The Most Important Sex Advice No One Ever Told You: Revamp Your Sex Life in 10 Minutes

1. 0:00 – 2:57

   Introduction

   1. MRMel Robbins0:00

      Am I having enough sex? Am I not having enough sex? And I suspect you're about to tell me, Dr. Rena, that I need to be talking to my partner about this and not you on a public podcast.

   2. RMDr. Rena Malik0:09

      (laughs)

   3. MRMel Robbins0:09

      Is my sex life healthy?

   4. RMDr. Rena Malik0:10

      Well, I think a lot of it comes from what we see on media, right? We see these people, they see each other, they immediately wanna have sex. They rip off their clothes and they orgasm within s- like seconds, right? That's not what sex is.

   5. MRMel Robbins0:22

      There are times where I have been having sex with my husband and I feel like I might have to pee.

   6. RMDr. Rena Malik0:28

      Mm-hmm.

   7. MRMel Robbins0:28

      And then I get nervous because I think that I'm gonna pee. But is that the same sensation that you might be about to (beep) .

   8. RMDr. Rena Malik0:37

      Well, so that's part of it. So this is hard to say.

   9. MRMel Robbins0:39

      Oh my God, Chris is gonna kill me. (laughs)

   10. RMDr. Rena Malik0:41

       (laughs)

   11. MRMel Robbins0:41

       (ticking) All righty, it's your friend Mel, and I'm so glad you're here with me today. I am thrilled to welcome Dr. Rena Malik to the Mel Robbins Podcast. She is a board certified, fellowship trained urologist, pelvic surgeon, and sexual health expert. She specializes in female pelvic medicine and reconstructive surgery and sexual medicine. She runs an extraordinarily busy medical practice that offers patient focused care in sexual health, bladder health, and hormone management, including an expertise in menopause and low testosterone. Dr. Rena is a powerhouse and she is known for her no shame science backed YouTube videos on sexual health that have over 300 million views. Dr. Rena has also published over 80 peer reviewed research articles and she was recently distinguished with the title of the 2020 American Urological Association Young Urologist of the Year Award. And if I keep talking to you about her credentials, I am going to chicken out on all the embarrassing questions about sex that are on my note cards in front of me. So how about you and I just jump right in? Because you and I have a lot to learn on how to have better sex starting tonight. I cannot wait to dig into this conversation.

   12. RMDr. Rena Malik2:03

       I'm so glad to be here.

   13. MRMel Robbins2:04

       So I wanna start by just asking you to speak directly to the person who's listening and explain what they might expect to change about their life if they take everything that you're about to share today to heart.

   14. RMDr. Rena Malik2:18

       Yeah. So when you listen to this episode, you are gonna figure out the answers to all those embarrassing questions you've never felt comfortable asking anyone. You're gonna feel more comfortable in your body. You will probably go take a mirror and look at your genitals and really analyze them because that's really important. We don't look at our bodies. So keep listening. You're gonna learn a ton of very important, helpful information that'll help you feel empowered to take care of your sex life.

   15. MRMel Robbins2:44

       Wow. I'm- I'm now focused, of course, about looking at my genitals.

   16. RMDr. Rena Malik2:47

       Yeah.

   17. MRMel Robbins2:47

       Which I'm like, I'm not doing on YouTube right now.

   18. RMDr. Rena Malik2:50

       (laughs)

   19. MRMel Robbins2:50

       Or I'm not gonna do play by play as you listen to the podcast, but I can't wait to hear how that's involved.

2. 2:57 – 4:27

   What is sexual health?

   1. MRMel Robbins2:57

      But can we start by just defining sexual health? What is it?

   2. RMDr. Rena Malik3:00

      So I always say that sexual health is health, right? We think of it as something completely different, like it's just a side of our lives, but it's actually a big part of our lives. So it is, you know, defined as something that you have psychological, emotional, physical wellbeing associated with pleasure, right? Giving and receiving pleasure.

   3. MRMel Robbins3:21

      Yes.

   4. RMDr. Rena Malik3:21

      But it's much more than that, right? It affects us psychologically when you're not having good sex. It affects us physically sometimes, and it really, like is a big part of shame, and we're gonna talk about that I'm sure, about how sometimes when you have problems with sex, you feel shame. But the other big thing is when you're having problems, sometimes that can signal other health conditions. So if you're having, for example, men who have erectile dysfunction are more likely to have heart disease, and so you're more likely to see erectile dysfunction first before you see heart problems. And while we don't have the data on that for women, it's probably very similar because the gen- genitals actually act very similarly.

   5. MRMel Robbins4:01

      I- I- I'm not sure I've ever heard anybody define sexual health in such a comprehensive and holistic way, because when I think about sexual health, I think is my sex life healthy and does that mean I'm having enough of it? Am I enjoying it? But you're talking about it an entirely different construct, which is it's integrated into your whole health and wellbeing as a human being.

   6. RMDr. Rena Malik4:25

      Absolutely.

   7. MRMel Robbins4:26

      Wow.

3. 4:27 – 6:40

   The biggest thing that we get wrong about our bodies when it comes to sex.

   1. MRMel Robbins4:27

      So what do we get wrong about our bodies when it comes to sexual health?

   2. RMDr. Rena Malik4:32

      Well, I think a lot of it comes from what we see on media, right? We see these people, they see each other, they immediately wanna have sex. They rip off their clothes and they orgasm within s- like seconds, right? Like, the- the male penetrates the female in a heterosexual relationship, the woman's orgasming in seconds, and it's like looks like the best time of their life. And that's not real life, right? That's not what sex is. Sex is playful. Sex is supposed to be fun. Sex is supposed to be a time to explore and try new things and sometimes be awkward and weird, right? There's weird noises. There's, you know, funny things that happen just like they happen anywhere in life, and sometimes it takes longer, sometimes it's quicker, but it's all sort of variation of normal, and sometimes it's not normal, but ultimately it's play. And I think what we really get wrong is we take it way too seriously and we take it so deeply into our souls as something to be insecure about or uncomfortable about, when really it should be something... The only time adults play is during sex. So we should allow ourselves to play and have fun.

   3. MRMel Robbins5:30

      I think you might've just changed my marriage.

   4. RMDr. Rena Malik5:32

      (laughs)

   5. MRMel Robbins5:32

      No, I- I've been married for 28 years and I love having sex with my husband, and at the same time, we have been together-

   6. RMDr. Rena Malik5:43

      Mm-hmm.

   7. MRMel Robbins5:43

      ... as partners for 30 years, and I have always thought about sex as like intimacy and orgasm and pleasure. That's it. And so the idea of redefining it as a moment and a chance for play with somebody that I love...Because you're right, like I would be mortified, even though I've been with Chris for 30 years, to have something embarrassing, whether it's a smell or a noise, emit during, like ruin the mood.

   8. RMDr. Rena Malik6:10

      Mm-hmm.

   9. MRMel Robbins6:10

      But if you think about it from the framework of play, it kinda changes everything.

   10. RMDr. Rena Malik6:17

       Yeah. It allows you to explore, try things that you've never tried before, and that's part of like when you've been together for a long time, right, you sort of get a script, right? You do the same thing, you know it works, you're gonna achieve climax doing this way, this time. But then it becomes boring, right?

   11. MRMel Robbins6:30

       Right.

   12. RMDr. Rena Malik6:30

       So you need to have that room to play and try different things, and be okay with it being awkward or funny or not great. Like every sexual encounter doesn't need to be

4. 6:40 – 8:09

   How to have better sex starting today.

   1. RMDr. Rena Malik6:40

      mind-blowing. It's okay to occasionally have mediocre sex, but like use it as a tool. You only get better at sex as you do more s- have more sex. And as you, you know, try new things, you will get better at those new things as well.

   2. MRMel Robbins6:52

      Well, you know, if I think back to when I was younger, right, before I got married, and have been in this relationship with Chris, I think I was relying on new partners to have the sex be different or fun.

   3. RMDr. Rena Malik7:05

      Mm-hmm.

   4. MRMel Robbins7:05

      But I would imagine that you're gonna tell us it's incredibly important that you bring that yourself to your sexual encounters, this ability to play, to experiment, regardless of whether you're in a longstanding committed relationship or you are, you know, having sex with multiple partners.

   5. RMDr. Rena Malik7:23

      Absolutely. I mean, you sort of have to, uh, w- have variety, right? In anything in life, right? You don't have the same meal every day, you don't eat the same dinner every day, you're- you're sort of doing maybe a different workout every day. Like you're trying different things all the time, and so just like in your day-to-day activities, sex needs to be a little variable at times.

   6. MRMel Robbins7:43

      Well, I was just laughing to myself 'cause I'm- I'm sitting here thinking, "Well, maybe we've been sex fasting to try-"

   7. RMDr. Rena Malik7:49

      (laughs)

   8. MRMel Robbins7:49

      "... to make it interesting since it hasn't changed (laughs) in a while."

   9. RMDr. Rena Malik7:52

      And that's not a bad thing. That's not a bad thing.

   10. MRMel Robbins7:54

       That's true. Um, one thing that I think a lot of us wonder is how much sex is normal and how much, uh, lack of sex? Like I'm- I'm not asking the question right, but what's the average amount

5. 8:09 – 11:01

   The average person has THIS much sex a year.

   1. MRMel Robbins8:09

      of sex that people are actually having?

   2. RMDr. Rena Malik8:11

      Yeah. So first off, it- what's normal? What's normal is so individual, right? So as long as you are both satisfied with the amount of sex you're having, like say you're having mind-blowing sex once a month and you're so happy with that, that's fine, right? But let me tell you some averages. So averages, yeah, on average, the average American has sex 52 times a year, so about once a week. If- but that's varied base- based on age. So you look at a 20-year-old, they're having sex about 80 times a year.

