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

Codie Sanchez 0:00 If you are having sex with a woman for five to six minutes, 90% chance she's not orgasming, even if she sounds like she is. I am thrilled today to bring on Dr. Rena Malik. She has a giant following online from being willing to talk about the taboo subjects in a way that is science and data backed. Are we having less sex-

Dr. Rena Malik 0:19 Absolutely

Codie Sanchez 0:19 ... than ever before?

Dr. Rena Malik 0:20 Absolutely.

Codie Sanchez 0:21 Are there studies that show how often women actually fake an orgasm?

Dr. Rena Malik 0:26 40% of women ha- fake an orgasm.

Codie Sanchez 0:28 But men-

Dr. Rena Malik 0:28 But men also fake orgasms

Codie Sanchez 0:29 ... whoa.

Dr. Rena Malik 0:30 Yes.

Codie Sanchez 0:31 Is the G-spot real? Really?

Dr. Rena Malik 0:32 If you exercise 150 minutes a week, moderate intensity cardiovascular exercise, it's as good as taking a Viagra.

Codie Sanchez 0:39 Wow. Women who watch porn and read those, like, kind of romance fantasy novels, it might increase our sex drive. Hi, I'm Codie Sanchez, and this is The Big Deal podcast. I wanna talk about a thing we don't talk about enough, which is how to have sex, how to have better sex, how to have sex longer with a partner that you adore. And so this podcast is really, really a special one, I think. And I wouldn't bring just anybody on here to talk to you about this. There's lots of people who talk a lot on the internet about things like sex. When we come to a subject matter like this, I wanted to bring you the best. She has published 80 peer-reviewed publications and been an online content editor for the Journal of Urology. You're gonna wanna listen to this episode, and I can also promise you, you're probably gonna wanna send it to a few friends. The reason that I wanted to have you on today was not to talk about health broadly.

Dr. Rena Malik 1:29 Yeah.

Codie Sanchez 1:29 But, you know, I talked to, to our mutual friend, and she was like, "You have to talk to Dr. Malik about sex." And I was like, "Excuse me?"

Dr. Rena Malik 1:35 [laughs]

Codie Sanchez 1:36 I'm like, I'm like in my spreadsheets right now. What are you talking about?

Dr. Rena Malik 1:39 You're like, "That's not what my audience comes to me for."

Codie Sanchez 1:41 Yeah.

Dr. Rena Malik 1:41 [laughs]

Codie Sanchez 1:41 And she was like, "There is an underpinning of society that obviously we have to procreate. And, um, you're happier. There's some studies that show that you might be wealthier if you procreate-

Dr. Rena Malik 1:52 Mm-hmm

Codie Sanchez 1:52 ... and get married and have kids."

Dr. Rena Malik 1:54 Mm-hmm.

Codie Sanchez 1:54 And so I think it's important that we talk about sex.

Dr. Rena Malik 1:56 It is.

Codie Sanchez 1:56 And at the end of this little session, what I'm hoping people listening to today will get is maybe just having better sex.

Dr. Rena Malik 2:02 Mm-hmm.

Codie Sanchez 2:02 Maybe having more sex.

Dr. Rena Malik 2:03 Mm-hmm.

Codie Sanchez 2:04 Maybe not feeling bad asking the questions that they wanna know about-

Dr. Rena Malik 2:08 Yeah

Codie Sanchez 2:08 ... good or bad sex.

Dr. Rena Malik 2:09 Yeah.

Codie Sanchez 2:10 Uh, erectile dysfunction not. So at the end, I hope everybody's like, "Ah, this is amazing. Now I'm gonna go have a little bit better sex, a little bit more sex," because who doesn't want that?

Dr. Rena Malik 2:17 Everybody wants that.

Codie Sanchez 2:18 Yeah.

Dr. Rena Malik 2:18 Right?

Codie Sanchez 2:18 Except bad sex. Nobody wants more bad sex.

Dr. Rena Malik 2:21 Right.

Codie Sanchez 2:21 You know?

Dr. Rena Malik 2:21 And that's the thing, there's a lot of bad sex.

Codie Sanchez 2:23 [laughs]

Dr. Rena Malik 2:24 Like, there's a lot of bad sex because people are not educated.

Codie Sanchez 2:28 Right.

Dr. Rena Malik 2:28 Right? They're like, they see what's on porn or what's in even media, right? Like, a guy penetrates a woman. Within minutes, they're orgasming. She's happy. He's happy, and it's like, "Oh, it was the best thing ever." It's like that's not reality. When you look at first time sex encounters, so let's say a man and a woman, 45% of the time, the woman's gonna orgasm. Only 45%. If you look at a lesbian first encounter, 95% of the time they orgasm.

Codie Sanchez 2:51 [laughs] That's such incredible advertising for lesbians everywhere. [laughs]

Dr. Rena Malik 2:56 [laughs]

Codie Sanchez 2:57 95% of the time?

Dr. Rena Malik 2:59 It's because they know the anatomy.

Codie Sanchez 3:01 Wow.

Dr. Rena Malik 3:01 It's so simple. They just know the anatomy.

Codie Sanchez 3:04 Of co- it makes all the sense in the world.

Dr. Rena Malik 3:05 Right. It's not like they're-

Codie Sanchez 3:05 They're also handy. They got all these extra pockets.

Dr. Rena Malik 3:07 [laughs]

Codie Sanchez 3:08 I just feel like being a lesbian is... That sounds great. I wish, you know?

Dr. Rena Malik 3:12 Yeah.

Codie Sanchez 3:12 Turns out I'm into dudes.

Dr. Rena Malik 3:13 Yeah, me too.

Codie Sanchez 3:13 But good on, good on you guys.

Dr. Rena Malik 3:15 Yeah.

Codie Sanchez 3:15 That's incredible. Yeah, it's not that they're, you know, better. They just are more knowledgeable.

Dr. Rena Malik 3:20 Absolutely.

Codie Sanchez 3:21 Like, what are some of the biggest myths that even smart people believe about sex these days?

Dr. Rena Malik 3:27 I think the biggest myth is that the bigger the penis, the better the sex. And the, the-

Codie Sanchez 3:33 Totally

Dr. Rena Malik 3:33 ... like, like, yeah, sure, some women have orgasms from cervical stimulation, but not a lot, right? So 85% of women need clitoral stimulation to climax-

Codie Sanchez 3:44 Yes

Dr. Rena Malik 3:44 ... which doesn't require a large penis. And so it's like, it's more about... And you know, people joke, "Oh, it's the motion in the ocean," whatever, whatever. Like, yeah, it is partially how you move and how you use your other, your other body, right? Your mouth, your fingers, your whatever, your toys, whatever you bring to the bedroom. Like, those things are just as important. And honestly, it's not even just about penetration. Like, it's about using, like, exploring, finding your erogenous zones. Like, like, you stimulating other areas and not just being so genital focused. Like, it's not all about the orgasm.

Codie Sanchez 4:14 Hmm.

Dr. Rena Malik 4:14 It's also about the pleasure you feel while you're being intimate and the connection you have with the person. So I think that is the biggest myth, is, like, that penetration and size are everything.

Codie Sanchez 4:24 I can't... That sounds right to me that onl- like, 85% of women need clitoral stimulation.

Dr. Rena Malik 4:29 Absolutely.

Codie Sanchez 4:29 Is, are there any studies that show how often women actually fake an orgasm?

Dr. Rena Malik 4:34 Yes, there are studies, and I think it's, like, as high as, like, 40% of women ha- fake an orgasm.

Codie Sanchez 4:39 Like, it's just-

Dr. Rena Malik 4:40 But men also fake orgasms.

Codie Sanchez 4:42 Whoa.

Dr. Rena Malik 4:42 Yes.

Codie Sanchez 4:43 Really?

Dr. Rena Malik 4:44 Yeah, so there's, you know, there's some men who have what's called delayed ejaculation.

Codie Sanchez 4:47 Uh-huh.

Dr. Rena Malik 4:47 So they will ejac- they will take, like, 30 minutes or more to ejaculate. It's, like, 9%. It's not a small number.

Codie Sanchez 4:53 No.

Dr. Rena Malik 4:53 But they don't talk, they don't complain about it, right? Because they're all trained to think this is a good thing. And so then they're just like, "I need it to be over, so I'm gonna fake it."

Codie Sanchez 5:01 That's, I, that almost, I think, would be worse as a man to fake it, right? 'Cause as a woman, you kinda, like, shake it off.

Dr. Rena Malik 5:06 Yeah.

Codie Sanchez 5:06 But as a man, you have, like, a physical manifestation of the fact that you're not done, don't you?

Dr. Rena Malik 5:10 Yes, yes. I mean, like, I think, um, they do, but they probably just... Like, I, I'm guessing, and, like, I, I don't think they've gotten to that detail in the research, but they probably, like, roll over, go to the bathroom, like-

Codie Sanchez 5:20 Yeah

Dr. Rena Malik 5:20 ... you know, whatever.

Codie Sanchez 5:21 Yeah, I mean, I have a girlfriend, um, who, God, we must have been 30 at the time, and she was married.

Dr. Rena Malik 5:26 Mm-hmm.

Codie Sanchez 5:26 And she had a kid already, maybe two, and she had told me she had never had an orgasm, 30 years old.

Dr. Rena Malik 5:31 Mm-hmm, mm-hmm.

Codie Sanchez 5:31 And I was sort of blown away, and it took her a while to, to say that out loud. And then we were in a group, like, a smal- slightly bigger group of women, and there was another woman.

Dr. Rena Malik 5:40 Mm-hmm.

Codie Sanchez 5:40 And so then I was like, "Oh, my God, how common is this?"

Dr. Rena Malik 5:44 12% of women have never had an orgasm. That's a lot of women.

Codie Sanchez 5:47 Wow.

Dr. Rena Malik 5:47 12%. And so, like, why is this? So a lot of times, it's just because we don't, women aren't taught, right? So the, one, there's not enough time for arousal. So arousal for women takes longer than men.

Codie Sanchez 5:58 Mm-hmm.

Dr. Rena Malik 5:58 It takes about 25 minutes on average. And so if you think about sex, the average duration for sex is about five to six minutes. So for a man to ejaculate, when they've act- they've actually done a study where they, like, took a stopwatch and timed it. Like, the partner puts on their stop- stopwatch, times penetration to climax, um, and they did it around the world, and it's around five to six minutes. And so if you think about that, if we're focused only on male pleasure, and the, the whole thing is penetration, then within five minutes they will climax and you will barely be aroused, right? [laughs] Like-

Codie Sanchez 6:31 Yeah

Dr. Rena Malik 6:31 ... you haven't even gotten there yet. And so if you're not focusing on mutual pleasure, then many women will not orgasm, right? So that's one. Two is... Yes, there's not enough time. Two is, like, yeah, if, if it hurts. So, like, sometimes we just assume you should be well-lubricated, everything should work. But sometimes people have reasons they don't lubricate well: genetics, they're on certain medications. And, and they, and they still have sex with their partner without lubrication because, like, "Why should I need it? I'm young, I'm healthy." Um, but lubricant is great. It makes things slippery, it makes things more fun, it makes things more pleasurable. So pain is certainly gonna prevent you from having an orgasm.

Codie Sanchez 7:01 Right.

Dr. Rena Malik 7:02 And then inadequate stimulation. So if you're not stimulating the clitoris, like I said, 85% of women need clitoral stimulation, and if you're just focusing on penetrative sex, and you don't have favorable anatomy that's gonna let you climax through vaginal penetration, then you're not gonna climax.

Codie Sanchez 7:16 Wow. So, like, men listening basically need to realize a couple things, which is if you are having sex with a woman for five to six minutes, 90% chance she's not orgasming, even if she sounds like she is.

Dr. Rena Malik 7:27 Yep.

Codie Sanchez 7:27 Just like baseline take that for what it is.

Dr. Rena Malik 7:30 Yeah.

Codie Sanchez 7:30 And if you're not doing some sort of foreplay and it's not lasting longer than 25 minutes, you're not fucking Casanova who's killing it magically in five to six minutes.

Dr. Rena Malik 7:39 [laughs]

Codie Sanchez 7:39 You're just... You know, the other person just doesn't wanna deal with the fact, uh, or come clean about it.

Dr. Rena Malik 7:45 Yeah.

Codie Sanchez 7:45 Which is, like, it's something that I don't think is said enough to dudes.

