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BigDeal by Codie Sanchez

Get Your Sex Life Back! What Everyone Gets Wrong About Sex & Libido: Dr. Rena Malik

My new book Own Or Be Owned is out now! I wrote Own or Be Owned to answer one question: How do you make more money, less miserably?

Codie SanchezhostDr. Rena Malikguest

Jun 11, 20251h 6mWatch on YouTube

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CHAPTERS

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Chapter summaries

Why orgasm gaps persist: anatomy, arousal time, and bad sex education
Codie Sanchez and Dr. Rena Malik open with blunt stats about orgasm frequency, faking orgasms, and how porn and media distort expectations. Dr. Malik explains why many heterosexual encounters don’t prioritize the anatomy and time needed for many women to orgasm.
- •Dr. Malik contrasts orgasm rates in first-time heterosexual encounters versus first-time lesbian encounters and attributes the difference to anatomy knowledge.
- •Dr. Malik says many people are poorly educated about sex and rely on porn/media depictions that don’t match reality.
- •Dr. Malik explains that many women need clitoral stimulation to climax and that penetration alone often isn’t sufficient.
- •Codie emphasizes that five to six minutes of penetrative sex is unlikely to result in orgasm for many women and frames this as a common misconception.
Performance myths: penis size, penetration obsession, and the reality of stimulation
The conversation turns to common beliefs about what makes sex “good,” especially around penis size and penetration. Dr. Malik reframes pleasure around communication, non-genital erogenous zones, and broader intimacy rather than a single act or outcome.
- •Dr. Malik identifies the belief that bigger penis size equals better sex as a major myth.
- •She says many women need clitoral stimulation and that pleasure can involve hands, mouth, toys, and exploration beyond penetration.
- •Dr. Malik argues sex is not only about orgasm; it’s also about pleasure and connection during intimacy.
- •Codie summarizes takeaways for men: focus on foreplay, duration, and stimulation rather than size.
Libido in long-term relationships: responsive desire, stress, and planning intimacy
Dr. Malik explains why libido often changes over time and how desire can shift from spontaneous to responsive in long-term relationships. She describes how stress, distraction, and lack of intentional intimacy can reduce desire—and how couples can reduce pressure while reconnecting.
- •Dr. Malik says low libido is common and describes how early-relationship excitement differs from long-term routines.
- •She explains “responsive desire,” where arousal can emerge after affectionate contact begins rather than before it.
- •Dr. Malik describes stress and mental distraction as major libido blockers and emphasizes being present.
- •She suggests making intentional time for intimacy (without guaranteeing sex) and adding flirtation/connection outside the bedroom.
Medical drivers of desire and ED: hormones, libido meds, and ED as a health warning sign
The discussion shifts into medical causes and treatments for low desire and erectile dysfunction. Dr. Malik outlines hormone changes, prescription options for female libido, and explains why ED can be an early sign of broader vascular health issues.
- •Dr. Malik links women’s libido decline partly to declining testosterone and notes both on-label and off-label options.
- •She describes Addyi as a nightly pill that gradually increases desire and Vyleesi as an as-needed injection that can increase desire more suddenly.
- •Dr. Malik gives prevalence figures for erectile dysfunction by age and emphasizes how common it is.
- •She says ED can be an early manifestation of blood-flow problems and frames it as a chance to investigate overall health rather than only prescribing medication.
Lifestyle, blood flow, and ED: exercise vs “just take a pill” healthcare
Dr. Malik details how cardiovascular health connects to sexual function and how lifestyle changes can improve erectile function. Codie challenges why healthcare often defaults to medication, and Dr. Malik explains time constraints and behavior-change challenges.
- •Dr. Malik says many ED cases relate to blood flow and that what’s good for the heart is good for the genitals.
- •She cites research that moderate-intensity cardio exercise at a specific weekly amount can be comparable to Viagra for ED outcomes.
- •Codie questions why Viagra is commonly prescribed; Dr. Malik points to short appointment times and patient preferences for quick fixes.
- •Dr. Malik notes fit men can still have ED due to factors like cholesterol, blood pressure, diet, or genetics.
Porn and arousal tools: when it helps, when it harms, and relationship mismatches
Codie and Dr. Malik explore porn and erotic content as tools that can either enhance intimacy or become a substitute for it. Dr. Malik emphasizes nuance: distress, shame cycles, and mismatched partner expectations can turn porn into a relationship stressor.
- •Dr. Malik says porn’s impact depends on context—whether someone is escaping dissatisfaction or using it to enhance a healthy relationship.
- •She describes how accessibility and using porn to avoid negative emotions can create a shame-driven cycle for some people.
- •Dr. Malik says porn use doesn’t always correlate with less partnered sex and notes couples who watch together may have more sex.
- •She frames “porn instead of sex” as primarily a relationship issue and suggests exploring the underlying dynamic rather than scapegoating porn.
How to talk about sex and improve it: communication, novelty, and the G-spot clarified
Dr. Malik gives practical frameworks for discussing sex without triggering defensiveness and encourages ongoing conversations. She also explains the G-spot as a zone, describes internal clitoral anatomy, and challenges media-driven assumptions about penetration-based orgasms.
- •Dr. Malik recommends giving a partner a heads-up before a sex conversation and starting with what’s already working.
- •She suggests lowering pressure, making sex more playful, and adding novelty (small changes in setting, routines, or tools).
- •Dr. Malik describes the G-spot as a zone and explains anatomical variation in why some people orgasm from penetration and others don’t.