   3. MRMel Robbins8:36

      Okay.

   4. RMDr. Rena Malik8:37

      So that's, you know, maybe once a week, s- maybe twice a week.

   5. MRMel Robbins8:39

      Okay.

   6. RMDr. Rena Malik8:39

      Whereas a 60-year-old is more on the order of 20 times a year, so maybe once every two weeks or so. And so it's variable, but, you know, what is a sexless marriage? So there's no true definition, but like the researchers will define it as less than 10 times a year. But again, like I said, if you're having sex 10 times a year and you're super satisfied, both of you, then it's not sexless. It's passionate, it's enjoyable, it's- it's great, you know? So I think ultimately, it's- it's very individualized, but really realizing that like there's no benchmark you have to meet.

   7. MRMel Robbins9:09

      Well, I think that there's, at least speaking for myself, there's always this sense that, uh, it's not enough.

   8. RMDr. Rena Malik9:16

      Mm-hmm.

   9. MRMel Robbins9:16

      Not only because I would love to have more, and so would my husband, but also the sense that other people are having a lot of sex, and that there's something wrong with us or our relationship because we're too tired, or, you know, we mean to but then we don't, or life gets in the way. And so I do think that a lot of us get caught up in our heads-

   10. RMDr. Rena Malik9:36

       Mm-hmm.

   11. MRMel Robbins9:37

       ... wondering, "Am I having enough sex? Am I not having enough sex?" And I suspect you're about to tell me, Dr. Rena, that I need to be talking to my partner about this and not you on a public podcast.

   12. RMDr. Rena Malik9:46

       (laughs)

   13. MRMel Robbins9:47

       But...

   14. RMDr. Rena Malik9:47

       Exactly. Exactly. It's really a couple thing. It's not a- or- or if you're m- you know, multiple, um, non-monogamous relationships, then it's you and those partners, right? But ultimately, it is not about keeping up with the Joneses, right? They could be having five-minute sex four times a week, and you're having like a passionate lovemaking experience that lasts an hour once a week, but it really ma- it's all about what you enjoy, what you like, what your partner feels good about, and that's what matters. It is not about what your neighbors are doing or your other partners or how often. Like I was watching (laughs) this TV show where this actress, they had like, um, a swing in their bedroom, and they were like, "Oh, we use it every day." And I was like, "Oh," I- I even felt like, "Oh, man, like they're having a lot of sex. (laughs) Like that's a lot." You know? That- that's amazing. And it, you know, is that something to aspire to? I'm like, yeah, if you have the energy and excitement and you both want that, great. But let's be real. Most people are busy, right? They're taking care of kids or aging parents or taking care of, um, work, becoming busier in their job, and that's just not realistic for a lot of people.

   15. MRMel Robbins10:51

       Well, if I put a swing in my bedroom, it would become a, uh, rack for dirty clothing.

   16. RMDr. Rena Malik10:57

       (laughs)

   17. MRMel Robbins10:57

       You know, that you kinda throw things on. So, um,

6. 11:01 – 13:25

   How long should sex really last?

   1. MRMel Robbins11:01

      how long should sex last?

   2. RMDr. Rena Malik11:05

      Yeah. So this is a great question. On average, people think that sex lasts, um, men think that it should l- last- should last about 16 minutes. They think it lasts about eight. This is, again, like the whole experience. Women want it to last about 25 minutes. But they've actually done studies where they've had couples have sex around the world, okay, and they've had them use stopwatches, so like the- the female partner will turn on the stopwatch when they penetrate and turn off the stopwatch when they stop penetrating, and the average time is about 5.7 minutes.So 5.3 to 5.7 minutes. So it's really not that long, not as long as we think. And so that's average, and that range is really wide, so it's like from .1 minute to 53 minutes. So, you know, again, it's a huge variability, but ultimately, again, it comes down to are you satisfied? Are you having an orgasm? Is he having an orgasm? Are you both feeling happy at the end of it? Because that timer doesn't include foreplay. That timer doesn't include the other things that you're doing. This is only talking about penetrative sex. Now, is that all sex is? No. Right? Sex is, is, uh, manual, it's oral, maybe anal. It could be no- non-genital. Like, you could still call sex, like, you're naked and you're stimulating other parts of the body. So, really, like, what is sex defined as, and are you both deriving pleasure from it? And I like to say, like, it's also about the, the journey, not just the destination. Like, yeah, orgasms are great and everybody wants an orgasm, but, like, is the rest of it fun? Are you enjoying the intimacy part of it, the, the tactile part of it, the stimulation? That sort of stuff, like, that matters.

   3. MRMel Robbins12:40

      Well, and to your point, the playfulness of it.

   4. RMDr. Rena Malik12:42

      Mm-hmm.

   5. MRMel Robbins12:42

      Um, how does a woman's vagina expand during sex?

   6. RMDr. Rena Malik12:47

      Yeah. So during sex, you know, you're, th- there's a lot of changes, not just the vagina expanding. So on average, the width is about 3 to 3.5 centimeters and the length is about 8 to 9 centimeters. And that will actually double in length and width during-

   7. MRMel Robbins13:02

      Double?

   8. RMDr. Rena Malik13:02

      Double. I- It can up to double during arousal, and to allow for, uh, you know, getting ready for penetration. Whether it's through a phallus, a finger, a toy, whatever, it's going to enlarge. The only thing that happens is the labia majora will, uh, will shrink, because they're usually closed off to make it little cl- uh, keep the introitus closed a bit, so they will kind of shrink a little bit, as well as the clitoral hood. The hood on top of the clitoris.

7. 13:25 – 17:12

   Here’s why foreplay is so important.

   1. RMDr. Rena Malik13:25

      And the labia minora will get engorged. They will get bigger and they will turn red or pinkish in color. So our body is just, like, amazing. It really protects us so that when we're about to have sex, we're not gonna hurt ourselves, right? You start making lubrication, you start getting wider, you start getting longer. Your cervix moves up and out of the way, 'cause sometimes it can be painful if you're penetrating and the cervix is still there. For some people, that's painful. So your body does all these things to make sure sex will be pleasurable.

   2. MRMel Robbins13:53

      Wow. How long does it take your body to do that?

   3. RMDr. Rena Malik13:57

      So everyone's a bit different. Um, we know that it's, you know, estimated maybe it can take up to 25 minutes for some women, so foreplay needs to be a part of sex for some people. Now, some people are faster, some people are longer. But ultimately, like, most women can tell you when they're ready, right? They can have that, to say, "You know what? I'm ready. I feel ready." Or, "I'm not ready." And I think the issue is sometimes people don't speak up about those things, right? They're just like, "Oh." Like, "Okay, maybe it's uncomfortable. Maybe it's, it'll, it'll be fine in a minute." Right? But, like, really there's a whole process. And then the other thing about lubrication a lot of people get wrong is they think that if you're well lubricated, you're aroused, and if you're not, you're not. But that's not exactly true. Certainly, there's many people where well lubrication correlates with arousal. However, there are some people who lubricate not because of arousal, just because of other things. They're-

   4. MRMel Robbins14:44

      Like what? What would you lubricate for?

   5. RMDr. Rena Malik14:46

      So, like, say you feel a threat is coming on, you know, and your body prepares itself so it doesn't get hurt, and so it might lubricate for that reason. Or it may see something that it seems somewhat erotic, or it may feel something somewhat erotic, and so your body just says, "Oh, that, that's sort of ... I'm tur- You know, you should get ready." But you may not mentally feel aroused, right? Um, but then there's people who are turned on and they don't make as much lubrication. Now, that can be due to genetics. That can be due to hormones, so, like, going through menopause, things like that. Lubrication decreases. And so it doesn't mean they're not aroused. That means you need to use a lubricant, or you need to consider other treatments to increase lubrication for the woman who may be struggling with that.

   6. MRMel Robbins15:24

      Well, it's interesting to hear you explain the actual medical mechanics of what's going on in our body, because I'd always just thought about foreplay kind of as a warmup, getting yourself in the mood. But when you all of a sudden s- said your cervix moves out of the way to get ready-

   7. RMDr. Rena Malik15:42

      Mm-hmm.

   8. MRMel Robbins15:42

      ... so that your vagina can double in length and width, I'm like, "Holy cow, there's a whole lot going on-

   9. RMDr. Rena Malik15:49

      Mm-hmm.

   10. MRMel Robbins15:50

       ... that takes a little bit of time." Which is why it makes it even more important in some cases-

   11. RMDr. Rena Malik15:54

       Yeah.

   12. MRMel Robbins15:54

       ... to really open yourself up to the play, and to give your body the chance to even relax into it so you can enjoy it.

   13. RMDr. Rena Malik16:02

       Absolutely.

   14. MRMel Robbins16:03

       And is that length of time different for men, typically?

   15. RMDr. Rena Malik16:07

       So men, you know, it's sort of very binary. They get an erection or they don't, right? And so that is not always the only sign that they're gonna have with arousal. You'll also see both men and women will have nipples sort of become more erect. There's other signs as well, but very often they're seeing the manifestation of that increased blood flow through penile erection. Now, in women, the homolog is their clitoris gets erect.

   16. MRMel Robbins16:31

       The homolog?

   17. RMDr. Rena Malik16:32

       The, the s-

   18. MRMel Robbins16:32

       What, what is that?

