180
01:12:39.558 --> 01:12:41.078
You're learning how to be more connected.

1181
01:12:42.059 --> 01:12:43.140
You're changing things up.

1182
01:12:43.160 --> 01:12:45.341
You're going on vacation or you're lying.

1183
01:12:45.901 --> 01:12:47.903
in a different direction and stuff like this.

1184
01:12:48.243 --> 01:12:55.409
But what else do you do to make sure that you... Because you don't have a ton of time to just chill all afternoon with this person.

1185
01:12:55.489 --> 01:12:56.290
Yeah.

1186
01:12:57.110 --> 01:12:59.012
So what do you do when you can spend time with them?

1187
01:12:59.032 --> 01:13:00.133
Well, let me ask you this.

1188
01:13:00.173 --> 01:13:00.993
Do you go on date night?

1189
01:13:01.294 --> 01:13:01.514
Yes.

1190
01:13:01.714 --> 01:13:03.075
Okay, so you make time for date night.

1191
01:13:03.095 --> 01:13:03.636
Very important.

1192
01:13:03.776 --> 01:13:05.237
But you make time for date night.

1193
01:13:05.357 --> 01:13:06.238
Always very important, yeah.

1194
01:13:06.258 --> 01:13:08.319
So let's make time for intimacy night.

1195
01:13:08.880 --> 01:13:14.665
So instead of let's go out for dinner, let's go out and get dressed up and go to the movies, let's stay in

1196
01:13:15.305 --> 01:13:17.226
Let's be close to each other physically.

1197
01:13:17.346 --> 01:13:20.969
Let's do something where we literally no phones, nothing else.

1198
01:13:21.049 --> 01:13:22.990
We are just going to be physically together.

1199
01:13:23.410 --> 01:13:24.571
Sex doesn't have to happen.

1200
01:13:25.011 --> 01:13:27.753
It can happen and it may happen and it will potentially happen.

1201
01:13:27.993 --> 01:13:29.374
But the goal is not sex.

1202
01:13:29.494 --> 01:13:33.496
The goal is let's be intimate, physically close together.

1203
01:13:34.117 --> 01:13:37.238
And let's try different things where we can increase our intimacy.

1204
01:13:37.559 --> 01:13:44.423
And so maybe, you know, every week you go on date night, maybe two of those weeks are instead of date night, it's intimacy night.

1205
01:13:45.411 --> 01:13:46.211
And you build it in.

1206
01:13:46.432 --> 01:13:48.993
And then when you're doing date night, do novel things.

1207
01:13:49.093 --> 01:13:55.197
Because actually, when you do novel things outside the bedroom, they've shown that it actually increases sexual satisfaction.

1208
01:13:56.177 --> 01:13:56.457
Really?

1209
01:13:56.497 --> 01:14:01.940
Yeah, because it's like, think about when you're doing a novel thing, you're aroused in a different way, right?

1210
01:14:01.960 --> 01:14:04.062
You might be nervous, you might be anxious, you might be excited.

1211
01:14:04.102 --> 01:14:04.942
That's all arousal.

1212
01:14:05.022 --> 01:14:06.663
Your brain just sees arousal, right?

1213
01:14:06.683 --> 01:14:08.204
And you're experiencing that like with a person.

1214
01:14:08.304 --> 01:14:08.504
Yeah.

1215
01:14:08.524 --> 01:14:10.846
And so then you're already it's kind of like a foreplay.

1216
01:14:10.866 --> 01:14:15.969
And then you come into the bedroom and you're like already a little bit like, you know, turned on to each other.

1217
01:14:16.189 --> 01:14:20.472
And I actually have to be intentional about reducing my stress.

1218
01:14:20.592 --> 01:14:21.993
Like I have to shut it off.

1219
01:14:22.073 --> 01:14:22.533
I have to.

1220
01:14:22.773 --> 01:14:23.554
And I'm working on it.