Dr. Rena Malik 7:48 If a woman has an orgasm and she's, like, not sure, she didn't have an orgasm.

Codie Sanchez 7:51 [laughs] That's, that's so true.

Dr. Rena Malik 7:54 [laughs] Yeah.

Codie Sanchez 7:54 And I think if you have to a- if you have to ask, she didn't have an orgasm either.

Dr. Rena Malik 7:59 Yeah. Yes.

Codie Sanchez 7:59 Like, that's really fascinating, and I think kind of freeing because it's not the size of your penis, so it doesn't really matter if it's huge or not.

Dr. Rena Malik 8:07 Mm-hmm.

Codie Sanchez 8:07 It's a lot about duration and consistency and touching the clitoris.

Dr. Rena Malik 8:10 Mm-hmm.

Codie Sanchez 8:10 And, like, this isn't rocket science, dudes. Um, and so you could, like, be pretty incredible with your woman with not that much work.

Dr. Rena Malik 8:18 Absolutely. And a lot of it comes from, like, just talk to them.

Codie Sanchez 8:21 Yeah.

Dr. Rena Malik 8:22 Like, "Baby, does this feel good?"

Codie Sanchez 8:23 Yeah.

Dr. Rena Malik 8:23 Like, "Do you like this? What turns you on? What do you like?" Like, show me... Or, or even watch. If someone is open to masturbating, watch them masturbate.

Codie Sanchez 8:31 Yeah.

Dr. Rena Malik 8:31 What do they do? Be like, "Let's masturbate together, I think that's hot." Like, whatever it is, right? And, and you're gonna find out what they like 'cause they're gonna do it. They're gonna do it well.

Codie Sanchez 8:39 Is it true that women start to desire sex less, and that our libido goes down as we get older? And if that is true, can we get it back, and how?

Dr. Rena Malik 8:48 Yes. So low libido is very common. In fact, 40% of women will have low libido in their lifetime. Your sexual desire is based on a variety of different things. So what happens initially, right, think about when you're younger and you're dating and you're really excited to see your partner. There's, like, this atmosphere of desire.

Codie Sanchez 9:04 Yeah.

Dr. Rena Malik 9:04 You're like, "Oh, I can't wait to go on a date with you. I'm gonna shave my legs, I'm gonna look really attractive. I'm gonna make sure I'm ready."

Codie Sanchez 9:11 Girl shower. Yeah, yeah, totally.

Dr. Rena Malik 9:11 Yeah. Ready for sex, right?

Codie Sanchez 9:12 Yes.

Dr. Rena Malik 9:12 If it comes, 'cause it might not, right? You're still dating. And so you're like, "Okay, let's, let's be ready." And then you get this, like, you get excited about it. And then you get to be with your partner and it's really fun and attractive and you, and you have a great time, and everything's wonderful. But then as you're in a longer term relationship, you're like, "They're always there."

Codie Sanchez 9:27 Yeah.

Dr. Rena Malik 9:27 "They're always there, and, um, I'm busy and I'm tired, and maybe I'm not in the mood today. Maybe you're not in the mood right now." And so it becomes like you never prioritize sex 'cause you're like, "Why would I prioritize sex? I've got a job, some kids. Like, uh, you know, my parents are aging. All this other stuff is going on. I'm... You know, like, that's, that'll happen when it happens. It's supposed to be spontaneous. I'm supposed to see my partner, see them, get turned on, and jump them, right? Like, that's how it should be." But the reality of the situation is, like, how often does that really happen? It becomes what's called responsive desire.

Codie Sanchez 9:55 Yes.

Dr. Rena Malik 9:55 So you start, like, being with your partner and you're like, you know, you start having foreplay, you start touching, cuddling, whatever. You're like, "Oh. Oh yeah, I do like that. Oh, I do want sex, but I didn't know it until I actually became a little bit intimate with my partner."

Codie Sanchez 10:07 Oh.

Dr. Rena Malik 10:07 I actually started being, touching them, being with them, like, "Oh yeah, I remember." And that's completely normal.

Codie Sanchez 10:13 Mm-hmm.

Dr. Rena Malik 10:13 And the thing is that people are so fixed on this, like, it needs to be spontaneous, that they won't even cuddle or be intimate with their partner because, like, oh, then they're gonna want sex, and I don't want sex. And so there's also this, like, back and forth. The issue becomes when you both don't wanna have sex because of low libido, that's okay. I mean, like, you guys are fine as a relationship. But when one person wants a lot and one person doesn't, that's where it becomes a problem. It's not a problem with the person who has low libido or the person who has high libido, it's about matching the relationship together, right?

Codie Sanchez 10:38 Yes.

Dr. Rena Malik 10:38 So I don't want ever to point fingers at someone who has low libido.

Codie Sanchez 10:41 Yes.

Dr. Rena Malik 10:41 But there are medical reasons. So obviously there are, like, lifestyle reasons like I talked about, and obviously stress is a huge killer of libido, right? If you're stressed about anything, like, you don't wanna have sex. You're thinking about that thing. You're not in your mindful moment to have sex, which is what you need to be. You need to be fully present, enjoying the pleasure that comes with being with your partner, and most of us are, like, thinking about what we gotta do after this is all over, right? [laughs] Like... And so, like, we don't take the time. And, and there's no foreplay, right?

Codie Sanchez 11:08 Yeah.

Dr. Rena Malik 11:08 So, like, when you're in a long-term relationship, and you're like, "Oh yeah, I see you all the time. I love you. Okay." But there's no, like, sexy texts or, like, "Let me just touch you in the morning and tell you how beautiful I think you are," or, like, "Hey, I can't wait for later." Like, there's no... And there's no planning. Like, "Hey, let's... This is gonna be our time. This is gonna be our time for intimacy. And let's, instead of date night where we go out to dinner and just talk," which is still really important. Like, and then we're bloated, we don't wanna have sex afterwards. [laughs]

Codie Sanchez 11:32 Things occur.

Dr. Rena Malik 11:33 It's like let's actually say, "Hey, this is gonna be time for intimacy. Like, we are gonna shut everything else out, put our phones away, be together, m- get naked. And if sex happens, it happens, but let's just, like, enjoy each other."

Codie Sanchez 11:44 Mm-hmm.

Dr. Rena Malik 11:44 Let's, like, put the pressure off, like, oh, I have to have sex.

Codie Sanchez 11:47 Mm-hmm.

Dr. Rena Malik 11:47 Let's just want to appreciate each other. So those are things that I think you can work on as a relationship, but, but there are reasons, like I said, why libido declines. So in women, we know that libido declines, and one of the reasons is because of testosterone.

Codie Sanchez 12:00 Hmm.

Dr. Rena Malik 12:01 So testosterone in women, we have more testosterone than we do estrogen in our bodies. So we actually... And that is the hormone of desire.

Codie Sanchez 12:07 Hmm.

Dr. Rena Malik 12:07 And so we talk about... It's actually having a moment right now, testosterone. But we know that it declines, and it doesn't decline, like, in menopause, like abruptly, but it declines quite significantly. So you'll find that your testosterone starts declining, and that can affect your ability to have desire. And so that's one reason. And then so we have, you know, off-label ways to improve desire, and we have on-label ways in terms of medications. So we have two on-label medications for premenopausal women. Now, they work for postmenopausal women, they work for men, um, but they are just studied for that population. And so there's one which is a pill you take every night. It's called Addyi. You take it every night before bedtime. It, um, slowly increases your desire. So it's not like you're gonna take it and all of a sudden have

Dr. Rena Malik 12:49 a desire, but you might, like, be doing the dishes and a TV show comes on, and you're like, "Oh, that's kinda hot," and you never thought that before, right? And you're like, "Okay, I s- I feel myself coming back. I'm getting myself back. I feel like myself again." Um, and then another one is Vyleesi, which is an injection you give yourself 45 minutes before sex, b- before you want to want, basically, and it gives you a very sudden increase in desire. And both of these work on the brain.

Codie Sanchez 13:12 Hmm.

Dr. Rena Malik 13:12 So they try to increase the hormones of desire, 'cause there's, like, a balance, like a seesaw. So there's hormones that increase desire and hormones that don't, or signals, and so we're increasing some of the signals that do increase desire. And so those are a couple options. And then off-label, also, you can do testosterone replacement for women.

Codie Sanchez 13:28 Interesting.

Dr. Rena Malik 13:28 Yeah.

Codie Sanchez 13:29 How big is the population of men that struggle with erectile dysfunction?

Dr. Rena Malik 13:33 So 52% of men over 50.

Codie Sanchez 13:35 Wow. That's-

Dr. Rena Malik 13:35 And that goes up every decade, so 60% at 60, 70% at 70, 80% at 80.

Codie Sanchez 13:40 So it's really common.

Dr. Rena Malik 13:41 Mm-hmm.

Codie Sanchez 13:41 Does that mean at, like, 40 or 30 it's 30 and-

Dr. Rena Malik 13:44 It's a little bit less

Codie Sanchez 13:45 ... 40%?

Dr. Rena Malik 13:45 It's a little bit less, probably, like, 25% in your 40s, but it's-

Codie Sanchez 13:50 But that's one out of four

Dr. Rena Malik 13:51 ... it's a lot. It's... And so that's why some guy will be like, "Oh, I'm 40. This shouldn't be happening to me." And the thing about erectile dysfunction is it's like a, um... it's like an opportunity to find out what's going on with the patient. And a lot of times they come in, and the doctor's like, "Here's some Viagra. Bye." And but it's, like, a real opportunity, because of the guys who have ED, 14% of those guys will go on to have a heart attack in seven years.

Codie Sanchez 14:12 Wow.

Dr. Rena Malik 14:13 And because it's a early manifestation of problems with blood flow, and problems with blood flow often lead to heart problems.

Codie Sanchez 14:19 Oh.

Dr. Rena Malik 14:19 And so it's, like, two to three years before you're gonna see a heart issue, you're gonna see erectile dysfunction.

Codie Sanchez 14:25 So what do you do to fix it?

Dr. Rena Malik 14:27 So it's the same things. Anything that's good for your heart is good for your genitals, right?

Codie Sanchez 14:30 Huh.

Dr. Rena Malik 14:30 So if it's for blood flow, and that's 70% of the reason that people have ED is from blood flow. I mean, there's obviously psychogenic issues, like it's in your head, but I think every guy who has issues with erectile dysfunction has that, right? They're, like, stressed about it.

Codie Sanchez 14:42 Mm-hmm.

Dr. Rena Malik 14:42 But 70% of guys with ED, it's because of a blood flow issue. And so what you need to do is improve blood flow. So how do you do that? You do that with diet, with exercise-

Codie Sanchez 14:50 Mm-hmm

Dr. Rena Malik 14:50 ... improving your cholesterol, improving your blood pressure, um, and moving your body, exer- like, uh, cardiovascular exercise, 150 minutes a week, um, those sorts of things. So the things that are, like, not sexy.

Codie Sanchez 15:00 [laughs]

Dr. Rena Malik 15:01 Like, nobody wants to do them, but they're so important.

Codie Sanchez 15:03 So you could liter- instead of taking Viagra, the research shows that you could solve ED in 70% of cases by working out more and eating healthy.

Dr. Rena Malik 15:12 So there's actually a study that shows that if you exercise 150 minutes a week, cur- moderate intensity cardiovascular exercise, it's as good as taking a Viagra.

Codie Sanchez 15:22 That's wild, because that's, what, 25 minutes a day?

Dr. Rena Malik 15:24 Yeah.

Codie Sanchez 15:24 So-

Dr. Rena Malik 15:24 30 minutes a day. 30 minutes a day, five days a week.

Codie Sanchez 15:26 Oh, yeah.

Dr. Rena Malik 15:27 Yeah.

Codie Sanchez 15:27 Fascinating. So w- then, then why is Viagra given so much instead of that?

Dr. Rena Malik 15:35 I think 'cause our healthcare system is broken, right? You have 15 minutes to talk to a patient, so you have to get the information, do the exam, and then talk to the patient, so you're like, "Here's something that can help you." And because a lot of patients, that's what they want. They want a pill-

Codie Sanchez 15:47 Mm-hmm

Dr. Rena Malik 15:47 ... that's gonna fix their problem.

Codie Sanchez 15:48 Mm-hmm. Yeah, and it's... I think, uh, Dr. Tina, when I had her on the pod, which was a great episode, too, we didn't talk about sex, but she was talking about how, you know, it is every, uh, doctor has, like, their version of the hammer.