   19. RMDr. Rena Malik16:33

       (laughs) A homolog is essentially when you have two structures that are, you know, made from the same embryologic tissues and they develop, you know, into th- their variety of structures. So in men and women, you start off with a genital bud, and this, in men, becomes the penis, and in women becomes the clitoris. So they are exactly identical. If you cut open an, an anatomical, um, you know, visual, uh, an anatomical visual of the penis and the clitoris, they're identical.

   20. MRMel Robbins16:58

       Really?

   21. RMDr. Rena Malik16:59

       They're identical. They have two bodies of erectile tissue, two spongy bodies that fill and engorge with blood. They look exactly the same.

   22. MRMel Robbins17:07

       That's wild.

   23. RMDr. Rena Malik17:08

       Yeah. So that's why it's, I mentioned earlier, looking at your own body

8. 17:12 – 20:50

   Grab a mirror and look at your own genitals, here’s why.

   1. RMDr. Rena Malik17:12

      with a mirror. So, one, it's also so that you can, if something is abnormal, you can see it, right? 'Cause sometimes people will have skin conditions and they won't know. They've never looked down there, right? So that's one reason. But two is to identify, where is the clitoris? Like, pull back the clitoral hood. Does it come back easily? A lot of women don't realize that they can actually get smegma, or, like, you know how b- if you have sons, you'll know this. Little boys get smegma under their foreskin. Um, it's, it's sort of like dead skin cells and oil.

   2. MRMel Robbins17:39

      (laughs)

   3. RMDr. Rena Malik17:39

      And it can actually... (laughs)

   4. MRMel Robbins17:40

      I'm laughing because they used to call the guy that I dated in high school smegma behind his back. (laughs)

   5. RMDr. Rena Malik17:47

      (laughs)

   6. MRMel Robbins17:47

      I don't know why. It's a terrible thing.

   7. RMDr. Rena Malik17:49

      It's terrible.

   8. MRMel Robbins17:49

      But okay. So women can get that too?

   9. RMDr. Rena Malik17:51

      Yeah. So sometimes that develops, and because women don't know, they don't look, they don't ever pull back the hood of the clitoris, which is basically like foreskin. It's the exact homolog, again that same word, of male foreskin. If you don't pull it back, you won't actually know that there's something developing under there that could then lead to discomfort, pain, maybe having less of a strong orgasm or having no orgasm at all. And so, you know, you have to look down there so you can see what your normal structures look like, where everything's located, and then you can actually identify, you know, what is normal and not normal if things changed. You can look down there and you can say, "Hey, I saw this before and it's different now."

   10. MRMel Robbins18:30

       If we were to take a mirror and take a look at ourselves-

   11. RMDr. Rena Malik18:33

       Yeah.

   12. MRMel Robbins18:33

       ... what are we looking for?

   13. RMDr. Rena Malik18:34

       Yeah. So I think ultimately, like, go online and take a picture of, type in vulvar anatomy, okay?

   14. MRMel Robbins18:41

       Vulvar?

   15. RMDr. Rena Malik18:42

       Yeah.

   16. MRMel Robbins18:42

       There's an R in it?

   17. RMDr. Rena Malik18:43

       Y- yeah. The vulva, vulvar anatomy.... right?

   18. MRMel Robbins18:46

       Okay.

   19. RMDr. Rena Malik18:46

       But anyway, so, um, you- from the outside in, th- the first thing you're gonna see is your labia majora. So those are sort of like the large lips of the vagina. Then you're gonna go and you're gonna see your labia minora. And so just look at the size, look at what they look like. Um, you know, of course make sure there's nothing abnormal, like you don't see a mole or something weird there that you've never seen before. Um, but just, like, so you know what they look like, right? Look at the clitoris. Follow it up, look at the clitoris. Pull back the clitoral hood gently and see if you can pull it back. Take a look at the clitoris and then look at the urethra, which is underneath and on top of the vagina. Make sure it looks normal to you. I mean, again, you don't, you don't know, it, everyone looks a little bit different, but like-

   20. MRMel Robbins19:24

       Right.

   21. RMDr. Rena Malik19:24

       ... get a baseline of what you look like. And then look at the vaginal canal. It should be prink- pink, supple, healthy looking, right? And then, um, and then you should sort of get a sense of what you're looking at. And then you could also see, like, sort of just what the size is, what it looks like. Just, again, everyone's different and if you look at, there's actually websites where you can look at, like, labia. A lot of people get worried about, like, "Are my labia too long or do they look too weird?" But, like, you can see all different s- shapes and sizes. It's very unique to you. You can see ones longer than the other. Some are long, some are short. And that's completely normal. Nothing to be ashamed of, nothing to worry about. And, like, just sort of knowing what you look like is empowering you because, again, like, 'cause if something changes, you can go back and look again and just say, like, "What is something different from what I remember?"

   22. MRMel Robbins20:08

       So Dr. Rena, I think we all know that there's different types of orgasms that you personally experience.

   23. RMDr. Rena Malik20:14

       Mm-hmm.

   24. MRMel Robbins20:15

       But from a medical or physiological experience, are there different types of orgasms?

   25. RMDr. Rena Malik20:21

       So the orgasm is the act, the, the feeling of a s- a buildup of tension and then a release, right?

   26. MRMel Robbins20:26

       Yes.

   27. RMDr. Rena Malik20:27

       And so, but there are different origins of those orgasms, but the orgasm is essentially the same thing. So there's the clitoral orgasm, which is the most reliable way to achieve orgasm. So 85% of women need some clitoral stimulation to have an orgasm. And some of them will do it with peniles, uh, penetration, but sometimes not. But 85% need their clitoris to be stimulated. So that's one. Then there's

9. 20:50 – 23:48

   Is the g-spot in women real?

   1. RMDr. Rena Malik20:50

      vaginal stimulation. So that's where you hear about the term the G-spot. And so that's in the anterior vaginal wall, so the top of the vagina, about two or three centimeters in is where we have a structure called the Skene's gland. And that is-

   2. MRMel Robbins21:03

      The who?

   3. RMDr. Rena Malik21:03

      It's called the Skene's gland.

   4. MRMel Robbins21:04

      Steens?

   5. RMDr. Rena Malik21:05

      Skene's.

   6. MRMel Robbins21:05

      Skene's.

   7. RMDr. Rena Malik21:06

      Yeah. Skene's gland.

   8. MRMel Robbins21:07

      Skene's. Skene's gland. Okay. The Skene's gland. And when you say it's two to three centimeters at the top?

   9. RMDr. Rena Malik21:14

      Yeah.

   10. MRMel Robbins21:14

       You're not talking about the end of the canal there?

   11. RMDr. Rena Malik21:16

       No. So from the front. So-

   12. MRMel Robbins21:18

       From the front.

   13. RMDr. Rena Malik21:18

       Yeah.

   14. MRMel Robbins21:18

       So it's, like, in the skin, in the tunnel.

   15. RMDr. Rena Malik21:21

       It's in the-

   16. MRMel Robbins21:21

       That's where the G-spot is?

   17. RMDr. Rena Malik21:22

       In the vagina. In the vagina. So your urethra is there.

   18. MRMel Robbins21:25

       Yeah.

   19. RMDr. Rena Malik21:25

       And then you put your finger in the vagina-

   20. MRMel Robbins21:26

       Yeah.

   21. RMDr. Rena Malik21:26

       ... and it's about two or three centimeters in.

   22. MRMel Robbins21:28

       And it's on the top?

   23. RMDr. Rena Malik21:29

       Correct.

   24. MRMel Robbins21:29

       So if you put your finger in and you lift up-

   25. RMDr. Rena Malik21:31

       Sim- Yep. Mm-hmm.

   26. MRMel Robbins21:32

       And this thing is real?

   27. RMDr. Rena Malik21:34

       So it's a zone. It's not a spot, it's not a button, right? (laughs)

   28. MRMel Robbins21:37

       Okay.

   29. RMDr. Rena Malik21:37

       People think, like, there's this, like, magical button.

   30. MRMel Robbins21:39

       Tap, tap, tap, tap, tap.
10. 23:48 – 26:05

    THIS percent of women are not able to have an orgasm.

    1. MRMel Robbins23:48

       somewhere, but is it true that 10% of women are physically not able to have an orgasm?

    2. RMDr. Rena Malik23:55

       So we know, yeah, 10 to 12% of women-

    3. MRMel Robbins23:57

       10 to 12%?

    4. RMDr. Rena Malik23:58

       Mm-hmm. Have-

    5. MRMel Robbins23:59

       That's not fair.

    6. RMDr. Rena Malik24:00

       I know. It's not fair, but we don't know if it's because they're not physically able or they're not getting enough stimulation to achieve orgasm. So the, this is because, so if you think about, I said the average time for sex, that really usually is time from male ejaculation, right? That's the time to ejaculate. But for women, the time to orgasm is different. So they've actually looked at this too. What is the average time to orgasm? So through sexual encounters, it's about 12 to 14 minutes. So many women, if you just have penis and vagina sex, are not gonna orgasm and they're not gonna have an orgasm because they never got enough stimulation for a long enough time to achieve an orgasm.

    7. MRMel Robbins24:39

       So I gotta ask a question. So when you talked about measuring the male orgasm, and I think the average was, like, 5.6-

    8. RMDr. Rena Malik24:49

       Mm-hmm.

    9. MRMel Robbins24:49

       ... minutes or something like that, the way they measured that is somebody starts a timer-... and all of a sudden you insert, and from the time of insertion to the orgasm or the ejaculation, that's how we measure that.

    10. RMDr. Rena Malik25:02

        Correct.

    11. MRMel Robbins25:03

        How do you do that? Like when do you start the timer for a woman? Is it when the stimulation on the clitoris or the G-spot or the cervix starts, or how does that?