1221
01:14:23.794 --> 01:14:27.076
Like I really and I actually just was talking to my other high performer friend about this.

1222
01:14:27.096 --> 01:14:30.978
Like you need you are going to burn out and like learn from my life experience.

1223
01:14:30.999 --> 01:14:33.280
Like you are going to burn out and something is going to happen.

1224
01:14:33.300 --> 01:14:36.282
Whether you burn out, you have a health issue, something's going to make you stop.

1225
01:14:36.302 --> 01:14:36.442
Yeah.

1226
01:14:37.243 --> 01:14:38.824
And you need to be intentional.

1227
01:14:38.844 --> 01:14:40.405
Like our kids, I have kids.

1228
01:14:40.806 --> 01:14:42.207
They're only so young so long.

1229
01:14:42.307 --> 01:14:43.728
They're going to be gone in a few years.

1230
01:14:43.748 --> 01:14:45.149
Like I need to be intentional.

1231
01:14:45.370 --> 01:14:47.331
They're not going to remember how hard mommy worked.

1232
01:14:48.092 --> 01:14:52.015
They're going to remember when I cuddled with them and watched TV with them every night.

1233
01:14:52.095 --> 01:14:58.381
And when we snuggled in bed before and I talked to them on their walk to school and like asked them about what's going on in their life.

1234
01:14:58.401 --> 01:14:59.281
They're not going to care.

1235
01:14:59.301 --> 01:15:01.323
I mean, yeah, it's cool mommy wrote a book.

1236
01:15:01.443 --> 01:15:04.626
But they're going to be like, oh, what matters more to me is the time she spent with me.

1237
01:15:04.987 --> 01:15:08.623
I think that this audience in particular really has to remember that.

1238
01:15:10.168 --> 01:15:15.769
You know, one of my good friends, I told this story a few times, but like I don't have kids yet, but that's sort of next for us.

1239
01:15:15.829 --> 01:15:21.751
And I always get stressed out about, see it's like, you can tell it just like comes out so many things that you're worrying about all the time.

1240
01:15:21.811 --> 01:15:23.111
Cause you don't want to screw anything up.

1241
01:15:23.131 --> 01:15:27.492
Cause like you want to be a high performer in one area, but then you carry it into everything else in your life.

1242
01:15:27.512 --> 01:15:29.073
But we want to have kids.

1243
01:15:29.113 --> 01:15:34.494
And I kept thinking about the fact that if I have, you know, how am I gonna have time for kids?

1244
01:15:34.534 --> 01:15:38.575
If I'm always working, you know, I look at my calendar, there's no white space in my calendar.

1245
01:15:39.395 --> 01:15:42.397
And he's actually the CEO of a publicly traded company.

1246
01:15:42.577 --> 01:15:45.138
He's exited two companies, so obviously high-performing.

1247
01:15:45.158 --> 01:15:46.059
But he's like, you don't get it.

1248
01:15:46.439 --> 01:15:58.625
Having kids forces you to be a better entrepreneur, a better high-performer, because you have to get X amount of work done in eight hours so you can be present with your kids.

1249
01:15:58.645 --> 01:16:02.767
So it actually makes you more effective and it makes you focus on things that are actually meaningful.

1250
01:16:03.287 --> 01:16:08.311
And I think that sometimes when we don't have those constraints, like it's, you know, what's the, what's the thing, right?

1251
01:16:08.331 --> 01:16:10.252
Like the, the work expands the time you give it.

1252
01:16:11.033 --> 01:16:11.874
It really does.

1253
01:16:12.014 --> 01:16:20.200
And if you don't have that time, so this is kind of like kids force constraints so that you are better during the time that you're working.

1254
01:16:21.060 --> 01:16:27.405
Scheduling intimacy forces constraints so that you don't have unlimited time that day just to work.

1255
01:16:27.465 --> 01:16:28.686
You put it on your calendar.