Dr. Rena Malik 16:00 Mm-hmm.

Codie Sanchez 16:00 Which is, like, you know, if you're a surgeon, um, you know, then that's gonna be your hammer. And you know, if, if you're a psychiatrist, then it's going to be pills. And so-

Dr. Rena Malik 16:08 Right

Codie Sanchez 16:08 ... it's like whatever is your biggest and hardest weapon is the one that you-

Dr. Rena Malik 16:11 And the one that works-

Codie Sanchez 16:12 ... resort to

Dr. Rena Malik 16:12 ... the most, right?

Codie Sanchez 16:13 Yeah.

Dr. Rena Malik 16:13 Because, like, exercise works, but it takes a long time.

Codie Sanchez 16:16 Mm-hmm.

Dr. Rena Malik 16:16 And you have to be consistent, and most people lose consistency.

Codie Sanchez 16:19 Mm-hmm.

Dr. Rena Malik 16:19 And we know that, right? For any behavior change-

Codie Sanchez 16:21 That's right

Dr. Rena Malik 16:21 ... it's very difficult to maintain.

Codie Sanchez 16:23 Yeah.

Dr. Rena Malik 16:23 And so the thing that's gonna be most effective is gonna be a medication for most people.

Codie Sanchez 16:26 Yeah, that's wild. But I had never thought about... So, so do you see very many men struggle with erectile dysfunction that are super fit?

Dr. Rena Malik 16:33 Yes, I do actually.

Codie Sanchez 16:35 So then what's going on there?

Dr. Rena Malik 16:36 Usually they have high cholesterol or they have high blood pressure.

Codie Sanchez 16:39 Mm-hmm.

Dr. Rena Malik 16:39 So they may have, um, family history that causes them to have high blood pressure, or their diet is affecting their cholesterol. And when you get deposits or atherosclerosis from high cholesterol, that affects blood flow.

Codie Sanchez 16:49 Interesting.

Dr. Rena Malik 16:50 And so they may not know it. They're, like, really fit. They're like the specimens of men, and their cholesterol's high, uh, because their... because of their diet or their genetics, and they then have issues with erectile dysfunction.

Codie Sanchez 17:01 'Cause you said something fascinating to me, which is that women who watch porn and read those, like, kind of romance fantasy novels actually might... it might increase our sex drive.

Dr. Rena Malik 17:10 Yeah, I think it de- so it depends on how good your sex is in general.

Codie Sanchez 17:14 Oh, interesting.

Dr. Rena Malik 17:14 So if you are dissatisfied with your partner and you're using these movies or books to escape and, like, in- uh, get pleasure for yourself, then it's not gonna lead to more intimacy because you're already having bad sex with your partner, right?

Codie Sanchez 17:28 Yeah.

Dr. Rena Malik 17:28 But whereas, like, you're in a good, healthy relationship, you enjoy your partner, and you're just using these as tools, right, to, like, enhance your pleasure so that when you're with your partner you're, like, really easily getting into the mindset of being able to be pleasured and to be focused and mindful-

Codie Sanchez 17:43 Hmm

Dr. Rena Malik 17:43 ... um, and enjoy. Whereas I think sometimes that's the hardest part for women, is that you can't get out of your own head, right? And we say that, but it's, there's data to it.

Codie Sanchez 17:51 Hmm.

Dr. Rena Malik 17:51 So, like, when you look at studies of, um... Lori Brotto is a researcher who did this study. They did 20 minutes of mindfulness, um, for women who were having low libido, 20 minutes of mindfulness outside of the bedroom every single day, and they saw that after, uh, I think it was six or eight weeks, they had significant improvements in all the domains of female sexual function: desire, arousal, libido, everything. And orgasm, everything. And a lot of those women, when they followed up with them a year later, many of them were still doing mindfulness because they had, and without being prompted, they were still doing it because they had so much benefit from it. Because being mindful outside of the bedroom helped them be more mindful in the bedroom.

Codie Sanchez 18:27 What does a mindfulness practice for sex look like?

Dr. Rena Malik 18:30 It's just, you know, sort of, I mean, there's different ways to do it, but generally think about, like, clearing your head and trying to focus on, you know, your breath and your body. And, you know, thoughts will come in, but sort of like-

Codie Sanchez 18:41 Yeah

Dr. Rena Malik 18:41 ... saying, "Okay, let that one go. Come back and focus," and sort of just training your brain to be able to focus on your body, what it feels like in space, your breath, those sorts of things.

Codie Sanchez 18:51 Oh, so str- it's not like visualizing sex. It's literally just straight up mindfulness practice.

Dr. Rena Malik 18:55 Just straight up mindfulness, yeah.

Codie Sanchez 18:56 Fas- so almost meditating could help you have a better sex life?

Dr. Rena Malik 18:59 Yeah, absolutely.

Codie Sanchez 19:00 Fascinating. I had no idea.

Dr. Rena Malik 19:02 Yeah.

Codie Sanchez 19:02 But I guess it ki- does make sense though for women because we're always thinking about something else.

Dr. Rena Malik 19:05 Yeah, I mean, you could think about it, right, even like doing a podcast. Like, we have long conversations with people, so we're better at listening for long periods of time-

Codie Sanchez 19:12 Yeah

Dr. Rena Malik 19:12 ... because we've trained ourselves to do that, whereas someone else may not be able to listen to somebody for two hours, right?

Codie Sanchez 19:17 You know, and we talked a little bit about porn for women, but let's talk about porn for men.

Dr. Rena Malik 19:21 Mm-hmm.

Codie Sanchez 19:22 Um, I've heard lots of negative things about porn. Is porn bad to watch?

Dr. Rena Malik 19:28 Yeah, so I think that, that there are, um, I think there's a few... Like, it's, it's a very complex and nuanced discussion. So I think porn has been around for a long, long time, right?

Codie Sanchez 19:37 Mm-hmm.

Dr. Rena Malik 19:37 It's not new. Porn has been around for a long time, but it's never been as accessible as it is today.

Codie Sanchez 19:42 No.

Dr. Rena Malik 19:42 It's in our pockets. It's everywhere you go. You can literally pull up a porn video for free anytime, and so that's a problem because people will use it as an escape from, like, distressing emotions. So it's like why are you using porn? There's actually studies that look at, like, what are, why do people use it? So people use it for pleasure. People use it for learning new skills. People use it to, um, to h- like, escape. People use it to avoid negative feelings.

Codie Sanchez 20:09 Hmm.

Dr. Rena Malik 20:09 And that's where it becomes a problem, right? You use it, um, for negative feelings, and then you might f- and if you have some, you know, moral incongruence, like you feel shame because of using it because of the way you were raised or because of what society tells you, and then you feel more bad feelings, and then you use it again, and then you have more bad feelings, and it becomes this vicious cycle.

Codie Sanchez 20:27 Hmm.

Dr. Rena Malik 20:27 And so that's where it becomes a problem. But there's many, many people... I mean, like, I think realistically a- 90-plus percent of the population has watched pornography at some point in their lifetime, and most people just use it as a tool to have pleasure, to enjoy, to entertain, right?

Codie Sanchez 20:42 Yeah.

Dr. Rena Malik 20:42 And in those cases, people tend to do fine. It's when it becomes this, like, moral incongruence and this shameful spiral where people start really having a problem with it, and then it starts being like, "Oh, I'd rather watch porn than hang out with people because that gives me distress," or, "I'd rather watch porn than hang out with you or, or get rejected from my partner because I don't have to work at that," right? And so they start using it as a, not as a tool for pleasure or enjoyment but as a tool for escaping life.

Codie Sanchez 21:07 So a- are there, are there studies that show the more porn you watch, the less sex you have?

Dr. Rena Malik 21:12 Not necessarily. So, um, it really de- it's not necessarily always correlated with the amount. So if you have, let's say, a moral incongruence, even if you watch porn once a year, you might be very distressed by it, right?

Codie Sanchez 21:23 Hmm.

Dr. Rena Malik 21:23 Whereas somebody could watch porn every day and, like, just use it as a tool, and they watch it with their partner.

Codie Sanchez 21:28 Yeah.

Dr. Rena Malik 21:28 And actually, couples who watch it together tend to have more sex.

Codie Sanchez 21:31 Hmm.

Dr. Rena Malik 21:32 Um, and couples who have the same sort of consumption patterns, so say your partner watches it three times a week and you watch it separately three times a week, they show that those couples tend to have more sex.

Codie Sanchez 21:41 Huh.

Dr. Rena Malik 21:41 Because they're, they both have similar, like, thoughts and ideas about s- I mean, I- I'm extrapolating, but, like, probably because they have similar ideas or they're more aroused together, whatever the case is. Um, and whereas when there's this, like, dichotomy where someone's using it a lot and someone's not, that's usually where we see more problems.

Codie Sanchez 21:56 If you're married and your partner is using porn instead of having sex with you, which seems to be like this is something people are talking about.

Dr. Rena Malik 22:04 Mm-hmm.

Codie Sanchez 22:04 Like, we're not having as much sex as I want, but my husband's watching porn or vice versa. Um, what do you do in that instance? And is that bad or good?

Dr. Rena Malik 22:13 Yeah, so this is a relationship issue, right? So if they're watching porn and they are, like, rejecting you for sex, that's a problem, right? That's a sign that... It's a red flag, right? That's a problem.

Codie Sanchez 22:23 Mm-hmm.

Dr. Rena Malik 22:23 Whereas if they're watching porn and they initiate with you and you, like, don't want to all the time, they're also humans, right? So they're like, "You keep rejecting me, and I still wanna have pleasure, so I'm gonna go somewhere else and get that pleasure, uh, without cheating on you," right?

Codie Sanchez 22:35 Yeah.

Dr. Rena Malik 22:35 Like, I might, like, use a v- a m- a movie. And, um, and so I think there's this balance, but I think really it's a relationship issue. It's like why is this happening? It's not like... It's, it's... Porn becomes a scapegoat, but why is this happening? Like, why? Like, is there truly just a problem that you have individually with the porn, or is there a relationship issue that we need to uncover?

Codie Sanchez 22:53 Hmm. So I wanna break down two things. So one is let's say that you're not having the amount of sex you ha- you wanna have right now in a relationship. What are a couple of things you could do today to change that? Um, you've given some pill examples, but what else, like practice wise, would you say this could work?

Dr. Rena Malik 23:10 So first and foremost, talk to your partner. Like, stop thinking about yourself. Like, actually sit down and be like, "Hey, I wanna talk to you about sex." It doesn't have to be in that moment. Give them a heads up because, look, no one knows how to talk about sex. It's very uncomfortable, right? I talk about it all the time, but, like, I, I know when I talk to people and I, like, they, I can feel them getting uncomfortable, right? And so I think it's like you have to give people a heads up and realize, like, your, their response might be like, "Oh, hell no."

Codie Sanchez 23:35 Yeah.

Dr. Rena Malik 23:35 Like, "What does this mean something's bad? Am I, is something wrong with me? Am I not pleasing you?" Or whatever, right? And so I think first give them a heads up. Then, like, be like, "Hey, I'd love to just, I just wanna talk about our sex life. Like, I think we are great, and I just wanna make it better potentially." And start with the good, right? Like, and ideally tell... I tell people, like, don't do it looking them face, face to face. Maybe go on a walk, maybe in the car. So, like, if the first time you're having a conversation, and just start by finding like what turns you on. And that's a great way to even with your, a new partner, what turns you on?

Codie Sanchez 24:05 Hmm.

Dr. Rena Malik 24:06 Like, what, what do you like, you know? And this is what I like. And like, "Oh, that's great," and like, "Do you like this?" Like, and it could be non-verbal when you're with them if it's a new partner, right? Like, um, you know, like You hear them, uh, responding in a certain way, that means they like it. And that's why I don't like faking, right?

Codie Sanchez 24:21 Mm.

Dr. Rena Malik 24:22 Like, don't fake. Like, tell... Like, when you like something, you will automatically make the noises they wanna hear, right? [laughs] Like, you don't need to fake it. Um, but so yeah, I would say that's first and foremost is start the conversation. It is not gonna be one conversation. It's gonna be an evolving, long time, every t- like, every so often you're gonna have to sit down and talk about it, like what works, what doesn't.

Codie Sanchez 24:43 Yeah.