    12. RMDr. Rena Malik25:12

        Yeah, I mean, I think it's variable but, you know, I-I don't remember exactly how they designed it in that study particularly.

    13. MRMel Robbins25:17

        Mm-hmm.

    14. RMDr. Rena Malik25:17

        But ultimately, yeah, it depends on, probably requires c- you know, clitoral stimulation, I said the most reliable route, so probably from the beginning of clitoral stimulation to the end. And, but interestingly, when women masturbate that time shortens, eight minutes.

    15. MRMel Robbins25:30

        Well, no kidding, we know where to go.

    16. RMDr. Rena Malik25:32

        Yeah. (laughs) Exactly.

    17. MRMel Robbins25:33

        Move this outta the way, focus right here.

    18. RMDr. Rena Malik25:35

        Right.

    19. MRMel Robbins25:36

        Yes.

    20. RMDr. Rena Malik25:36

        Right, right. And sometimes you're just too polite to say, "Hey, you're doing this the wrong way," like...

    21. MRMel Robbins25:40

        Tilt your head in a different direction.

    22. RMDr. Rena Malik25:42

        Yeah. (laughs)

    23. MRMel Robbins25:42

        Yes.

    24. RMDr. Rena Malik25:42

        Exactly, exactly.

    25. MRMel Robbins25:44

        (laughs) This is why we need to be on a walk-

    26. RMDr. Rena Malik25:47

        Yes.

    27. MRMel Robbins25:47

        ... with our partners looking straight at, "By the way-"

    28. RMDr. Rena Malik25:50

        (laughs)

    29. MRMel Robbins25:50

        ... tilt your head towards two o'clock-

    30. RMDr. Rena Malik25:52

        Yeah.
11. 26:05 – 28:56

    Do this one thing to increase your chances of having an orgasm.

    1. RMDr. Rena Malik26:05

       thing you can do tonight is focus on the encounter. Don't think about the homework your kids have to do, don't think about what you have to do for work tomorrow, don't think about your to-do list that you are never gonna get done because we're never gonna get done, right? Focus on being present and communicate, like actually talk to your partner, guide them along the way. And non-verbal communication works well too. So like sometimes we feel uncomfortable telling them, "Move your head to the, you know, two o'clock," but you can gently move their head, right? There are things you can do, very gentle, very nudging, that can make you have an orgasm quicker, more efficiently, and in a more pleasurable way.

    2. MRMel Robbins26:46

       So in preparing to talk to you, one of the things that I stumbled upon is that there's like half a million papers written on the penis but only 2,000 studies done on the clitoris? Like w- why?

    3. RMDr. Rena Malik27:00

       You know, I wish I could tell you there was a, a really easy reason, but I will ge- venture a guess that most studies were designed by men for men, right? And so a lot of investigation has gone into male genitalia and male studies, and the penis is a little bit easier to study, right? It's sort of like right there, whereas the clitoris is not as easy to study because you can't s- you know, you can't... I mean, there are now ways to measure clitoral engorgement and we're... there's definitely more investigation going on now, but it's been sort of largely ignored. In fact, we didn't even know how many nerve endings a clitoris had until like two years ago.

    4. MRMel Robbins27:34

       How the hell did you figure it out?

    5. RMDr. Rena Malik27:35

       So they actually looked at, you know, u- uh, biopsy studies to look at the number of nerve endings, and so they did this study and they f- so we used to think they had 8,000 nerve endings but now we know that it's more than 10,000. And so, like, this is recent data, like in the last few years, and that's amazing, right? We didn't even know how many nerve endings the clitoris had. So there's so much work to be done, but it's really a societal view of women's pleasure, right? We've always been thought of as not... uh, it's never been a priority. Who talks about female pleasure? Not many people, right? They talk about male pleasure, they talk about erections, they talk about their, you know, ability to maintain erections, but they don't talk about women having issues with sex, they're often said, "Here's a gl- have a glass of wine, just relax." You know? They're not told like, "Hey, your pleasure matters and you having an orgasm matters and you feeling good matters." Like it's, it's amazing to me. And you know, we're the only person in the world, women are the only ones who have a clitoris, which is the only organ in the body that's made only for pleasure. There's no other organ, like the penis has a urethra, you urinate from the penis, women have a clitoris and the only point of the clitoris is to have pleasure.

    6. MRMel Robbins28:41

       Ooh, that's cool.

    7. RMDr. Rena Malik28:42

       Yeah.

    8. MRMel Robbins28:43

       That's the only reason we have it?

    9. RMDr. Rena Malik28:45

       Yeah.

    10. MRMel Robbins28:46

        That's pretty cool.

    11. RMDr. Rena Malik28:47

        That's all the function that it offers, that's the only function.

    12. MRMel Robbins28:49

        Well, that's a lot of function-

    13. RMDr. Rena Malik28:50

        Yeah.

    14. MRMel Robbins28:51

        ... that we should be, like, really taking seriously.

    15. RMDr. Rena Malik28:54

        Absolutely.

    16. MRMel Robbins28:55

        That's pretty awesome.

12. 28:56 – 32:54

    Squirting vs. Ejaculation: What’s the difference?

    1. MRMel Robbins28:56

       Can we talk about squirting?

    2. RMDr. Rena Malik28:57

       Yes.

    3. MRMel Robbins28:58

       Is it, is it... is that like peeing when you're ejaculating? What exactly is that?

    4. RMDr. Rena Malik29:02

       Yeah. So you brought up a few things. So squirting and ejaculating are two separate things, so let's talk about those difference. So squirting is defined as like this large volume of fluid that is gushing out of the urethra at the time of climax or during arousal, whereas ejaculation is a smaller, sort of white-ish, thicker amount of fluid that is coming from the urethra. Oftentimes people may not notice it, uh, when they orgasm or climax. And so where are these fluids coming from? So the female ejaculate we think comes from those Skene's glands, right? Those Skene's glands actually produce something called PSA which men produce in their prostate and so we can... they've actually tested the fluids and said, "Okay, yes, there is PSA in this fluid." There's also PSA in squirting. So some of the fluid from squirting is coming from those Skene's glands, but they're really small, they're like two to four grams in size.

    5. MRMel Robbins29:51

       Wait, so where is it coming out of?

    6. RMDr. Rena Malik29:52

       Those little Skene's glands, those, that, that gland-

    7. MRMel Robbins29:54

       So from inside the vagina?

    8. RMDr. Rena Malik29:56

       Inside the vagina there's these tiny, like sort of duck-like structures-

    9. MRMel Robbins29:59

       Okay.

    10. RMDr. Rena Malik29:59

        ... that hold a little bit of fluid and that when you have a lot of engorgement of the clitoris they will, it will squeeze some of that fluid out into the urethra and emit as ejaculate.

    11. MRMel Robbins30:10

        Okay, I'm embarrassed to ask you this, like really embarrassed, but is that where you pee out of? (laughs)

    12. RMDr. Rena Malik30:17

        The urethra is where you pee out... No, see this is why-

    13. MRMel Robbins30:20

        Okay, well so I got... (laughs)

    14. RMDr. Rena Malik30:21

        (laughs)

    15. MRMel Robbins30:21

        Well, 'cause you talked about the-

    16. RMDr. Rena Malik30:22

        The pee tube, yes.

    17. MRMel Robbins30:23

        ... the, the gland that I know is the location of the G-spot area and so when you started talking about that gland and the prostate I'm like, "Okay, wait a minute, that thing's up inside the vagina which means it's coming out the main event here."

    18. RMDr. Rena Malik30:35

        Correct.

    19. MRMel Robbins30:35

        But then you said urethra and I'm like, "I think that's where you pee."

    20. RMDr. Rena Malik30:38

        Right. I'm sorry, I should've clarified.

    21. MRMel Robbins30:40

        So it sounds like... No, no, I don't know, (laughs) so I'm... so I am so worried. Like so now here's what I'm thinking and this is way too much information I'm sure for everybody listening but I don't g- I don't care, I'm just gonna say it anyway. There are times where I have been having sex with my husband and I feel like I might have to pee.

    22. RMDr. Rena Malik30:58

        Mm-hmm.

    23. MRMel Robbins30:59

        And then I get nervous because I think that I'm gonna pee.But is that the same sensation, that you might be about to squirt? (laughs) Like I'm like (laughs) very excited.

    24. RMDr. Rena Malik31:08

        You know, I- I think if you...

    25. MRMel Robbins31:10

        Oh, my God.

    26. RMDr. Rena Malik31:10

        So this is hard to say-

    27. MRMel Robbins31:11

        Chris is gonna kill me. (laughs)

    28. RMDr. Rena Malik31:13

        No, no, it's... Look-

    29. MRMel Robbins31:14

        (gasps)

    30. RMDr. Rena Malik31:14

        ... you- you're not the only one thinking this question, right? I'm sure there's many women out there who are like, "Am I gonna pee? Am I gonna squirt? Like what's gonna happen?" So-
13. 32:54 – 37:46

    Can women actually squirt?

    1. RMDr. Rena Malik32:54

       you know, interestingly, they've looked at how women feel about squirting, so-

    2. MRMel Robbins32:56

       Yeah, how do we feel about it? 'Cause you can tell-

    3. RMDr. Rena Malik32:58

       So, so when... Yeah.

    4. MRMel Robbins32:58

       ... I feel like I don't know how I feel about it.