1256
01:16:28.706 --> 01:16:29.427
Just like you did for date night.

1257
01:16:29.447 --> 01:16:30.387
You put it on your calendar.

1258
01:16:30.407 --> 01:16:31.328
It all seems to work out.

1259
01:16:31.908 --> 01:16:32.849
And you make it work.

1260
01:16:33.309 --> 01:16:42.137
You know, when something comes up, like let's say something comes up in your business and you had a whole day planned, everything can get canceled because now that issue becomes a priority.

1261
01:16:42.657 --> 01:16:47.481
And so really like the constraints that we're putting on ourselves are the things that we think we have to do.

1262
01:16:47.621 --> 01:16:49.823
A lot of them, they don't have to be done in that time frame.

1263
01:16:49.863 --> 01:16:51.044
We're doing that to ourselves.

1264
01:16:51.644 --> 01:16:55.747
So it's really about like, what is your what is a legacy you want to leave?

1265
01:16:55.787 --> 01:16:56.448
What is enough?

1266
01:16:56.748 --> 01:16:56.908
Right?

1267
01:16:56.928 --> 01:16:59.570
Like, I think this is the challenge that we have to ask ourselves a lot.

1268
01:16:59.590 --> 01:17:01.572
Like, what do we need more in life?

1269
01:17:01.812 --> 01:17:02.012
Right?

1270
01:17:02.032 --> 01:17:03.193
Like, when is enough?

1271
01:17:03.453 --> 01:17:04.174
When is it enough?

1272
01:17:04.534 --> 01:17:06.576
You know, because it'll never be enough.

1273
01:17:06.776 --> 01:17:14.482
Like, if you asked me, like, I don't think that even if I exit for a huge amount of money today, I would be like, what's next?

1274
01:17:15.002 --> 01:17:16.023
What am I going to do next?

1275
01:17:16.063 --> 01:17:17.945
Like, I'm not going to go sit on a yacht in Ibiza.

1276
01:17:17.965 --> 01:17:20.227
Like, I'm going to find something else to do.

1277
01:17:20.247 --> 01:17:24.171
No, because you're ambitious and you like doing shit and building stuff.

1278
01:17:24.251 --> 01:17:24.552
Right.

1279
01:17:24.692 --> 01:17:25.613
But so what's next?

1280
01:17:25.673 --> 01:17:27.975
It's like, well, what's enough?

1281
01:17:28.135 --> 01:17:31.498
And, like, if you really ask yourself, like, I have enough.

1282
01:17:31.879 --> 01:17:33.621
I have everything I need.

1283
01:17:34.141 --> 01:17:35.482
then what are the priorities?

1284
01:17:35.542 --> 01:17:40.607
In the beginning of the book, I actually make you go through this exercise because I did it for myself.

1285
01:17:40.628 --> 01:17:41.749
Like, what do I want to be?

1286
01:17:41.949 --> 01:17:43.490
What do I see myself?

1287
01:17:43.630 --> 01:17:44.692
What matters to me?

1288
01:17:44.972 --> 01:17:46.653
And actually work is not on there.

1289
01:17:46.894 --> 01:17:51.438
It's like my family, my husband, my, you know, my values, my health.

1290
01:17:51.518 --> 01:17:55.662
Like those are the things that are actually more valuable to me.

1291
01:17:56.083 --> 01:17:58.105
And I had to do the work to realize that.

1292
01:17:58.525 --> 01:18:14.144
I think the most important thing is really, in terms of my relationship, is like I really prioritize it because I never want to be in a situation where we are in a touchless existence.

1293
01:18:14.564 --> 01:18:17.368
Because it's so easy to slip into this...

1294
01:18:17.908 --> 01:18:22.149
this period of life where you're busy and you don't have time for each other.

1295
01:18:22.589 --> 01:18:25.050
And then sex falls apart because of other things.