Dr. Rena Malik 24:43 And, and I think the other thing is, like, adding novelty, right? So we think about, like, it's good to have a routine, a comfort, like, "Oh, this always works. We both, like, enjoy it. We both climax," whatever it is. But like, it gets... Y- you know, if you're eating dinner, you don't wanna eat chicken every day, right? So some days you wanna have a steak or you wanna have tofu or, like, whatever, right? And so it's like you wanna change it up, and the same thing goes for sex. So it doesn't even have to be that crazy. Like, it might be doing it on a different side of the bed-

Codie Sanchez 25:10 Yeah

Dr. Rena Malik 25:10 ... or, like, in the kitchen instead of the bedroom. Um, or you could buy stuff. Like, you could buy things to just play with and have fun. Again, sex is supposed to be play. It shouldn't be that serious. So, like, just be open and be playful and enjoy, and I think you will find that just incorporating these small things can make a huge difference.

Codie Sanchez 25:28 Is it ever possible in relationships for it to just stay spontaneous forever, or is that just something we are telling ourselves that is a- another way for us to beat ourselves up? That we read these romance novels-

Dr. Rena Malik 25:39 [laughs]

Codie Sanchez 25:39 ... which are like women's form of porn, I think-

Dr. Rena Malik 25:41 Yes

Codie Sanchez 25:41 ... these days.

Dr. Rena Malik 25:42 Yeah.

Codie Sanchez 25:42 And it's like all of a sudden the hulk's picking up the woman every seven seconds. They're having sex everywhere. The sex is glorious. She has to do nothing. Um, you know, it's, it's totally blissful. Um, and then we should have that for the 50 years that we're married. Like, is that reasonable, or is it totally unreasonable to think that you won't have to plan sex as you get older?

Dr. Rena Malik 26:02 I would say that it's likely unreasonable to think that, right? I mean, I can't say there's not people. I mean, there's certainly people who are more sexual. And like, say you are reading those books, like, that means you're probably gonna be more into your partner.

Codie Sanchez 26:13 Yeah.

Dr. Rena Malik 26:13 So there's data that, like, women who watch pornography, and this is not, like, everybody, but, like, women who enjoy those sorts of things are more sexually adventurous, more, you know, they like to have sex with their partner, and they actually have more sex if you look at the amount of time they have sex with their partner. So, um, so there is, like, you know, if you are, you know, potentially consuming things together as a couple or you, but, or you, that's naturally the kind of person you are, then yes, absolutely. If your partner's also that way, it's possible. But I would say most times you have to work at it because life is ever-evolving, right? Like, your priorities are not the same at all times in your life. Imagine yourself 10 years ago, very different than where you're sitting right now, and it'll be very different 10 years from now. And so, you know, it, it takes work. And I think the h- thing is people are so afraid to work at sex.

Codie Sanchez 27:01 Yeah.

Dr. Rena Malik 27:01 Like, "Why should I have to work at sex?"

Codie Sanchez 27:02 Right.

Dr. Rena Malik 27:03 Right? It's a natural thing. But guess what? You had to learn every- you had to learn how to walk. Like, you have to learn how to get good at sex, and it doesn't just happen. You're not just gonna be good at it because you're good-looking or because you have a large organ or because-

Codie Sanchez 27:15 [laughs]

Dr. Rena Malik 27:15 ... like, whatever. It's not gonna just make you good at sex, right? And so you have to learn, you have to practice, and you have to learn with your partner if you're in a relationship, right? Like, what do they like? Everyone's not exactly the same. And so yes, there's things that work for m- many, many people, but, um, it's about finding out what they like and really, like, identifying that and playing. Sex is supposed to be playful.

Codie Sanchez 27:36 Is the G-spot real?

Dr. Rena Malik 27:37 Yeah. The G-spot is a zone, actually. It's not a spot. And I think people are like, "Where is it? What is it?" Like, "Is it a button you have to find it?" Like, no, it's just an area, right? [laughs] So it's, like, the top of the vagina-

Codie Sanchez 27:47 Yeah

Dr. Rena Malik 27:47 ... and it's about two to three centimeters in. That's where it's very densely innervated. Um, there's an area called the Skene's glands which also have s- innervation there, and so that can be very pleasurable. But what I tell most people, like, "Oh, if I stimulate that area, they're gonna orgasm." But a G-spot in a female is the same as the prostate in the male. And so while some guys like prostate play, not everyone does, and not everyone orgasms from prostate play. And so the same thing goes for women. And I think the, the other thing is, like, there's variations in anatomy. So in the G-zone, there's also, like, the clitoral bodies which people also don't realize. It's not just the glands, the little head that you see on the outside. It actually goes deep into the pelvis. And so, and it curves downward just like the male penis does. And so there's a shaft, basically, but it's internal.

Codie Sanchez 28:30 Mm-hmm.

Dr. Rena Malik 28:31 And so when you're stimulating the G-zone, you're also stimulating the clitoral shaft.

Codie Sanchez 28:35 Yeah.

Dr. Rena Malik 28:35 And so for some people, where there's maybe some, um, the, the, the width of that area or, like, the, the volume in that area is different, you might get more clitoral stimulation through vaginal penetration. And so those people may orgasm more easily through vaginal penetration, um, whereas others will not. It's just an anatomic difference.

Codie Sanchez 28:52 Yeah.

Dr. Rena Malik 28:52 Like, it's not a big deal, but there's other ways to stimulate a partner and really get them to climax. And what does it matter if it's not your penis doing it? It's you doing it. That's what matters.

Codie Sanchez 29:00 Wh- why did... Where did we get this belief that women come every single time from, uh, penetration?

Dr. Rena Malik 29:08 Well-

Codie Sanchez 29:09 Like, why is that so pervasive?

Dr. Rena Malik 29:10 Yeah. I, I mean, I, I can't say where it started, but I can tell you that, like, it's, like, think about every movie you watch where there's a sex scene. It is literally, there's... Like, I, I can't remember. The first time I saw, like, clitoral stimulation in a mainstream TV show or movie was, like, Sex Life, that show on Netflix, right?

Codie Sanchez 29:26 Yeah, you're right.

Dr. Rena Malik 29:27 I don't think I saw it ever before that. Like, on Sex and the City, I don't remember anyone, like, except for talking about vibrators, I don't remember them ever doing anything besides penetrative sex.

Codie Sanchez 29:35 You're so right.

Dr. Rena Malik 29:36 Right?

Codie Sanchez 29:36 Yeah.

Dr. Rena Malik 29:36 So it was always depicted as penetrative sex, and that's what gets people off. And so I can imagine that, like, okay, then women are like, "Hey, I'm having penetrative sex. I'm not orgasming. Maybe I need a bigger penis."

Codie Sanchez 29:48 [laughs]

Dr. Rena Malik 29:48 "Like, maybe that's the answer. Like, I don't know."

Codie Sanchez 29:50 Yeah.

Dr. Rena Malik 29:50 Right? They don't know 'cause no one taught them.

Codie Sanchez 29:52 Yeah.

Dr. Rena Malik 29:52 And so they're like, "Maybe bigger will be better. Maybe girthier will be better." Well, girthier might be a little better because you're having more pressure on the, on the, uh, s- shaft of the clitoris. But like, yeah, so what, like, what exactly is... You know? So I think it's, one, there's no education. Two, it was never shown to us. And three, there's always been this obsession with, like, penile size. Like, my kids are, like, 9 and 11. Well, my 11-year-old will talk about his penis.

Codie Sanchez 30:15 [laughs]

Dr. Rena Malik 30:16 ... everything at home 'cause I'm his mom, but like, [laughs] you know, like, I'm like, "Dude, like, you haven't gone through puberty. Like, chill," you know? [laughs]

Codie Sanchez 30:24 [laughs]

Dr. Rena Malik 30:24 You know.

Codie Sanchez 30:24 Hope- but that, like-

Dr. Rena Malik 30:25 Hopefully he never listens to this podcast. [laughs]

Codie Sanchez 30:27 Yeah, exactly. Well, or finds your YouTube channel.

Dr. Rena Malik 30:29 [laughs]

Codie Sanchez 30:30 So, like, let's talk about that because I think there's also a lot of commentary about what's normal in penis size.

Dr. Rena Malik 30:38 Mm-hmm.

Codie Sanchez 30:38 What is actually normal?

Dr. Rena Malik 30:40 It's about 5.3 to 5.7 inches erect, so not huge. Um, not like what we think is average, right? Everyone's like, "Oh, um, you know, 12" ... I want a 12... Like, 12? Do you know how big 12 inches is?

Codie Sanchez 30:52 Opt out. Unsubscribe.

Dr. Rena Malik 30:53 [laughs]

Codie Sanchez 30:53 No, thank you. Absolutely not.

Dr. Rena Malik 30:56 Like, no. That's not... And so when you look at the average people are gonna range between, like, 5 to 5.7 inches s- er, fully erect. And so, you know, that is average. And then when you look at, like, the, the bell curve, like, most people fall into that category. And when you start going to, like, seven and a half to eight inches, that's, like, the top 5%, and, like, they're probably all, like, you know,

Dr. Rena Malik 31:17 porn stars. Um. [laughs]

Codie Sanchez 31:18 [laughs]

Dr. Rena Malik 31:19 But no, not, not exactly, but, you know, a lot of them are. And so, you know, I think it's just, like, what we see, right? People see, like, people who are in erotic films, and they're, you have very large organs, and they're using, like, camera tricks and all this stuff to make it look bigger. And, um, and so they're like, "Oh, that's gotta be what's normal."

Codie Sanchez 31:35 So many brands are obsessed with new customers, but the best brands, they know retention is where the margin lives. And Omnisend is retention in a box. You get abandoned cart flows, thank you sequences, review requests, re-engagement messages all automated. Email and SMS are triggered by actual customer behavior, so if someone buys, hit them with an upsell. Someone ghosts, win them back before they're gone for good. You don't even have to write the sequences. They've got the templates that just work. The ROI is real, and it keeps getting better the longer it runs. Acquisition gets the glory, but retention builds the empire. Omnisend makes sure your business stops leaking customers and starts compounding them. Is it true, and are there studies that show that young men watching increasingly more porn-

Dr. Rena Malik 32:19 Mm-hmm

Codie Sanchez 32:19 ... um, have problems later on in life, and what are those problems? Is that happening to our younger generation? What's going on there?

Dr. Rena Malik 32:26 Yeah, so it's hard to study, but I definitely think there is. So what's happening is that this is how young men are learning about sex. They don't learn anything in school. There's only 22 states in the United States that are required to have accurate sexual education in school.

Codie Sanchez 32:39 Interesting.

Dr. Rena Malik 32:40 So th- you might have sexual education. It might be accurate, it might not. [laughs] And usually it's just how to put on a condom, how to get consent, and that's pretty much most of it, right? You're not gonna have a lot of, like, this is what happens when you get aroused. This is what happens when you have sex. This is what happens to the female body when it gets aroused. Like, there's no discussion about that, right? And so people don't know. And their parents are also just, like, talking about, like, being safe, safe sex.

Codie Sanchez 33:03 Yeah.

Dr. Rena Malik 33:03 It's usually very instructional, right?

Codie Sanchez 33:05 Right.

Dr. Rena Malik 33:05 Like, or not instructional. It's usually very, like, abstinence or safety based.

Codie Sanchez 33:09 Right.

Dr. Rena Malik 33:09 Now they're like, "How do I, how do I? I need instructions," so then I go to porn, right? Because I don't have anywhere else to learn this. I can't ask my parents. How could I ask them, right? And, um, and they've... That would be so weird. And so, like, we don't ta- and parents are like, "Well, they should be learning that at school." And so I always say, like, you as a parent have to talk to your kid about sex. You have to. It is your job. Like, you just have to teach them because that is your job. You are the adult. Get over it. Like, talk to them about sex and talk to them about porn because what happens is they're gonna come across it. You can put all the blockers you want. The average age of a young person seeing porn is 10.

Codie Sanchez 33:41 Whoa.

Dr. Rena Malik 33:41 10.

Codie Sanchez 33:42 Wow.

Dr. Rena Malik 33:43 So before 10, you should talk to your kid about porn because what if they come across something on their friend's phone or wherever and they're like, "What is this?"

Codie Sanchez 33:51 And they're stimulated and then they're confused.