    5. RMDr. Rena Malik32:59

       Yeah, yeah. And so what... Some women are like, "Oh, it's a superpower. I feel like I have this amazing thing." Other women feel shameful about it probably 'cause, again, they're not sure what's happening. And some women are like, "This is just a big mess for me to clean up." Like, (laughs) "I don't like it," right? And men seem to feel like... I think it's like their visual of, like, you're having an orgasm, right? So they really like that visual, but there's actually another way to tell, right? So when you're having an orgasm, your pelvic floor muscles will contract in a rhythmic contraction, and so you can actually feel that, right? So men can feel that if they're inserted in a female and she has an orgasm, she's gonna... Her pelvic floor muscles are gonna contract like every .8 seconds or so, right? And so you're actually gonna... You can feel that, right? So you can't... You... That's one way to tell. Uh, but yeah. Women squirt. Some women don't. Does it matter? No. Can you teach yourself to? Maybe. I mean, I don't know.

    6. MRMel Robbins33:49

       How would you teach yourself to squirt?

    7. RMDr. Rena Malik33:50

       The- What they say in literature is, like, it's really a component of how, um, how erect the clitoris is, so how, you know, aggressive that clitoris gets erect, and that's ar- arousal, right? How aroused the woman is. So-

    8. MRMel Robbins34:02

       So you wanna drink a lot of water, pull back the hood-

    9. RMDr. Rena Malik34:05

       (laughs)

    10. MRMel Robbins34:05

        ... take a long time to warm yourself up, lots of lubricant-

    11. RMDr. Rena Malik34:09

        Yep.

    12. MRMel Robbins34:09

        ... and stay focused in the moment.

    13. RMDr. Rena Malik34:11

        Exactly.

    14. MRMel Robbins34:12

        Okay. I might have a heart attack if it actually happened to me. (laughs) I don't like... I'm literally... And then, of course, I'd be like, "Was that okay? I'm really sorry."

    15. RMDr. Rena Malik34:18

        (laughs)

    16. MRMel Robbins34:18

        "Does it taste bad? Wah." Oh, my God. Okay. My... You know who's gonna kill me for this episode?

    17. RMDr. Rena Malik34:24

        Your husband.

    18. MRMel Robbins34:24

        My daughters.

    19. RMDr. Rena Malik34:25

        Oh. (laughs)

    20. MRMel Robbins34:25

        Chris doesn't care. He- Chris will literally be like, "If you come home with- with new techniques and a desire to make our sex life better, you could talk about whatever the fuck you want." But I'm sure our daughters would be like, "Mom..." (bubbling sound)

    21. RMDr. Rena Malik34:37

        (laughs)

    22. MRMel Robbins34:37

        "Why did you do that?" Um, Dr. Rena, can you talk about why your sexual health is so important, especially during hormone changes like menopause?

    23. RMDr. Rena Malik34:50

        Yeah. So, you know, I- I'm a menopause-certified practitioner, so you can, you can sort of become a menopause-certified practitioner by going through The Menopause Society. And, you know, during menopause, our body goes through these immense changes, right? Our estrogen drops precipitously. So what happens when your estrogen drops precipitously is the tissues in your vagina and your vulva, they all change. They all become... Uh, b- The- the- the lubrication that you produce decreases. That can make sex more uncomfortable. That can make you more uncomfortable just sitting day-to-day, right? Uh, your labia tend to shrink. Like imagine any part of male genitalia shrunk, like wh- it would be insane. Like w- there'd be, there'd be tons of papers about it, right? (laughs) But there's- there's no real like, "Okay, women's v- labia shrink."

    24. MRMel Robbins35:37

        Does that matter?

    25. RMDr. Rena Malik35:38

        Well, you know, the- there's a couple things that-

    26. MRMel Robbins35:40

        'Cause the labia is just the, like, the curtains on the outside, right?

    27. RMDr. Rena Malik35:44

        Mm-hmm. But they're there as a protection, right? They're to protect you from friction. They're there to protect you from bacteria. And so what happens a lot of the times, forget... Say you're not sexually active, say you're not interested in being sexually active, it puts you at higher risk of getting recurrent UTIs. So you mentioned earlier-

    28. MRMel Robbins35:59

        Really?

    29. RMDr. Rena Malik35:59

        Yes.

    30. MRMel Robbins35:59

        The outside being smaller?
14. 37:46 – 42:19

    Should pain ever be normal during sex?

    1. RMDr. Rena Malik37:46

       who will.

    2. MRMel Robbins37:47

       Is pain normal...

    3. RMDr. Rena Malik37:48

       No.

    4. MRMel Robbins37:48

       ... during sex?

    5. RMDr. Rena Malik37:49

       Pain is never- should never be normal. So I think people always make this assumption, right? Like, "Oh, it's okay to have a glass of wine," or, um, "You can have sex and the first time will be painful." It shouldn't be, right? It's probably painful because you're rushing or maybe you have actually an abnormality. Something is going on. Maybe your pelvic floor is abnormal. Maybe your, um... Maybe you have endometriosis. Maybe there's a medical condition there that needs to be uncovered. But sex should not be painful. And, you know, yes, sometimes there are like, um, very large phalluses which can be uncomfortable and there are actually products you can buy that you can put on the phallus so less of it gets inserted. Sometimes you will see people have pain with that. Or c-

    6. MRMel Robbins38:28

       In terms of the end of it hitting your cervix or something?

    7. RMDr. Rena Malik38:32

       Correct. Correct.

    8. MRMel Robbins38:32

       Okay.

    9. RMDr. Rena Malik38:32

       So s- there are some, you know, obviously there are some cases where, like, you can't, uh, deal with anatomy, maybe that's just not the right-

    10. MRMel Robbins38:38

        Mm-hmm.

    11. RMDr. Rena Malik38:39

        ... that size is too big. That's okay. You can still address that. But otherwise, you know, there should be ways for you to find pleasurable positions or comfort during sex. It should not be painful. And you shouldn't be rushing, right? A lot of people rush through sex and they're not allowing themselves to get lubricated. They're not allowing those changes to happen. And then if you do all those things and you're still having pain, see a doctor. Like, there are lots of things that can cause pain and we can help you with that.

    12. MRMel Robbins39:04

        What is the truth about how you can have good sex?

    13. RMDr. Rena Malik39:09

        So to truly have good sex, you need to be completely vulnerable. You need to first feel safe, of course, but then you need to be completely vulnerable to allow yourself to, you know, completely experience the pleasure you're feeling, right? Because otherwise if you're not completely vulnerable, if you're not completely there and present, you're not gonna be able to experience the sensations you're having. You're gonna be thinking about other things. So it's being vulnerable and being present and that's gonna allow you to have the best sex of your life, right? And that sometimes takes a lot of effort for people and a lot of energy and, uh, actual work towards getting there, but it's worth the work, right? Because you want sex to be a good experience. You want it to be fun. You want it to be transformative at times. And so actually taking the time to sort of, like, you know, f- work through the kinks of sex, which is I think a lot of times we're like, "Oh, how do I even talk about this? How do I bring this up? Things are not perfect, but, like, I don't want to hurt anyone's feelings." We're a very polite society, right? And it's like, no, this is something that takes work. Just like hard conversations in your relationship have to happen, conversations about sex occasionally need to happen.

    14. MRMel Robbins40:16

        So now I can feel the person listening going, "I don't wanna have that conversation."

    15. RMDr. Rena Malik40:20

        Mm-hmm.

    16. MRMel Robbins40:21

        "How do I even start having that conversation?"

    17. RMDr. Rena Malik40:23

        Absolutely.

    18. MRMel Robbins40:23

        So how do you start, Dr. Rena, having the conversation about the kind of sex that you want or... Do we even know what kind of sex that we want?

    19. RMDr. Rena Malik40:32

        Well, some people do and some people don't, right? I think it starts with self-exploration. And so I think people, you know, have very different preconceived notions about that. Like men, it's very common to have self-exploration, and women it's sort of variable. Like some women will be in their 20s before they've tried any self-exploration. Some women have never tried it at all. So I think ultimately actually first of all figuring out what you like, and that can be with partners too. Like, you know, you, if you have a partner who's experimenting or you've had multiple partners and you've sort of figured out what you like, but it does take a little bit of identification first. And then about having the conversation, right? I think people think, "I'm gonna have one conversation, it's gonna be done, and it's gonna be great," right?

    20. MRMel Robbins41:10

        Yeah.

    21. RMDr. Rena Malik41:10

        Or, "I'm gonna try to have a conversation, it doesn't go the way I want to and then that's it, I'm never gonna try again." But it's not like that, right? It's gonna take multiple conversations and it's going to be, you know, awkward for both of you because no one taught us how to talk about sex. No one taught us how to have sex, first of all, right? You remember sexual education in high school or, or elementary school or middle school, wherever you learned it, but, like, no one taught you how to actually mechanically have sex. So that's one thing.

    22. MRMel Robbins41:35

        Yeah.

    23. RMDr. Rena Malik41:35

        And two, no one talked, taught us how to talk about sex unless you're in a very progressive household. And so you're like, okay, you're gonna have this conversation. You're both gonna feel awkward. Someone may shut down. And that doesn't mean that it has to stop. It just means that, like, you're gonna try again another time and you're gonna say, "Okay, let's have a conversation outside of the bedroom. Let's, maybe it'll be more comfortable if we're sitting in a car so we're not staring at each other or we're going for a walk so we're not staring at each other and then we can talk about, like, 'Hey, you know, let's just have this conversation. Let's do our best to be open about it.' I wanna talk to you about what I like and what I, you know, maybe would like to try and I'd love to hear the same from you." And trying to just be very positive and, you know, in terms of, like, bringing up what you like, what you enjoy they do and then offering

15. 42:19 – 45:19

    How to address what’s NOT working for you in the bedroom.