1296
01:18:25.430 --> 01:18:37.894
And then literally like, there's a couple I talk about in the book, but like, because every time the, the husband tried to touch the wife, she would be like, I don't want to have sex with you that, that like, she would be like, move away.

1297
01:18:37.914 --> 01:18:39.354
And they just stopped touching.

1298
01:18:39.814 --> 01:18:41.175
Like they didn't even, you know what I mean?

1299
01:18:41.195 --> 01:18:42.715
And I was like, I never want that.

1300
01:18:42.795 --> 01:18:49.177
And like, I realized that you have to be intentional about keeping those connections in your life.

1301
01:18:49.197 --> 01:18:59.681
So whether it's, you know, with my partner, with my kids, I just, I really think that that part of it has become so important to me because I see the social aspects of people's lives too.

1302
01:18:59.861 --> 01:19:04.262
More, I mean, the medical aspects, like those we didn't, I knew that going into medical school, right?

1303
01:19:04.542 --> 01:19:06.983
But the social aspects of how I see people living

1304
01:19:07.403 --> 01:19:15.150
Like when they don't communicate and they let things go, like it just falls apart and they're devastated.

1305
01:19:15.230 --> 01:19:16.631
And that really breaks my heart.

1306
01:19:17.031 --> 01:19:23.136
You and your partner both want to feel seen and you want to feel loved and attended to.

1307
01:19:23.156 --> 01:19:28.981
And sometimes because of life, it can get pushed aside because you take them for granted.

1308
01:19:29.021 --> 01:19:29.462
They're there.

1309
01:19:29.982 --> 01:19:31.143
Like you've already gotten married.

1310
01:19:31.163 --> 01:19:32.043
You're already together.

1311
01:19:32.483 --> 01:19:34.524
Like, you know, of course I love you.

1312
01:19:35.124 --> 01:19:35.244
Right?

1313
01:19:35.264 --> 01:19:36.205
Of course I love you.

1314
01:19:36.385 --> 01:19:39.686
But if you don't show love, it's going to disappear.

1315
01:19:40.346 --> 01:19:55.013
For somebody right now who's in a relationship and who is struggling or listening to this and gets stressed out, what's the message that you want them to take away after they listen to this, after they read your book, The Hard Truth?

1316
01:19:55.033 --> 01:19:55.913
Like what's the one thing?

1317
01:19:56.902 --> 01:20:01.204
Well, before you get stressed, what I will say is you can make one tiny change.

1318
01:20:01.564 --> 01:20:03.045
You don't have to do everything.

1319
01:20:03.425 --> 01:20:08.287
Start with one tiny thing that is so easy that there's no excuse you can make.

1320
01:20:08.307 --> 01:20:11.809
Like there's no like, oh, I don't have the white space in my account, but you can do this one thing.

1321
01:20:12.129 --> 01:20:16.991
So find that one thing based on whatever pillar needs the most work and start there.

1322
01:20:17.391 --> 01:20:20.933
So I would say that just know that you are worth everything.

1323
01:20:21.693 --> 01:20:31.900
working for, your sex life is worth prioritizing and you can do it because you've built a lot of big things and you can build this too.

1324
01:20:32.280 --> 01:20:34.221
So first of all, thank you for chatting.

1325
01:20:34.241 --> 01:20:35.262
Where can people get the book?

1326
01:20:35.362 --> 01:20:36.403
Where can people connect with you?

1327
01:20:36.423 --> 01:20:37.603
We'll put all the links in the show notes.

1328
01:20:37.623 --> 01:20:40.105
You can find me anywhere on social media at RenamalickMD.

1329
01:20:40.125 --> 01:20:43.768
My biggest platform is YouTube and I'm creating content there all the time.

1330
01:20:43.948 --> 01:20:48.511
The book is called The Hard Truth, Everything Men Need to Know for Good Health, Great Sex and Long Life.

1331
01:20:48.971 --> 01:20:50.532
And you can find it anywhere books are sold.