- •They discuss how mainstream media reinforces penetration as the default and how that shapes expectations and insecurity.
Porn as sex education and how to talk to kids about sex (before they see it)
Dr. Malik argues that porn has become a primary sex educator for many kids because school and parents often avoid real education. She describes how early exposure can create confusion, anxiety, and performance pressure, and shares how she approaches age-appropriate conversations with her children.
- •Dr. Malik says sexual education is often limited to safety/abstinence framing and doesn’t explain arousal or realistic sexual response.
- •She states the average age of first porn exposure is very young and says parents should address porn proactively.
- •Dr. Malik explains how porn-driven expectations can lead to anxiety during early sexual experiences and subsequent arousal issues.
- •She outlines her approach: teach body parts, normalize erections, answer questions directly, and keep the door open for follow-ups.
Learning what you like: self-exploration, shame reduction, and sensate focus
The conversation turns toward personal exploration and how people can learn preferences without shame. Dr. Malik describes differences in social messaging for boys and girls and introduces sensate focus as a therapeutic tool to reduce performance pressure and rebuild pleasure.
- •Dr. Malik encourages exploring one’s own body to understand what feels good and emphasizes “permission” without shame.
- •She discusses how adults’ reactions can create early shame and suggests framing self-touch as private rather than “bad.”
- •Dr. Malik explains sensate focus: initially no penetration and even no genital touch, focusing on sensual exploration first.
- •She emphasizes that not knowing what you like is common and that couples can discover preferences together over time.
Sex as a biomarker—and why people are having less sex
Dr. Malik frames sexual function as a window into overall health, from blood flow to hormones to mental wellbeing. She and Codie discuss the trend of declining sexual activity and the role of phones, stress, and reduced community support.
- •Dr. Malik calls sexual function a strong biomarker and says dysfunction can point to vascular, hormonal, neurologic, medication-related, or mental factors.
- •She notes examples of metabolic conditions affecting arousal and libido and emphasizes the need to investigate root causes.
- •Dr. Malik and Codie agree people are having less sex and discuss attention shifts to phones and higher life stressors.
- •They discuss how modern isolation and reduced communal support can make relationships and intimacy harder to sustain.
Extending ‘sex span’: desire in older age, avoidance cycles, and health connections
Codie asks how long people want to remain sexually active, and Dr. Malik shares what she found when looking at older adults’ sexual desire. She explains how avoiding sex after dysfunction can reduce desire further and connects ongoing intimacy with blood flow, connection, and wellbeing.
- •Dr. Malik says even very old adults can still want sex and that desire can remain when intimacy is cultivated over time.
- •She explains how sexual dysfunction can lead to avoidance, and avoidance can lower desire further.
- •Dr. Malik describes how reduced genital blood flow can contribute to tissue changes that make function harder over time.
- •She discusses research linking regular sex with better mood outcomes and longer life, while noting frequency goals shouldn’t become pressure.
Pelvic floor basics: weak vs tight muscles, symptoms, and why internal therapy can help
Codie raises pelvic floor therapy after hearing about a friend’s internal treatment. Dr. Malik explains what the pelvic floor is, how dysfunction can be due to weakness or tightness, why Kegels aren’t always the answer, and how physical therapy may include relaxation work and internal muscle release.
- •Dr. Malik defines the pelvic floor as a bowl of muscles involved in stability, organ support, urination/defecation, pregnancy, and sexual function.
- •She distinguishes weak pelvic floor issues (often associated with leakage/prolapse) from tight pelvic floor issues (often linked to stress/trauma/tension).
- •Dr. Malik lists potential symptoms of a tight pelvic floor, including urinary, bowel, pain, and sexual effects for both men and women.
- •She describes relaxation approaches (breathing, stretches/yoga poses) and explains why pelvic floor PT may include internal muscle massage to release tension.
Substances and sex: short-term boosts, long-term tradeoffs, and alcohol’s effects on arousal
Codie asks about cannabis and alcohol as tools for sexual enhancement. Dr. Malik distinguishes short-term libido increases from potential long-term decreases with chronic use, and she cautions about alcohol’s broader health risks and its potential role in arousal difficulties for men.
- •Dr. Malik says marijuana/THC/CBD can increase libido in the short term but may reduce desire with chronic frequent use.
- •She says alcohol can lower inhibition for some people but carries broader health concerns and can lead to poor judgment when intoxicated.
- •Dr. Malik discusses alcohol-related erection issues in men and notes the strongest evidence appears in heavier chronic use patterns.
- •She emphasizes that occasional arousal difficulties can happen and encourages not panicking when they do.
The future of intimacy: societal supports, fertility pressures, and AI/robot sex
In the closing stretch, Codie asks about where intimacy trends are headed and whether society can reverse declining sex and fertility. Dr. Malik discusses the need for structural support for families and mothers, then the conversation shifts to AI intimacy—why human connection may remain uniquely compelling.
- •Dr. Malik says changes are necessary to address population decline and discusses how stress, incentives, and support systems shape birth rates and intimacy.
- •Codie and Dr. Malik discuss workplace and childcare pressures influencing women’s decisions about pregnancy and timing.
- •They explore the likelihood of AI/robot sex and Dr. Malik’s concern that “always-yes” dynamics could replace human tension and connection.
- •Dr. Malik references brain research suggesting stronger responses with a real person and emphasizes human touch and connection as distinct from porn/tools.

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