    1. RMDr. Rena Malik42:19

       suggestions. Say, "You know, I would really like it if you tried this next time. That would really turn me on." And that would, you know, be received well instead of saying, like, "Oh, you do this and I really hate it," right? 'Cause that's gonna make-

    2. MRMel Robbins42:28

       Oh my God. I can't even imagine saying that to somebody.

    3. RMDr. Rena Malik42:31

       (laughs) Right, but, you know, I mean some people might be like, "You know, I really hate that." I- they don't know how to say it so they just blurt it out, right? They just want to get it over with. And so that's gonna just make a negative... That's gonna end that conversation and you're probably never gonna have a conversation again. So trying to keep it positive, keeping it sort of like, "This really turns me on. This is what I really like." And then obviously you know your partner, so sort of like how do they communicate and using those same communication skills like you're having a tough conversation about finances or about your kids or whatever and bringing that to talking about sex.

    4. MRMel Robbins43:00

       Okay. So I just wanna make sure, Dr. Rena, I have-... really extracted the what I'm doing.

    5. RMDr. Rena Malik43:06

       Mm-hmm.

    6. MRMel Robbins43:06

       So you said don't have the conversation in the bedroom.

    7. RMDr. Rena Malik43:08

       Mm-mm.

    8. MRMel Robbins43:09

       You might wanna have the conversation while you're both focused on something else, like you're taking a walk, you're side by side, you're talking and walking. You're not necessarily doing the death stare at each other-

    9. RMDr. Rena Malik43:19

       Mm-mm.

    10. MRMel Robbins43:19

        ... so it doesn't have to be so intense. What is the opening line? Like, how do I get into this?

    11. RMDr. Rena Malik43:24

        So you could, I mean, there's a few ways to do it, right? You could say, like, at some point be like, "Hey, babe, I'd love to have this conversation with you at this time at this day." Or, like, you know, or at some point, and maybe let them offer a time. But say like, "You know, I'd really love to just carve out some time where we can talk about this," so that you're a little bit-

    12. MRMel Robbins43:38

        About sex.

    13. RMDr. Rena Malik43:39

        Yeah, about sex.

    14. MRMel Robbins43:39

        Okay.

    15. RMDr. Rena Malik43:40

        And just say like, so you're primed a little bit, right? Like, "We're gonna have a little bit of a charged conversation. I don't know where it's gonna go, but, like, like, I really just wanna make our sex life even better." Right? Or even greater. And like, I love-

    16. MRMel Robbins43:49

        Well, I think that's a great lead-in.

    17. RMDr. Rena Malik43:51

        Yeah.

    18. MRMel Robbins43:51

        Like, I wouldn't, I wouldn't prime my husband because I think he'd panic that he's doing something wrong.

    19. RMDr. Rena Malik43:55

        Right.

    20. MRMel Robbins43:55

        But I love the thing where you're like, okay, we're driving a car, we're on our way somewhere, "Hey, babe, I'd love to talk about how we can make our sex life better."

    21. RMDr. Rena Malik44:01

        Yeah. And honestly, like, if they wanna have sex and, you know, if, so s- say you're a female in a heterosexual relationship and a man hears, "I wanna have more sex or better sex"-

    22. MRMel Robbins44:11

        Right.

    23. RMDr. Rena Malik44:11

        ... that's pretty exciting for them, right? They're like, "Okay."

    24. MRMel Robbins44:13

        Of course.

    25. RMDr. Rena Malik44:13

        You know, usually, I mean, not always, it's the man who wants, uh, sex more often than the female. Now, that's not always the case and it's not, it's not abnormal if a man wants sex less, let's just preface that. But, you know, more common we see it that way. And so most people are gonna respond to that quite favorably and say, "You know, let's, yeah, let's talk about it."

    26. MRMel Robbins44:30

        Do you have advice about how you should communicate with your partner about when you wanna have sex?

    27. RMDr. Rena Malik44:37

        Yeah. So I mean, I think this is an interesting question because, um, you know, who initiates, right? Like, w- is it, is it always-

    28. MRMel Robbins44:42

        This is a big issue with, like, it's, and, and I don't mean issue like we're in therapy about this.

    29. RMDr. Rena Malik44:47

        Mm-hmm. Mm-hmm.

    30. MRMel Robbins44:47

        But this is something that's, that I think my husband and I have gotten into a, like, you kinda notice-
16. 45:19 – 49:10

    How to initiate sex and be in the moment.

    1. RMDr. Rena Malik45:19

       think, you know, in terms of, like, initiation, right? I think one is, like, are you... Is it that they're initiating when you're not in the mood or are they initiating-

    2. MRMel Robbins45:27

       Mm-hmm.

    3. RMDr. Rena Malik45:27

       ... in a way that is not attractive, right? Like, there's a, you know, like, are they just grabbing you or, like, they're just doing something that, like, they think is playful, right? They're not trying to be gross, they're just trying to be playful and, like, get you in the mood. And that's how they're communicating and that might not be your communication style. So one is like, where is the issue there? And, like, you know, maybe they, they... It's, it's hard for someone if it's always the same person and they keep initiating every single time and you keep saying no. Like, it becomes very difficult to keep initiating.

    4. MRMel Robbins45:57

       Yeah.

    5. RMDr. Rena Malik45:57

       And then they're waiting for you. So sometimes I'll tell people, like, "Okay, one, you gotta sort of figure that out." Like, you know, why, like, if you are always saying no or you're t- turning them down quite often, like, why are you? Like, think about that and then say, like, "How can I make it so that I'm more receiving of them?" Like, what are they doing or what at what time... Maybe it's like you're not a morning person and, you know, they're always ready to go in the morning. Like, you know, you have to communicate that with them. Um, or maybe it's the way they're approaching you. And then, you know, vice versa you sort of, like, it's, it's good for both partners to initiate, right? I think it takes courage, it takes effort, even in long-term relationships to, like, disrupt someone's day and be like, "Hey, I wanna initiate." And the other thing that I think about initiation that's important is that desire is not always spontaneous. So what we see in the movies, right? Like, people see their partner, they get really turned on, they immediately wanna have sex.

    6. MRMel Robbins46:45

       Right.

    7. RMDr. Rena Malik46:45

       That's not normal for a lot of people, particularly in long-term relationships. It's like when you go to the gym. You don't always wanna go to the gym, but once-

    8. MRMel Robbins46:53

       Never.

    9. RMDr. Rena Malik46:53

       ... you're, once you're there you're glad you did. Right? So same thing with sex. Sometimes you have to initiate, let yourself be in the moment and, like, like, oh, you start touching each other. You're like, "Oh, yeah, I like this." But you didn't, like, when they started you weren't really in the mood. But, like, you know, you started cuddling, started touching, you're like, "Oh, wait, yeah, I like this. Okay. Oh, oh, I'm in the mood." Right? That's responsive desire. So there's sort of a different way to think about it. It doesn't mean that you don't want it in the, right that second. It may just be that you need to be warmed up and in the mood, and then you'll feel the desire. And then you'll be like, "Okay, yes, I'm, I'm ready to have sex with you." And maybe that'll work sometimes and sometimes it won't, but it's completely normal in terms of desire to have it come after the initiation sometimes.

    10. MRMel Robbins47:32

        Uh, you know, (clears throat) to your point of thinking about it as play, like, two things that have made a huge difference for Chris and I is, um, texting each other.

    11. RMDr. Rena Malik47:41

        Mm-hmm.

    12. MRMel Robbins47:42

        And being like, "How about 2:00?"

    13. RMDr. Rena Malik47:44

        Yeah.

    14. MRMel Robbins47:44

        So it becomes more of a midday thing that... 'Cause, 'cause we became the couple that were really attracted to each other and wanted to have more sex, but we were just freaking exhausted.

    15. RMDr. Rena Malik47:56

        Yeah.

    16. MRMel Robbins47:57

        And we also had slightly different bedtimes so by the time I got into bed, Chris was always, already asleep and-

    17. RMDr. Rena Malik48:02

        Mm-hmm.

    18. MRMel Robbins48:02

        ... by the time he's waking up it's fi- And so I think you can get into that rhythm too.

    19. RMDr. Rena Malik48:07

        Yeah.

    20. MRMel Robbins48:08

        Where you're just not having sex not because you don't want to, but life is overwhelming and you're tired and you're on slightly different schedules. And so disrupting that assumption that it should happen in the morning or the evening-

    21. RMDr. Rena Malik48:22

        Yes, absolutely.

    22. MRMel Robbins48:22

        ... and creating more moments of, "What about 3:00? I gotta break a m-" You know, that-

    23. RMDr. Rena Malik48:27

        Yeah.

    24. MRMel Robbins48:27

        ... kind of thing makes it more fun. And makes it... And also, we created this agreement that it didn't have to lead to orgasm. That it was just a moment to be together-

    25. RMDr. Rena Malik48:39

        Exactly.

    26. MRMel Robbins48:39

        ... for half an hour or whatever, and just be intimate.

    27. RMDr. Rena Malik48:43

        And that's, that's exactly what we tell people to do. It's really important to prioritize your sex life if you want it to be a priority. Right? So, like, actually making time. Like, think about when you were younger and you used to go on a date, right? You would get, you would say, "Oh, we're gonna see each other Friday. I'm gonna get all ready. I'm gonna shave my legs, I'm gonna do my makeup. Um, I'm gonna make sure, like, oh, we might have sex. It's sort of exciting." So you have something to look forward to. And it can actually be really, really fun to allow

17. 49:10 – 51:21

    When testosterone (the hormone of desire) is the highest for men and women.