Dr. Rena Malik 33:52 They're stimulated, they're confused, and then so they, they watch it maybe even a few times, who knows what, right? And then they have sex the first time, and they're like, "Oh, this didn't go like the movie did," right? "She didn't respond the way," or, "He didn't respond the way that that happened, so is something wrong with me? Am I broken? Now I'm stressed, and the next time I try to have sex, that stress is either making it difficult for me as a man to get an erection or as a woman to get aroused because I'm like, 'What's wrong with me? What's wrong with me? What's wrong with me?'" I'm thinking like, "I'm so stressed about it that I can't function." And now I'm like, "I'm broken. I'm truly broken. Something is wrong with me. And oh, but I can't go to a doctor because... Or when I do go to the doctor, I get dismissed because unfortunately they're just, 'Oh, it's all in your head,'" right? And-

Codie Sanchez 34:33 Right

Dr. Rena Malik 34:33 ... and so, uh, because, you know, you see a young person, everything should be fine with you. Your blood flow, everything should be fine, so it's gotta be psychogenic. And so they get dismissed. No one has the conversation, like, why it might be in your head. And then you're like, "Okay, now I'm, I'm just broken. And, and, and, and porn ruined me," or, "Whatever ruined me." And yeah, part of it is, like, should 10-year-olds be watching porn? No. You know? [laughs] Like, I think equivocally everyone can agree that that should not be the case, that you should not be watching porn until you are an adult and you can c- separate fantasy from reality.

Codie Sanchez 35:04 Yeah. But it's what would that even look like? Like, do you think parents should teach their kids, like, not just about sex. It's so fasc- I've only ever gotten the safety talk.

Dr. Rena Malik 35:15 Mm-hmm.

Codie Sanchez 35:15 I got the, you know, here's what happens.

Dr. Rena Malik 35:17 Mm-hmm.

Codie Sanchez 35:17 Boy meets girl. Don't get pregnant. Uh-

Dr. Rena Malik 35:20 Use a condom. Yep

Codie Sanchez 35:20 ... use a condom. This is what it looks like if you have a baby. Oh my God, that's so scary.

Dr. Rena Malik 35:24 Yeah.

Codie Sanchez 35:24 Um, but I never got the here's what good sex feels like.

Dr. Rena Malik 35:28 Mm-hmm.

Codie Sanchez 35:28 Or, like, what would that even look like?

Dr. Rena Malik 35:30 Yeah, so I think it-

Codie Sanchez 35:31 What do you do with your kids?

Dr. Rena Malik 35:31 Yeah, so I, I don't start with, like, let's talk about s- Like, first we teach obviously, like, what are your body parts?

Codie Sanchez 35:37 Okay.

Dr. Rena Malik 35:37 And how does sex work? And what happens during sex? And why is, like... So, like, you start with... So I have boys. I can tell you for boys what I do. So okay, they get an erection, and they're like, "Mommy, why is it getting bigger?" And, and most parents are like, "Oh my God, it's just-

Codie Sanchez 35:50 Panic

Dr. Rena Malik 35:50 ... it's nothing," right?

Codie Sanchez 35:51 Yeah. [laughs]

Dr. Rena Malik 35:51 And so sometimes you do panic. Like, I remember the first time my son asked me about sex, and I said, "Okay, give me a minute. Let me think about how I'm gonna answer you. I'll tell you later." Right? 'Cause I was like, I hadn't thought it through yet. And so even me, who teaches-

Codie Sanchez 36:03 Yeah

Dr. Rena Malik 36:03 ... about sex was like, I hadn't thought about how to talk to my son about it. So I said, "Okay, let me think about it." And so then I came back to him and I said, "Okay, well, you know," so we'd already talked about erections because you, they get them. They get spontaneous erections all the time, young boys. And so I'm like, "Okay, this is normal. This is what happens. It's because there's more blood flow there. And, um, it's a totally normal thing." And so they're like, "Oh, okay, it's normal." I'm like, "Yeah, sometimes it feels tingly or it feels different or it feels, you know, that's normal. Completely normal. Nothing bad is happening to you."

Codie Sanchez 36:28 Yeah.

Dr. Rena Malik 36:28 I reassure them, right? And then, you know, when they ask, "Well, what is sex?" Then I'm like, "Okay, well, that's what happens," and I'd obviously preface it with, like, you only do it with someone that you're, you know, so your, whatever your personal values are.

Codie Sanchez 36:39 Yeah.

Dr. Rena Malik 36:39 You bring that into the conversation. And then You know, you be safe about it. But I was like, I tell them the basics. Like, you know, you, you know how you get an erection. Well, you know, when your partner is aroused and they also get, um, lubricated and, and then you insert the penis in the vagina, right? And like [laughs] so they'll, they're like, "Okay?"

Codie Sanchez 36:55 [laughs]

Dr. Rena Malik 36:56 And I'm like, "Look, I know this is a lot. Like, ask me questions."

Codie Sanchez 37:00 Yeah.

Dr. Rena Malik 37:00 And so I let them... 'Cause sometimes you can't think like a kid. You can't, like, think what they're thinking. So then you say, "Well, what do you wanna know about it?" Like, even if you don't wanna just go into the whole, like-

Codie Sanchez 37:08 Yeah

Dr. Rena Malik 37:08 ... semantics. Like, what, what are you curious about? Like, what do you wanna know? And, and so just answer the best you can. And even if you're a little awkward or you're uncomfortable, like, they don't really know that. They just know that you're talking to them and you're their parent, right?

Codie Sanchez 37:22 Yeah.

Dr. Rena Malik 37:22 I mean, think about when you were a kid, like, your parents, you thought they were amazing. You were like, "They just do everything." Like, I- you never thought that they were insecure or, like, awkward.

Codie Sanchez 37:30 No.

Dr. Rena Malik 37:30 You were just like, "Oh, they're just perfect. Like, they're my parents." And I mean, most people have a good relationship. But like, um, so I think, you know, it's just, like, ask and then leave the door open.

Codie Sanchez 37:38 Yeah.

Dr. Rena Malik 37:38 So, like, talking about porn is really awkward, but what I would say is like, "Hey, you might come across some videos where you see people having sex," because we already talked about sex, right? "And, and they might be confusing to you. So if you do, just come talk to me."

Codie Sanchez 37:51 Yeah.

Dr. Rena Malik 37:51 Like, I want you to be able, comfortable, and you build that relationship with them where they can talk to you about it.

Codie Sanchez 37:55 Yeah, it's so true. I mean, God, what a difference it would be in even, like, our generation if we had also learned what, what it was s- not supposed to feel like is the right word, but, like, I can only imagine if my mom had been like, "This is the clitoris." Like, I don't think I knew what that, I-

Dr. Rena Malik 38:10 Mm-hmm

Codie Sanchez 38:11 ... what that was until I was, like, 25.

Dr. Rena Malik 38:12 Yeah.

Codie Sanchez 38:12 You know?

Dr. Rena Malik 38:12 I mean, med students don't know what it is, right?

Codie Sanchez 38:14 [laughs]

Dr. Rena Malik 38:14 Like, I, I have medical students putting catheters for women.

Codie Sanchez 38:17 Yeah.

Dr. Rena Malik 38:17 I'm a urologist, and so we would teach them how to put it in, and so many would, like, go towards the clitoris. I'm like, "Nope. Down. The urethra is lower."

Codie Sanchez 38:23 [laughs] Right.

Dr. Rena Malik 38:24 [laughs] That's the clitoris. And so, you know, and even in our training, there's very little discussion about the clitoris. We're s- now starting to have this discussion, like, hey, the clitoris has foreskin. Hey, it can get smegma. It can, there's other issues. You have to look at the clitoris, and you have to examine the clitoris because other- what if there's a problem there? What if there's a pathology there? And so it's, um, it's like even people who are doing these genital exams, like your gynecologist and your urologist, are not getting really trained on it.

Codie Sanchez 38:52 Right. And where do you go if people wanna get better at sex? So say they actually wanna learn how to have sex better-

Dr. Rena Malik 38:59 Mm-hmm

Codie Sanchez 38:59 ... and they wanna know themselves better too.

Dr. Rena Malik 39:01 Yeah.

Codie Sanchez 39:01 Like, what do you tell them?

Dr. Rena Malik 39:02 Well, I tell people you have to explore, right?

Codie Sanchez 39:04 Yeah.

Dr. Rena Malik 39:04 So, like, I, I would say getting better with sex is one with yourself and one with a partner. So explore by yourself, understand, like, what happens when you touch certain areas, or what areas do you like to have touched? And, like, sometimes that's very uncomfortable for people. Like, you have to sort of meet people where they are.

Codie Sanchez 39:19 Yeah.

Dr. Rena Malik 39:19 So if they're not comfortable with that, then there's other ways. But, like, I would say that's one way.

Codie Sanchez 39:22 Do you give them a book? Do you say, like, "I like these books," or no?

Dr. Rena Malik 39:25 Not necessarily. I think that innately people, like, kids, n- like, you know, kids will, like, touch themselves. Like, they know, you know inherently what feels good.

Codie Sanchez 39:34 What you like.

Dr. Rena Malik 39:34 Right?

Codie Sanchez 39:34 Yeah.

Dr. Rena Malik 39:35 And they're not doing it because they, like, wanna feel pleasure. They're doing it 'cause they think it soothes them, right?

Codie Sanchez 39:39 Yeah.

Dr. Rena Malik 39:39 They don't know. They're like, "It soothes me," right? And so, um, people generally know, and so it's like, you know, giving them permission.

Codie Sanchez 39:45 Yeah.

Dr. Rena Malik 39:45 Like, it's okay to explore your own body. It's your body, right?

Codie Sanchez 39:48 Mm-hmm.

Dr. Rena Malik 39:48 You're allowed to understand what you like and don't like. Like, I think it's very different for boys and girls.

Dr. Rena Malik 39:53 Like, boys, they, they figure it out very easily.

Codie Sanchez 39:55 They really do.

Dr. Rena Malik 39:55 And, and they're, they're, they're going at it, right? And no one ever even questions it. Like, oh, he's probably just jerking off in his room, right?

Codie Sanchez 40:01 [laughs]

Dr. Rena Malik 40:02 Like, it's like [laughs] it's like, okay. And, and that's g- fine. No one ever says, um, like, "Oh, you shouldn't..." I mean, so maybe they do say you shouldn't do that, but, like, people just do it, right?

Codie Sanchez 40:10 Yeah.

Dr. Rena Malik 40:10 And then they're like, "Oh, just don't do it in front of people."

Codie Sanchez 40:12 Yeah. [laughs] Exactly.

Dr. Rena Malik 40:14 Right? Don't do it in the living room. [laughs]

Codie Sanchez 40:16 [laughs]

Dr. Rena Malik 40:17 Like, but it's, it's like, you know, it is something, though, that we do cloud in shame, so you'll be like, "Oh my God, don't do that." Like-

Codie Sanchez 40:22 Right

Dr. Rena Malik 40:22 ... that's another way. Like, don't react to your kids. Just be like, "Hey, this is, you know, it's fine to do this, but, like, you should do this in privacy."

Codie Sanchez 40:29 Right.

Dr. Rena Malik 40:29 "This is something we do privately."

Codie Sanchez 40:30 Right.

Dr. Rena Malik 40:31 Um, because that also internalizes the shame around sex very early on. Now, for women, it's like, it's never, I mean, it's not as obvious, and it's not as intuitive, and there's a lot more, like, be a good girl, don't do this, don't... Like, and so there's a lot less, like, openness. So it's also, like, starting at a young age, like, hey, like, this is your body. This is your anatomy. This is, you know, what sex is. This is what pleasure is. Like, tau- teaching our girls that. And then, um, I think, you know, again, f- meeting people where they are, talk to your partner, explore. So one thing that we do often when people are really in their heads about sex is, like, the sex therapist will prescribe something called sensate focus. So what that is, is we say you're not allowed to penetrate. You're not even allowed to touch the genitals. You, when you're with your partner, want to explore other areas. Find your erogenous zones. Touch everywhere, but don't touch the genitals. And start really just in, like, there's no stress about that, right? You don't have to perform. Nothing has to happen. Like, but just touch each other and feel sensual and enjoy each other, and figure out what feels good. And once you're, like, in your head, and you're like, oh, wow, this is great, I'm enjoying it, then you start touching genitals. And then you're like, okay, now I'm not stressed about that either. Then we start talking about penetrative sex.

Codie Sanchez 41:35 Mm-hmm.

Dr. Rena Malik 41:35 And so sort of a way to just work together, and if you're like, "I don't know what I like," like, you know, it's hard to admit that. It's hard to admit that.