    1. RMDr. Rena Malik49:10

       that to be a thing. And the other thing about timing is, you know-Our hormones fluctuate throughout the day. So in the morning between 7:00 and 10:00 AM is when testosterone is highest for, for both men and women, but more so men.

    2. MRMel Robbins49:23

       Oh.

    3. RMDr. Rena Malik49:23

       And so that will be... Testosterone is the hormone of desire. So very often people will actually feel more desire in the morning, and so that's not unreasonable to utilize your hormones and, uh, use them to your advantage. Like, "Okay, we're gonna schedule time in the morning because we're both gonna be sort of like ab- able to receive because we have more hormones on our side."

    4. MRMel Robbins49:43

       Yeah. Just don't put it in the family calendar as mom and dad-

    5. RMDr. Rena Malik49:46

       (laughs)

    6. MRMel Robbins49:46

       ... are banging right now. Do not disturb, right? You gotta have like a code name for it. Walking the dog-

    7. RMDr. Rena Malik49:51

       Yeah.

    8. MRMel Robbins49:51

       ... (laughs) is something that is like... (laughs)

    9. RMDr. Rena Malik49:52

       Yeah, or like on date night, have sex first. Don't go out to dinner first.

    10. MRMel Robbins49:56

        Ooh, I like that.

    11. RMDr. Rena Malik49:57

        Yeah. Yeah. So have date night, have dinner, whatever you normally do, but have sex first, right? Don't get, don't eat a ton of food, get bloated, drink a bunch of drinks, then you're like not even able to like really-

    12. MRMel Robbins50:06

        Right. And then a lot of us then are driving home and start arguing about something stupid-

    13. RMDr. Rena Malik50:10

        Yeah.

    14. MRMel Robbins50:10

        ... and then we just like storm into the bedroom.

    15. RMDr. Rena Malik50:11

        Yeah.

    16. MRMel Robbins50:11

        That's a genius idea.

    17. RMDr. Rena Malik50:13

        Absolutely.

    18. MRMel Robbins50:14

        Yeah. That's the appetizer.

    19. RMDr. Rena Malik50:15

        Yeah.

    20. MRMel Robbins50:15

        Each other. I love that. What are some of the most common sexual insecurities, Dr. Rena?

    21. RMDr. Rena Malik50:22

        So for... We've touched on a couple of them. So for women, it's vaginal odor is pretty common, and then body image insecurities, so like breasts or butts, and we find that this actually is very common in younger women, and as they age, those insecurities get less and less for a lot of people because you're more comfortable in your own body, you're more comfortable talking about sex or knowing what pleasure is for you and what you need to achieve pleasure or orgasm, but those are very common. And then other ones are like, particularly when you're younger, is like being inexperienced or being, um, like making noises or things like that can be sort of pretty common insecurities, but like I said, sex is play. There's gonna be noises. Like you're gonna have a queef or you're gonna like... there's gonna be some weird noises and that's okay. It's like, it's normal. It's... Your body's gonna make noises when you're doing these activities, right? And then for men, most commonly it's penile size. So they're worried that like one, am I normal? And two, is it gonna shrink with age? And then they're also worried about ejaculating too soon.

18. 51:21 – 54:47

    The truth about whether or not the penis shrinks with age.

    1. RMDr. Rena Malik51:21

       So those are sort of the most common insecurities.

    2. MRMel Robbins51:23

       Does the penis shrink with age?

    3. RMDr. Rena Malik51:26

       Yeah. So not exactly. It, it can shrink commonly. It really depends. So one is you gain weight. A lot of men gain weight, and then as they gain weight, they're seeing less of their penis because there's weight on the mons, which is that area right above the penis, that gets fatter so they're seeing less penis. So that's one.

    4. MRMel Robbins51:42

       So it's like an optical illusion.

    5. RMDr. Rena Malik51:44

       That's one. Yeah.

    6. MRMel Robbins51:45

       So the penis didn't actually get shorter.

    7. RMDr. Rena Malik51:47

       They got bigger.

    8. MRMel Robbins51:47

       You're... Uh, yeah, you got bigger. (laughs) Oh my God.

    9. RMDr. Rena Malik51:50

       (laughs)

    10. MRMel Robbins51:50

        That's a very delicate way (laughs) to say that, but okay.

    11. RMDr. Rena Malik51:53

        But it's... You know, it happens. And then two is if you smoke, it can shrink because-

    12. MRMel Robbins51:57

        What?

    13. RMDr. Rena Malik51:58

        Yeah. Because smoking can change the collagen content of tissue and so it won't be as flexible. So sometimes, you know, men are showers or growers. Some people who are shower... who are growers, meaning like when they get an erection they grow quite a bit, that will become less prominent because their tissues are now less elastic from all the smoking. Um, and then if you have erectile dysfunction, you can actually get, um, some... that, that decreased blood flow to the tissues can cause scar tissue or fibrosis and that's like, you know, for... very, like, delayed. So not very early on, but if you're not getting any erections at all over time you can develop scar tissue and then that can shrink the penis.

    14. MRMel Robbins52:35

        Can a man ejaculate without an erection? Like, if you think about a lot of men that start to struggle with testosterone or prostate issues and they can't achieve a erection-

    15. RMDr. Rena Malik52:48

        Mm-hmm.

    16. MRMel Robbins52:49

        ... can they still ejaculate?

    17. RMDr. Rena Malik52:50

        Yeah. You can orgasm, you can ejaculate, uh, you know-

    18. MRMel Robbins52:53

        Wait, you can have an orgasm without an erection as a man?

    19. RMDr. Rena Malik52:55

        Exactly. Exactly.

    20. MRMel Robbins52:56

        How?

    21. RMDr. Rena Malik52:57

        So you just stimulate. It just... You don't... The erection is like... the erection is, is important for, for being able to pene-... but you can still stimulate the penis and the genitals without an erection, right? You can use other types of sex to stimulate the partner and then they can still have an orgasm, they can still experience pleasure, but they won't have the optics of having an erection. And that's very mentally tied to orgasm. So very often-

    22. MRMel Robbins53:21

        Yeah.

    23. RMDr. Rena Malik53:21

        ... it's difficult for men because they're like, "I don't see an erection. I'm not aroused. I'm not mentally there." So that takes a little bit of training and work to sort of be like, "Okay. I'm okay with the fact that I'm not getting erections. We can still achieve pleasure." But you need to... again, the same things, be vulnerable, be present, be mindful about what's going on to achieve an orgasm without an erection.

    24. MRMel Robbins53:43

        What should you do to help your partner if they can't get an erection but you do want them to have an orgasm? Like I don't... I, I, I didn't even know it was possible.

    25. RMDr. Rena Malik53:52

        Yeah. So I think again it's sort of like they have to be willing to receive that-

    26. MRMel Robbins53:57

        Okay.

    27. RMDr. Rena Malik53:57

        ... that pleasure and stimulation. So sometimes what, what we tell people and what sex therapists will tell people is like, "Start working on not actually having sex. First start by just doing what's called sensate focus. So touch yourselves all over your body, explore your bodies, don't touch the genitals." So do just that. Like enjoy the pleasure of touching each other, right? And then once you're feeling very comfortable and confident with that, then you can incorporate some genital touching. Just touching, right? And then once you feel comfortable with that, then you can move on to more stimulation, whether it's penetrative or oral and sort of like, you know, but then you're working on being mindful with just the basics. There's no pressure of an erection. There's no pressure of an orgasm. It's just experiencing those moments and like really being present in the moment.

    28. MRMel Robbins54:44

        Wow. That's pretty cool.

    29. RMDr. Rena Malik54:46

        Yeah.

19. 54:47 – 57:06

    Reasons people feel shame around sex.

    1. RMDr. Rena Malik54:47

    2. MRMel Robbins54:47

       Um, what are some of the reasons-... Dr. Rena, that people experience shame around sex?

    3. RMDr. Rena Malik54:52

       I think a lot of it stems from feeling not good enough.

    4. MRMel Robbins54:57

       Mm.

    5. RMDr. Rena Malik54:57

       Right? Like whether in men it's being... Having strong enough erections, lasting long enough. For women, it's like, "Am I, you know, am I having an orgasm? Am I am, am I pleasuring my partner? Do I smell? Do I look okay? Do I..." You know, all those things, and that's really what causes a lot of shame. And unfortunately, a lot of it stems from lack of education, right? Like, not knowing what's normal and what's okay. And a lot of it is because we're not learning from anybody who... Like, we're not learning what real sex should look like. We're learning from TV or from pornography, and those are not real. They're made-up, created products to arouse you or to get you entertained. It's not real life. And so there's so much insecurity there that, like, people are just holding onto that. And I think it's very, it's very common in the US because we're sort of a sexually prude society. But if you look at other countries which are more sexually open like, you know, northern, in Northern Europe, like, they're much more progressive about sex. They talk about sex. They teach their children about even the names of their genitals very early. There was one, um, animated series that came out from, I think it was Denmark, where they had this real... This boy with a very long phallus, and the whole, the whole episodes were about, like, his long phallus getting caught on things and, like... But it was like, you know, they were using it as a teaching tool, and I was like watching this being like, "Oh my god," like, "What, what's going (laughs) on here?"

    6. MRMel Robbins56:17

       (laughs)

    7. RMDr. Rena Malik56:17

       Because it's so radical for us-

    8. MRMel Robbins56:19

       Right.

    9. RMDr. Rena Malik56:19

       ... in the United States. But like, for them, it's just a teaching tool. Like, "This is your penis. This is, like, how you take care of a healthy penis." They probably use it to sort of really educate their children.