Codie Sanchez 41:42 Yeah.

Dr. Rena Malik 41:42 And so to be like, to say to your partner, like, "I don't really know, and, like, I'd love for us to figure it out together."

Codie Sanchez 41:47 And a lot of this stuff about sex seems like it's really about your health-

Dr. Rena Malik 41:51 Mm-hmm

Codie Sanchez 41:51 ... overall, uh, like entire bodily health, not just genital health, and then simultaneously relationship or mental.

Dr. Rena Malik 41:57 Yeah.

Codie Sanchez 41:57 It's like we keep treating this one area-

Dr. Rena Malik 42:00 [laughs] Everything

Codie Sanchez 42:01 ... but it's actually just a symptom of the human.

Dr. Rena Malik 42:03 Yeah, absolutely. I mean, it's, i- if you, like, it's such a good biomarker of health, your ability to have sex, so to have desire, to get aroused, to climax, and to feel good at the end of it all. All those things should be intact, right? And when there's a problem with one of them, it tells us, hey, is there a blood flow problem? Is there a hormonal problem? Is there a mental problem? Is there a neurologic problem? Is there something that you're taking that's affecting your sexual function?

Codie Sanchez 42:29 Right.

Dr. Rena Malik 42:29 And so we gotta investigate all those things, and I can't tell you, like, this is one of the greatest ways to find out if something is wrong with you metabolically in your body, right?

Codie Sanchez 42:38 Mm-hmm.

Dr. Rena Malik 42:38 Because it's sign that something is awry, and we need to investigate, and oftentimes it's a metabolic cause, um, for men and women, right? Like, it, there's prob- like, I can tell you that women with diabetes have less, um, arousal and, and often have less, have more issues with libido.

Codie Sanchez 42:55 Hmm. Yeah. But, and then so overall, do you think- It, the, the data seems to say, are we having less sex-

Dr. Rena Malik 43:03 Absolutely

Codie Sanchez 43:03 ... than ever before?

Dr. Rena Malik 43:04 Absolutely.

Codie Sanchez 43:05 So across the country, what's sort of happening?

Dr. Rena Malik 43:07 I mean, there's so many things that I could speculate on. One is I think that, like, we have phones, right?

Codie Sanchez 43:13 Mm-hmm.

Dr. Rena Malik 43:13 So, like, in the bed before going to sleep, or, like, when you're bored, you look at your phone. But before sometimes you'd be bored, and you're like, "Hey, my partner's next to me. Like, I'll just have sex with them. Like, why not?" Right? Or they'd initiate, and you wouldn't be like, "Hey, leave me alone. I gotta look at my sudoku," or whatever. [laughs]

Codie Sanchez 43:27 Yeah.

Dr. Rena Malik 43:27 Whatever you're doing, right? Um, and, and now, like, you have something else that's constantly taking your attention away. So I think that's one. Two is that the stressors are so much higher, right?

Codie Sanchez 43:37 Mm-hmm.

Dr. Rena Malik 43:37 Like, uh, I think the w- the world has changed.

Codie Sanchez 43:40 Mm-hmm.

Dr. Rena Malik 43:40 The economic landscape has changed. Like, it's more difficult to financially, like, own a home. There's just so many different things, right? So I think that there's more stressors in life.

Codie Sanchez 43:48 Yeah.

Dr. Rena Malik 43:48 Um, and I think that those... And there's more expectations from people. Like, we're much more individualized, and so, like, when, you know, like in India, for example, it's much more a community feel. So, like, everyone raises the kids. Everyone takes care of the kids. Everyone helps each other, and so you have, like, more people to help you, whereas now we just, like, are an island to ourselves.

Codie Sanchez 44:06 Yeah.

Dr. Rena Malik 44:07 Mm-hmm.

Codie Sanchez 44:07 Yeah, you know, it's interesting because, um, I, we, we talk a lot about things that could progress society, you know-

Dr. Rena Malik 44:14 Mm-hmm

Codie Sanchez 44:14 ... forward, and at the end of the day, it sort of feels like there's been this kind of continuous attack on the nuclear family. N- not saying that in some conspiratorial way, just like so many things that have been created have sort of torn apart this nuclear family. And so I think it's so important to talk about sex because that's where life comes from, you know?

Dr. Rena Malik 44:31 Yeah.

Codie Sanchez 44:31 And, and for whatever reason, what did our parents always say? Don't talk about religion, sex, and politics, and money, right?

Dr. Rena Malik 44:39 Yeah. [laughs]

Codie Sanchez 44:39 And I, I, m- for the life of me, I can't understand why you wouldn't talk about money. I can't understand why you wouldn't talk about faith in a positive way.

Dr. Rena Malik 44:46 Mm-hmm.

Codie Sanchez 44:46 I can't understand why you wouldn't talk about sex in a non-shameful, you know, um, inappropriate way.

Dr. Rena Malik 44:52 Mm-hmm.

Codie Sanchez 44:52 Um, and so it, it does feel like there's kind of like this resurgence of people willing to talk about it, so I'm really glad that you do.

Dr. Rena Malik 44:57 Thank you.

Codie Sanchez 44:57 Because yeah, I mean, it's... And it's, it's hard to do it in a way that is both entertaining and also super informative.

Dr. Rena Malik 45:04 Yeah, and you know, I think it's just, it's just so important. Like, it, it does p- it's how we progress in society, right? That's why there's so much urge for sex. That's why people wanna have a lot of sex. That's why sex sells, because we are hardwired to look for sex.

Codie Sanchez 45:17 Yeah.

Dr. Rena Malik 45:17 We are hardwired to procreate. And so it is so important, and if we literally stop having sex because of all these external factors, then, like, what's gonna happen to society? Like, who's gonna take care of our aging population? Like, what, what's gonna happen? It's a problem.

Codie Sanchez 45:32 Let's say that, you know, there's quite a few people here that wanna extend their sex span-

Dr. Rena Malik 45:38 Mm-hmm

Codie Sanchez 45:38 ... which I didn't even know that that's a word.

Dr. Rena Malik 45:40 Yeah.

Codie Sanchez 45:40 Um, like, how long do humans normally want to still have sex? Like, until what age? And how do we increase the amount and duration of our age to want to

Codie Sanchez 45:51 have sex?

Dr. Rena Malik 45:51 So it's interesting. I actually did a study when I was a resident. I don't think I ever published it, but I did a study because I was like... L- I asked this exact question. I was like, "What about older people? Like, how old are they when they s-" And it turns out that 80, 90-year-olds still wanna have sex.

Codie Sanchez 46:04 Hmm.

Dr. Rena Malik 46:04 And honestly, what I think what happens is that, um, if you, if you continue to cultivate desire, like you still, like, took care of yourself and you continue to have sex throughout your life, and you, um, and you k- you will still continue to want it, right?

Codie Sanchez 46:18 Mm-hmm.

Dr. Rena Malik 46:18 Because there's a natural urge to want pleasure and to enjoy people, and to have intimacy and connection. But what really happens is sometimes people start getting sexual dysfunction, and so they avoid sex. And then as you stop having sex or you start avoiding it, your desire decreases, too.

Codie Sanchez 46:33 Hmm.

Dr. Rena Malik 46:33 And so that whole thing about use it or lose it is sort of true in the sense that, like, if you don't continue to have sex, um, you, your desire will automatically get lower. The other thing is if you're not getting good blood flow to the genitals, they will start to develop changes in the tissues which will lead to maybe scarring or what we call fibrosis, which will then make it even more difficult to get blood flow down there-

Codie Sanchez 46:53 Hmm

Dr. Rena Malik 46:54 ... 'cause the tissues are no longer healthy. And so that's the other thing that happens. So that's why I think sex span is much shorter than lifespan, because you can live without blood flow to your genitals, but you can't necessarily get an erection or get clitoral tumescence, um, and feel arousal because you're not getting good blood flow down there.

Codie Sanchez 47:12 Hmm.

Dr. Rena Malik 47:12 Um, and then because you're not using it and your desire's going down, you're just not having sex, right?

Codie Sanchez 47:17 Hmm.

Dr. Rena Malik 47:17 Um, and so I think that the, the, the reason to improve sex span is, one, like, we know that people who have more sex live longer. There's actually data to support that when you're having sex once a week, that those people live longer and have less depression than people that don't. Um, now I don't think you should, like, have to strive for once a week if that's not in your... But, like, meaning you're continuing to have regular sex with your partner. And I think that's the take home because, one, you're getting good... We know that things are functioning well. It's a biomarker of health. You're getting good blood flow. Getting... Your hormones are working. All those things are in good order. You're intimate with another person. You're connecting with another person, which is so vital for feeling human connection. Um, and so I think all those things take into... You're usually happier, um, and happiness has a good positive predictive, predictive value. And so all those things together are t- gonna expand your lifespan.

Codie Sanchez 48:04 Let's talk about, um, pelvic floor.

Dr. Rena Malik 48:07 Mm-hmm.

Codie Sanchez 48:07 So you brought this up before. I had no ide- I, I, I don't even think I knew this was a thing until I was, like, 35, and one of my girlfriends actually the other week told me something that I thought was crazy. You probably understand. But she's like she had some pelvic floor issues.

Dr. Rena Malik 48:20 Mm-hmm.

Codie Sanchez 48:21 And so she went, and she got a pelvic floor massage.

Dr. Rena Malik 48:24 Mm-hmm.

Codie Sanchez 48:25 Which is like, I don't think she called it a massage. I'm gonna call it a massage.

Dr. Rena Malik 48:28 [laughs]

Codie Sanchez 48:28 But, like, they-

Dr. Rena Malik 48:29 I'm sure I know what she called it. [laughs]

Codie Sanchez 48:30 Yeah. [laughs] They go in, and they

Codie Sanchez 48:32 actually... What, what is this pelvic floor?

Dr. Rena Malik 48:34 Okay, yeah. So-

Codie Sanchez 48:34 How do we fix it? Why are people massaging the insides of my friends' vaginas?

Dr. Rena Malik 48:38 [laughs]

Codie Sanchez 48:38 What's going on here? [laughs]

Dr. Rena Malik 48:40 Yeah, so, um, so okay. Pelvic floor is a bowl of muscles, right? It sits in our pelvis. Men and women have a pelvic floor. I think people forget this.

Codie Sanchez 48:47 Hmm.

Dr. Rena Malik 48:47 Like, men also have a pelvic floor, and- The pelvic floor is like something that's like a part of our core musculature. So people think abs, right? But it's abs, back muscles, pelvic floor. It's activated all the time. We're using it with every step. It's helping us remain stable. It's helping hold up our organs. It's helping us when we pee and poop. It's helping women when they're pregnant. Like, it's part of our sex lives. It contracts, like I said, .8 seconds. It's part of, you know, that whole sexual response. And so it's a very important structure, right? A bu- m- many structures, a bunch of muscles all together. And so these muscles usually work fine, and we don't think about it. They're just doing the, what they need to do. But they can become dysfunctional. So there's a couple different ways they can become dysfunctional. They can become dysfunctional when they're weak. So that's where people are like, "Do Kegels, do Kegels, do Kegels," to strengthen the muscles. And that's when women are maybe leaking with, um, coughing, sneezing, jumping on the trampoline. Um, maybe they're having some prolapse, like things are falling down. Um, with men, we don't see it as often, but they might notice that their, [smacks lips] um, their v- in very extreme circumstances, they have rectal prolapse, like their rectum will prolapse out. But sometimes they'll just maybe-

Codie Sanchez 49:50 That means that like-

Dr. Rena Malik 49:51 Like protrudes out their bottom-

Codie Sanchez 49:53 Extends, yeah

Dr. Rena Malik 49:53 ... when they, when they have a poop. Um, and then [laughs]

Codie Sanchez 49:55 That does not sound fun. [laughs]

Dr. Rena Malik 49:56 No, it's very rare. And then, um, but, you know, more often it'll be like, oh, maybe their ejaculate is, uh, not s- going as far as it used to, right?

Codie Sanchez 50:04 Oh.

Dr. Rena Malik 50:04 It's just not as, as forceful as it used to be. Um, and so but usually you can't tell with men when it's weak. So that's very common, and that's what we think about a lot when we think about the pelvic floor, 'cause we're like, "Do your Kegels," right? To strengthen your pelvic floor. And-

Codie Sanchez 50:16 Which is just squeezing your vagina

Dr. Rena Malik 50:19 ... it's essentially a exercise where you're pulling the pelvic floor muscles, you're contracting them. You're squeezing them up-

Codie Sanchez 50:23 Yeah

Dr. Rena Malik 50:23 ... and in, right?

Codie Sanchez 50:24 Yeah.

Dr. Rena Malik 50:24 And so we describe it, there's many different ways to describe it, but like, it's like as if you're peeing and you stop the stream of urine. Um, you don't wanna do it when you're urinating, but that's how you can figure out the moves. For women, we'll say like squeezing up and in in the vagina, like you're trying-

Codie Sanchez 50:37 Yeah

Dr. Rena Malik 50:37 ... to pluck a blueberry up with your vagina. Um, [laughs] and then for men, w- I tell them like, it's like you're... Or you're, like, holding in a fart. For both genders, you're holding in a fart.

Codie Sanchez 50:46 Jesus. [laughs]

Dr. Rena Malik 50:47 Um, and then for men, I'll tell them it's like you're lifting up your penis off the ground without touching it.

Codie Sanchez 50:51 Yeah.

Dr. Rena Malik 50:51 Um, and I just say, but you don't wanna be clen- It's hard, because you're, it's natural to clench your abdomen and your bottom, but you don't wanna clench those. You just wanna focus on those pelvic floor muscles.

Codie Sanchez 51:00 Mm.

Dr. Rena Malik 51:01 Um, and so it's basically a contraction. Squeeze and relax, just like you would do a bicep contraction, right? Um, and so that's a Kegel, and it's great for strengthening the pelvic floor, but it's not the only thing you need to do.

Codie Sanchez 51:12 Mm.

Dr. Rena Malik 51:12 And it's, it's good when you have a weak pelvic floor, but when you have a tight pelvic floor, which is what I think your, your friend had, um, it actually can hurt you to do Kegels, because you're strengthening an already tight and tense muscle.

Codie Sanchez 51:22 Mm.

Dr. Rena Malik 51:22 And you wanna relax that muscle first. And so when people have a tight pelvic floor, and this is pretty common, and I think underdiagnosed, is when people have a lot of tension in that pelvic floor, and it's tight and contracted. And why does that happen? Because of trauma, because of stress, because of, um, anxiety, uh, because of other conditions sometimes can cause, like if you had surgery or other things, can, like, tense up those muscles. And just like people get TMJ and they tense their jaw at night-

Codie Sanchez 51:47 Yeah

Dr. Rena Malik 51:48 ... and they wake up with headaches, and they don't even know they're doing it, it's the same thing. It's not like you're controlling your pelvic floor. It's just your body's response-

Codie Sanchez 51:54 Yep

Dr. Rena Malik 51:54 ... to that, whatever the cause is. And so I don't want anybody to feel shame if they have a tight pelvic floor. It just happens. It's nothing you can control. And so then when it happens, um, people, when, usually don't do anything. They just, they might notice, "Oh, I'm going to the bathroom a little more often. I'm maybe having some constipation. Maybe I'm having back pain. Maybe I'm having pain with sex. Maybe I'm having pain with orgasm. Um, and with men, I might be having a little bit less strong erections. Uh, maybe I'm having pain in the testicles for men." And so you're like, "Okay, what's going on?" Something is off, and it could present in any of those ways. So I describe it as like if you had your bicep curl and your bicep was stuck like this, obviously your bicep might hurt, but your shoulder might hurt.

Codie Sanchez 52:31 Yeah.

Dr. Rena Malik 52:31 Your elbow might hurt. Your wrist might hurt. So you're gonna see dysfunction in areas that are connected to the pelvic floor. And so in those cases, we need to learn how to relax those muscles. And so there's different exercises you can do to relax, like yoga poses, like child's pose, happy baby, um, figure four, low deep squats, diaphragmatic breathing. All those things can help. Um, but sometimes people will actually, like, massage the muscles. Just like you would massage a muscle that's tense.

Codie Sanchez 52:56 Mm-hmm.

Dr. Rena Malik 52:56 The same thing, is they massage those muscles to help relax the muscles. And so pelvic floor physical therapy, when you go to a physical therapist, can include that if you feel comfortable-

Codie Sanchez 53:06 Mm-hmm

Dr. Rena Malik 53:06 ... um, in sort of helping you learn how to relax those muscles.

Codie Sanchez 53:09 I, uh, just immediately started giving her shit, which set my-

Dr. Rena Malik 53:12 [laughs]

Codie Sanchez 53:12 ... my, my maturity level with this. I was like, "You did what? Where? What happened?" But, um, she said it really helped her.

Dr. Rena Malik 53:19 Yeah.

Codie Sanchez 53:19 And, uh, and she didn't realize basically how much stress and everything she had. Uh, but I live in Austin, where you are now, so I'm like, "I don't know."

Dr. Rena Malik 53:27 [laughs]

Codie Sanchez 53:27 You know? It might just be like the woo-woo people in Austin, but maybe it's not. There seems to be a lot of data that says that, like, drugs and alcohol, um, for sex are

Codie Sanchez 53:37 bad.

Dr. Rena Malik 53:37 Mm-hmm.

Codie Sanchez 53:38 But I have a lot of girlfriends, totally qualitatively, that'll use, like, cannabis, let's say.

Dr. Rena Malik 53:42 Mm-hmm

Codie Sanchez 53:42 ... because it can be a vasodilator from what I understand-

Dr. Rena Malik 53:45 Mm-hmm

Codie Sanchez 53:45 ... and open up blood flow.

Dr. Rena Malik 53:46 Mm-hmm.

Codie Sanchez 53:46 And actually find that it's incredible-

Dr. Rena Malik 53:48 Yeah

Codie Sanchez 53:48 ... for sex when targeted. What is it about drugs and alcohol and sex for women? Should we use them? Should we not?

Dr. Rena Malik 53:54 [smacks lips] So marijuana, CBD, THC, whichever form you wanna use, has been shown to increase libido in the short term, right? It's, the problem becomes you're using it all the time.

Codie Sanchez 54:04 Mm-hmm.

Dr. Rena Malik 54:04 Because it does sort of mellow you out, right? And it can then, over chronic use, sort of just decrease desire, right, over long periods.

Codie Sanchez 54:11 Mm-hmm.

Dr. Rena Malik 54:11 But when you're introducing it in short spurts, it can absolutely increase libido. Um, and in terms of alcohol, uh, for some people it does allow them to get uninhibited or be more spontaneous. But again, when you're using it all the time, it, I mean, generally speaking, alcohol as a whole has been found more and more to be just not healthy, right?

Codie Sanchez 54:30 Yeah.

Dr. Rena Malik 54:30 It's more c- causes concern for cancer, um, you know, overall health, so many different areas, right? And so, like, I think for that reason, I just don't recommend it, right?

Codie Sanchez 54:40 Yeah.

Dr. Rena Malik 54:40 Um, and then you can also make poor judgment calls if you're too inebriated, right? Um, and then we talk about alcohol for men causing sometimes arousal issues, like having difficulty with erections, and I suspect that probably the same is for women, although we've never studied it.

Codie Sanchez 54:54 Oh, interesting.

Dr. Rena Malik 54:55 Yeah.

Codie Sanchez 54:55 So, like, if you drink and you're a man-

Dr. Rena Malik 54:57 Mm-hmm

Codie Sanchez 54:57 ... you have an increased likelihood of decreased arousal. You're more likely to not be aroused.

Dr. Rena Malik 55:03 Correct. And that's, you know, I, interesting, I actually did a deep dive in the data. That's what we tell people, right? Like, you can get whiskey dick if you get-

Codie Sanchez 55:09 Yeah

Dr. Rena Malik 55:09 ... too inebriated.

Codie Sanchez 55:10 Yeah.

Dr. Rena Malik 55:10 Um, and that's probably true, but, like, I think that when you look at the data, it's more when people who are, like, chronically having a lot of alcohol use that are really having these problems.

Codie Sanchez 55:20 Interesting.

Dr. Rena Malik 55:20 But I think it's, it's also a nice thing to say, like, look, th- things happen, right? Like, for men, like, things happen, and sometimes you won't have an erection. And, like, there might be a reason for it. Like, don't freak out.

Codie Sanchez 55:30 Yeah.

Dr. Rena Malik 55:30 And I think that's the real take home I want people to take. But I think, again, for women, it can sometimes- ... c- cause changes in arousal. It depends on the level of inebriation, and these are hard to study.

Codie Sanchez 55:39 Well, I hope that people take this podcast, and they share it with people, and they follow you on, on the s- the social channels because I think these are things that are really hard to talk about-

Dr. Rena Malik 55:48 Mm-hmm

Codie Sanchez 55:48 ... by yourself to your partner.

Dr. Rena Malik 55:50 Absolutely.

Codie Sanchez 55:50 You know, and I think they're hard for you to talk about maybe with your family. But if you can, you know, forward an episode along that talks about it in a way that is not lowbrow-

Dr. Rena Malik 55:58 Yeah

Codie Sanchez 55:58 ... but is also really approachable. We don't have to listen to, you know, love Andrew, but we don't have to listen to, you know, three and a half hours super data-heavy-

Dr. Rena Malik 56:06 [laughs]

Codie Sanchez 56:06 ... podcast on sex, but we also don't have to listen to, you know, Call Her Daddy, um, you know, hyper-sexualized.

Dr. Rena Malik 56:13 Right.

Codie Sanchez 56:13 You can just, like, you know, talk to a doctor who's done this for decades-

Dr. Rena Malik 56:17 Yeah

Codie Sanchez 56:17 ... in a way that's really, really approachable. So hopefully, if you're listening, you felt the same way and you forward this to somebody that you think would benefit. I think where I wanna end is, like, a couple futuristic things.

Dr. Rena Malik 56:27 Mm-hmm.

Codie Sanchez 56:27 So, you know, you've been a, you've been a clinician. Um, you've been a researcher.

Dr. Rena Malik 56:32 Mm-hmm.

Codie Sanchez 56:32 Uh, you have been on social media with h- hundreds of millions of people viewing, um, your work all regarding sex. Do you think in the future we're going to change some of these trajectories? Like, will it be possible for us to have more sex in the future? Do you have positive outlooks on how we could change this? Or are you like, unless we make major changes, uh, fertility is gonna be an issue, and sexual intimacy is gonna be an issue, and you don't like where the future's headed?

Dr. Rena Malik 57:04 We have to make changes, and I think people are starting to see it. Like, I think... So in Europe, they're making decisions. They're making some legislation, I forget which country exactly, where they're encouraging their c- um, giving incentives for people to go on vacation because vacation is stress, but not because they want people to go on vacation and use their money. Because they actually want people to go on vacation, de-stress, and have sex-

Codie Sanchez 57:23 Mm

Dr. Rena Malik 57:23 ... and have babies.

Codie Sanchez 57:24 Yeah.

Dr. Rena Malik 57:24 Right? Because they're realizing that their population is declining, and the, who's gonna take care of the aging generation? So I think it is gonna have to come to some degree from, um, from legislation. Also, like, women are delaying childbirth because there's no support, right? Like, you're young and you don't have... You don't wanna quit your job, uh, but childcare is expensive, and, like, there's no support. And women are not getting motivated or promoted, or they're looked at as l- you know, not as valuable employees because they're gonna go have pregnancy. We have to change that, right?

Codie Sanchez 57:53 Yeah.

Dr. Rena Malik 57:54 And so I think there will be changes. I think there have to be changes because otherwise we're headed to a place where we're just not propagating society, right? And so I'm hopeful that, like, I think in general, like, things go in a sine wave. Like, there's gonna be, like, some pendulums swing one way, and then things are gonna go back. Ultimately, it always sort of s- goes ebbs and flows if you look at, like, the trajectory of history, right?

Codie Sanchez 58:15 Mm-hmm.

Dr. Rena Malik 58:15 So I'm hopeful. I mean, I have to be. Like, otherwise y- we wouldn't have made it this far in, in society, so.

Codie Sanchez 58:20 Yeah. Well, it's a really good point about women today too with, you know, the, the repercussions of sex ideally, which are pregnancy.

Dr. Rena Malik 58:28 Mm-hmm.

Codie Sanchez 58:28 You know, I, I still felt like this. I mean, I have a lot of resources. I'm relatively successful, and I'm, I'm 38 now.

Dr. Rena Malik 58:34 Yeah.

Codie Sanchez 58:35 And I can't tell you, probably up until a few years ago, I thought, "I don't know how I could do it."

Dr. Rena Malik 58:39 Mm-hmm.

Codie Sanchez 58:39 Like, I don't know if I could have a baby, and work as much as I need to, um, you know, and grow this business, and be relevant, and, like, all of these real fears.

Dr. Rena Malik 58:48 Mm-hmm.

Codie Sanchez 58:48 And so I think, you know, and then I, and then I employ mothers here who are incredible-

Dr. Rena Malik 58:54 Right

Codie Sanchez 58:54 ... you know? And, like, more efficient arguably and more effective in a lot of ways than, um, than somebody who doesn't, and yet-

Dr. Rena Malik 59:02 I mean, working together is so important, right?

Codie Sanchez 59:04 Yeah.

Dr. Rena Malik 59:04 Like, we all bring something unique to the table. And so I think it's just, it's, it's just like we have to value that. We have to support mothers, uh, in having children but also allow them to succeed in their own right. And I think that, um, there's, you know, there's some people who are better mothers 'cause they work. I know I am.

Codie Sanchez 59:21 Yeah.

Dr. Rena Malik 59:21 Right? Like, I'm more intentional with my kids. I spend more quality time with them because I go to work, and then I come home, and I'm present with them because I now have been stimulated as a human adult.

Codie Sanchez 59:30 100%.

Dr. Rena Malik 59:31 And, um, and so I think that... But there's some people who would be better staying at home, and that's okay too, right? But, like, we just have to promote that and support that.

Codie Sanchez 59:38 Do you think we'll have sex with robots in the not too distant future?

Dr. Rena Malik 59:41 I'm sure we will. Um, but I, I hope that, like, it just won't... Like, you don't want someone to yes you to death, right?

Codie Sanchez 59:48 Right.

Dr. Rena Malik 59:48 You need a little bit of tension.

Codie Sanchez 59:50 Yeah.

Dr. Rena Malik 59:50 Um, I just worry that the AIs will learn that tension, and then we're in trouble, right?

Codie Sanchez 59:54 Yeah.

Dr. Rena Malik 59:54 Because you don't wanna just be like, "Yes, yes, yes, I think you're great," all the time. Like, that gets boring. Um, y- we need human c- like, connection, and so I just, I don't know. I mean, I think that's a little

Dr. Rena Malik 1:00:04 bit scary.

Codie Sanchez 1:00:04 I know. I was at this, uh, event the other day, and it was a, um, an AI event with one of the... I won't say the name of the company, but a, a well-known company, um, in the AI space. And the woman and man who are running the talk, they basically were saying, "Well..." It was kind of a boring talk, honestly. I was listening, and it was over my head, and, um-

Dr. Rena Malik 1:00:22 Mm-hmm

Codie Sanchez 1:00:22 ... I don't really know. And they were saying, "Yeah, well, AI's gonna do this and this, and AI, you know, we already have friendships with AI, and we have, um, you know, working relationships with AI. You know, we'll start to have intimacy with AI, and, and then we'll eventually have sex with AI." And I was like, "Excuse me," you know?

Dr. Rena Malik 1:00:38 [laughs]

Codie Sanchez 1:00:38 And I just... It sort of, like, snapped me out, and I raised my hand. I was like, "I'm sorry. You're gonna have to double click on the last thing about us having sex with AI." And they had said a statement that I thought was so interesting. They were like, "Well, um, we have already had sex with magazines, AKA Playboy-

Dr. Rena Malik 1:00:52 Yeah

Codie Sanchez 1:00:53 ... et cetera."

Dr. Rena Malik 1:00:53 Mm-hmm.

Codie Sanchez 1:00:53 "We've had sex with computers, obviously porn. We have sex with our phone, you know, porn." And then one guy in the back was like, "Yeah, sometimes if it's a good-looking cloud, you know?" [laughs]

Dr. Rena Malik 1:01:02 [laughs]

Codie Sanchez 1:01:02 "And, like, when I was a kid." And I kind of did chuckle while simultaneously being really scared about the future in some ways because we humans sometimes do like the path of least resistance.

Dr. Rena Malik 1:01:11 Yeah.

Codie Sanchez 1:01:11 And so if we can go down a slippery slope in which the, the robot or AI always says yes and gives us exactly what we want, um, it already seems like we're choosing less, uh, difficulty in, you know, health, and relationships, and marriage. So I think it's really important, the stuff that you're saying out there, because maybe it's not actually so hard. Maybe having sex with a human is incredibly more fulfilling than porn is in all the ways imaginable.

Dr. Rena Malik 1:01:37 Oh, it is, absolutely.

Codie Sanchez 1:01:37 And it's so accessible.

Dr. Rena Malik 1:01:39 When you look at brain studies, like, yeah, your brain, it lights up with porn, but it lights up way more with a person.

Codie Sanchez 1:01:46 Interesting.

Dr. Rena Malik 1:01:46 Way more. And so, like, if you look at the research, so yeah, you... Our bodies want people. It's just becoming more and more difficult, and we're becoming more and more distanced. Because of it. And I think, like I said, I think... I, I'm very hopeful that it's gonna come back to, like, sort of back to some level of normalcy. And we have a responsibility. Like, I know people wanna make money, and AI dolls sound like a great idea, but, like, we have a responsibility to, to withhold and to take care of, uh, society as a whole. Like, we can't just turn us into, like, you know, AI-loving humans and like, "Oh, we're filling a gap with AI." Like, no, we need to fix the gap.

Codie Sanchez 1:02:23 Yeah. You do hope that entrepreneurs choose a path that is better for society as opposed to only makes money. We'll have to see what ends up happening there.

Dr. Rena Malik 1:02:30 Yeah.

Codie Sanchez 1:02:30 But I, I think that's, that's very, very true, is like you get to choose the thing that's, that you work on. Um, but you know, it's, it's an interesting point. So like, so, so the brain studies can actually show that you get more pleasure from having sex with a human?

Dr. Rena Malik 1:02:46 They just, they just show up the areas light up, right?

Codie Sanchez 1:02:48 Interesting.

Dr. Rena Malik 1:02:48 So yes, that they light up more intensely. And it's because, I, I suspect because there's, like, touch receptors of the skin that can only be stimulated by a human hand. Not even a gloved hand. It has to be a human touch. And so I think that is the reason that you're getting additional inputs that are, like, much more pleasurable.

Codie Sanchez 1:03:08 That's actually one of the best use cases I've heard against pure robot sex-

Dr. Rena Malik 1:03:12 Mm-hmm

Codie Sanchez 1:03:13 ... is that it might be more fulfilling-

Dr. Rena Malik 1:03:16 Yeah

Codie Sanchez 1:03:16 ... uh, scientifically with a human. I think we already all know spiritually-

Dr. Rena Malik 1:03:21 Yeah

Codie Sanchez 1:03:21 ... uh, that with a human it makes much more sense. And, and also, I mean, anybody who's ever masturbated to porn before, I don't think at the end of masturbating to porn you're like, "Oh, bliss universe."

Dr. Rena Malik 1:03:30 [laughs]

Codie Sanchez 1:03:30 "This is, like, incredible. I just had a spiritual transcendence."

Dr. Rena Malik 1:03:34 It's a-

Codie Sanchez 1:03:34 You're kinda like-

Dr. Rena Malik 1:03:35 It's a tool.

Codie Sanchez 1:03:36 Yeah.

Dr. Rena Malik 1:03:36 It's a tool. It is not a person.

Codie Sanchez 1:03:37 You're like, "I showered-

Dr. Rena Malik 1:03:38 Yeah

Codie Sanchez 1:03:38 ... and that happened."

Dr. Rena Malik 1:03:39 It's like, "I felt nice." Sure.

Codie Sanchez 1:03:40 You know? Y- yeah, exactly.

Dr. Rena Malik 1:03:42 Yeah.

Codie Sanchez 1:03:42 Um-

Dr. Rena Malik 1:03:42 It's, it's a prequel to the real thing eventually, right? Like, when you're with a partner.

Codie Sanchez 1:03:46 Yeah. Well, I-

Dr. Rena Malik 1:03:47 As it should be.

Codie Sanchez 1:03:48 I love that.

Dr. Rena Malik 1:03:49 Yeah.

Codie Sanchez 1:03:49 Well, thank you so much for being here. This was so interesting, and we're gonna do the whole thing at the beginning. But where do you... I mean, your YouTube channel's incredible.

Dr. Rena Malik 1:03:55 Thank you.

Codie Sanchez 1:03:56 Uh, is that where you like to send more people? Or do you go to Instagram too?

Dr. Rena Malik 1:03:59 Yeah.

Codie Sanchez 1:03:59 Or-

Dr. Rena Malik 1:03:59 Yeah, I, on YouTube, that's my biggest channel, but I also have a podcast, and I have an Instagram. All the social. I'm on all the socials, but the biggest one is YouTube-

Codie Sanchez 1:04:06 Yeah

Dr. Rena Malik 1:04:07 ... and then podcast.

Codie Sanchez 1:04:07 And Dr. Rena Malik everywhere?

Dr. Rena Malik 1:04:08 Rena Malik MD everywhere.

Codie Sanchez 1:04:10 MD.

Dr. Rena Malik 1:04:10 Mm-hmm.

Codie Sanchez 1:04:10 Yes. Important couple letters-

Dr. Rena Malik 1:04:12 Yeah

Codie Sanchez 1:04:12 ... that you spent a lot of years vying-

Dr. Rena Malik 1:04:13 I did

Codie Sanchez 1:04:13 ... getting those two.

Dr. Rena Malik 1:04:14 I did. And you have to type the whole thing in on Instagram 'cause I get shadow banned all the time.

Codie Sanchez 1:04:18 No way. Because-

Dr. Rena Malik 1:04:18 So if you type in Rena Malik MD or you won't find me

Codie Sanchez 1:04:20 ... because you're talking about penis size on the Reg?

Dr. Rena Malik 1:04:23 And sex. [laughs]

Codie Sanchez 1:04:24 [laughs] That's why. Well, I guess with all the-

Dr. Rena Malik 1:04:27 Yeah

Codie Sanchez 1:04:27 ... OnlyFans or something.

Dr. Rena Malik 1:04:29 I, you know, it's interesting to me because they will... There's, like, women posting, like, see-through dresses, and they're fine.

Codie Sanchez 1:04:35 Yeah.

Dr. Rena Malik 1:04:35 And it's like people talking about sex from a scientific background, like, and all of us, like sex therapists, doctors, like, who talk about sex, we all get shadow banned.

Codie Sanchez 1:04:43 That's fascin- You'd think that Facebook by some point would be able to, like, double-click on the fact that you're sitting here in, like, a, a button-down talking, [laughs] talk, talking about pelvic floor, you know?

Dr. Rena Malik 1:04:52 I know. I know. You think so.

Codie Sanchez 1:04:54 But not quite.

Dr. Rena Malik 1:04:55 Not there yet.

Codie Sanchez 1:04:56 Um, one, one, one of my favorite videos of yours was actually talking about, uh, we'll link it in the sho- show notes, was actually talking about, um, pelvic floor, which is where I learned a lot from it-

Dr. Rena Malik 1:05:07 Mm-hmm

Codie Sanchez 1:05:07 ... and how important that is for pregnancy and for longevity-

Dr. Rena Malik 1:05:11 Mm-hmm

Codie Sanchez 1:05:11 ... which I didn't realize, and I also did think the ones on penis size was pretty clever, so.

Dr. Rena Malik 1:05:15 Yeah. Thank you. [laughs]

Codie Sanchez 1:05:16 [laughs] Thank you so much for being here.

Dr. Rena Malik 1:05:18 No problem. Thank you.

Codie Sanchez 1:05:19 At the end, I was gonna have Rena sign a postcard, and I asked her what she would say to her young self, and she said, "Don't fake orgasm," which make me sort of giggle, but I think is also really true. If you guys liked this podcast, please do me a favor. Like and subscribe. Turns out a bunch of you come every single week. Like, 40% of you come every single week, and you listen to the podcast, but you don't actually subscribe. So make sure to follow along. Also, if you're like me right now, you're probably thinking of that one friend or your partner that you know would benefit from listening to this podcast. Do the thing that is the most beautiful gift you can give anybody. Forward this along to somebody else who probably needs to have this conversation and hasn't. I think we've gotta normalize talking about sex, and you can be the person to do that right now. So send this to a friend. [paper rustles]