    10. MRMel Robbins56:29

        How does porn impact the sexual expectations between partners?

    11. RMDr. Rena Malik56:34

        Yeah, I mean, I think it really depends on when you're introduced to pornography. Like, I think if you're introduced older, which a lot of, you know, um, our generations didn't have access to pornography like they do now, right? You had to, like, find a magazine, find a, a DVD or vi- not even DVD, like a VCR and, like, a ti- a tape and like-

    12. MRMel Robbins56:51

        Or in my case, one of my friends' dads who had a secret stash of magazines-

    13. RMDr. Rena Malik56:56

        Yeah. (laughs)

    14. MRMel Robbins56:56

        ... that we discovered, yes.

    15. RMDr. Rena Malik56:58

        Yeah. So you had to find it and then find a quiet room to, to look at it where nobody would find you. Like, there was like a, a lot of planning involved-

    16. MRMel Robbins57:03

        Mm.

    17. RMDr. Rena Malik57:03

        ... to even see that. Now it's just so accessible.

20. 57:06 – 58:21

    Porn and its effect on sexual expectations between partners.

    1. RMDr. Rena Malik57:06

       So one, I think when you see pornography when you're younger, unless someone tells you, like you actually have to talk to your kids about like, "You might see this. This is not real life." Um, but like, then you're like, "Oh, that's what sex should look like. That's, you know, what the encounter should go like. This is how long I should last. This is how much ejaculate volume I should have. This is how quickly she should orgasm. This is how she should respond, or this is how I should respond, or this..." You know, all these things, "I should be squirting these large volumes," right? Like, all these things you see in pornography, they are created, and these are professional actors, right? They have, uh, trained their bodies, or they've chosen to do this profession because they're able to do these things, like whatever it is. But this is not real life. And so I think what it hurts us is when we start using that as a model of what real is. And then if you keep using that as like what turns you on, then real life's not gonna turn you on, right? Because you're turned on by something that's so different and so unique and so not what real sex is like that you might say, "Hey, I'm having trouble because I just don't know, like, it's not happening like I expected it to." So your expectations are different. I think once you're older and you have a fully formed frontal lobe, you can sort of differentiate real from fake. But I think when you're younger, and I worry about that for our

21. 58:21 – 1:01:31

    How your mental health impacts your sex life.

    1. RMDr. Rena Malik58:21

       younger kids, like they don't, they don't know.

    2. MRMel Robbins58:23

       Um, can you talk a little bit about how mental health can impact your sex life?

    3. RMDr. Rena Malik58:29

       Mental health is a huge impact. So one, I, I always say like, is it the sexual health that created the mental health or the mental health that created the sexual health problem? Because sometimes you, you dig deep and you find out that the reason they're having mental health problems is because of some deficiency they're having in their sex life. So that's one possible thing, but they're very commonly commingled. So when you look at like people with depression, anxiety, or taking meds for depression or anxiety, about 30 to 60% of those people will have sexual dysfunction. So it's very, very common. And some of it's because of the medications. So-

    4. MRMel Robbins59:03

       Sexual dysfunction is defined as what?

    5. RMDr. Rena Malik59:06

       So it could be a variety of things. A... Very commonly, it could be low libido. It could be difficulties with erections, ejaculation, um, arousal. Any of those categories you could have problems with, orgasms even, depending on, you know, what the issue is, but also those medications, SSRIs particularly, have high rates of sexual side effects. And so they're dose dependent, so some people on low doses won't experience them, but some people on higher doses will. And it can be really difficult because they need those medications to feel good, but then they can't have... You know, they're, they're maybe having trouble with desire, which is probably the most common thing we'll see. But also think about it. If you're not feeling good about yourself for whatever reason, it's very difficult to allow yourself to experience pleasure and enjoy pleasure because you're, you're, you're feeling bad all the time. And that's the same thing about stress, right? If you're really stressed all the time, it's extremely difficult to allow yourself to experience pleasure, because that's just taking over. All that cortisol and those negative feelings are taking over your body, and you can't relax enough to enjoy pleasure.

    6. MRMel Robbins1:00:11

       You know, that's true, 'cause I- I do see a direct connection between periods of my life where I'm super stressed out and a complete lack of a sex drive. And if you think about stress as you being in a state of fight or flight all the time-

    7. RMDr. Rena Malik1:00:28

       Mm-hmm.

    8. MRMel Robbins1:00:28

       ... it's kind of hard to drop in and be present, which is one of the big things you have been telling us today. You gotta look at it as play, and you gotta figure out how to be present.

    9. RMDr. Rena Malik1:00:36

       Mm-hmm.

    10. MRMel Robbins1:00:37

        Otherwise, you're not gonna enjoy it as much as you could.

    11. RMDr. Rena Malik1:00:39

        Yeah. In fact, they've looked at people who have mindfulness practices, and they found that people who maintain mindfulness practices for like eight weeks, for example, are more likely to ha- score better on like sexual function indexes. So they're actually having better sa- more satisfied sex and, you know, scoring better in a whole bunch of different domains, particularly desire being one of them. And so, you know, it's part of like, again, mindfulness is gonna help us be present, not just in sex but in a whole variety of things. But our society is so busy right now. Everyone's like, "How can I get mindfulness in?" And what I tell people is like, "Just start with a minute or two minutes a day where you're dedicating some time to yourself and you're trying to be mindful, and then you can build up a mindfulness practice." It may benefit you, you know? And it's free. It's completely free. Like try it and see. The only thing you're giving is time, but you're giving that time to yourself. You're giving that time to improving yourself.

22. 1:01:31 – 1:04:38

    How to reclaim your sexual health after experiencing trauma.

    1. MRMel Robbins1:01:31

       Dr. Rena, can you talk a little bit about how somebody who has experienced trauma can reclaim their sexual health?

    2. RMDr. Rena Malik1:01:39

       Yeah. So trauma's very challenging, and I think it takes... You know, if you've experienced trauma, I strongly suggest you see a mental health professional because there's gonna be a lot of layers there that you need to kind of work through to really, you know, be sure that you're sort of feeling safe. That's the most important thing, is you have to feel safe. And I can't teach you how to feel safe. You have to work on the thoughts around your trauma and- and be able to sort of navigate the- those through whether cognitive behavioral therapy or other things that they can offer you to sort of be able to feel safe. 'Cause if- if you don't feel safe because of your past trauma, you're never gonna be able to have good sex.

    3. MRMel Robbins1:02:15

       I mean, that makes sense-

    4. RMDr. Rena Malik1:02:16

       Mm-hmm.

    5. MRMel Robbins1:02:16

       ... 'cause you're always gonna be kind of in a trauma response in your body-

    6. RMDr. Rena Malik1:02:21

       Right.

    7. MRMel Robbins1:02:21

       ... protecting yourself-

    8. RMDr. Rena Malik1:02:22

       Mm-hmm.

    9. MRMel Robbins1:02:23

       ... and not be able to connect with your partner.

    10. RMDr. Rena Malik1:02:25

        Yeah.

    11. MRMel Robbins1:02:25

        Um, let's talk... I've got some questions here for our male listeners and for our listeners who love them. I read that men who ejaculate 21 times a month lower their risk for prostate cancer. Is that true?

    12. RMDr. Rena Malik1:02:41

        Yeah. So there was one study that looked at... This was a very well done study, and they basically followed men for almost 20 years. Okay? They followed, like, 40,000 men for 21 years, and they looked at their numbers of ejaculation per month, and they basically categorized them one to three, four to seven, on and on and on. Right? And so they- they had these categories, and what they found was that men who ejaculated 21 times or more a month were a third less likely to develop cancer, prostate cancer specifically, in that timeframe, um, compared to men who ejaculate only four to seven times a month. And they did a pretty good job of trying to control for other variables, like other, you know, health conditions, smoking, dietary factors. So it was a really well done study. Now, does that mean that you need to ejaculate 21 times or more a month? No, not necessarily. I think it's really, you know... Who's ejaculating 21 times? They're having either really great sex, they have a great partner, they have a good social relationship, they're very comfortable with themselves, maybe they're healthy enough to ejaculate 21 times a month. So there's some variables that you just can't control for. And so I think ultimately, it again goes back to why sexual health is health. If you're able to ejaculate 21 times or more a month, like yeah, you might be cleaning the pipes and you might be getting rid of some free radicals or things that would lead to cancer, so that's not a bad thing necessarily, but ultimately, it's probably an indicator that you're healthier.

    13. MRMel Robbins1:04:01

        Is there any corresponding study around women ejaculating more and it improving our health?

    14. RMDr. Rena Malik1:04:06

        Not yet. Not yet. But we know there's so many benefits to orgasm, right? You have, uh, decreased blood pressure. Your mood is better. You're getting better sleep with orgasms. So I anticipate the findings would be similar, right? Because these things are very difficult to study, how... I mean, we know good sleep is important for a variety of health factors, right? So sleep is important. We know having lower blood pressure is important. So all these things, you're probably, like, a healthier person if you're having more orgasms because you're- you know, again, you're- you're having all these benefits of orgasm.

    15. MRMel Robbins1:04:36

        How can a

23. 1:04:38 – 1:11:58

    Masturbation techniques that can negatively affect men’s sex life.

    1. MRMel Robbins1:04:38

       guy's masturbation technique impact their sex life?

    2. RMDr. Rena Malik1:04:41

       Yeah. So I never like to shame people for masturbation. I think that, you know, masturbation is a healthy form of self-exploration, and it's rare that it becomes a problem. But certainly, there are certain types of masturbation that have been correlated with having more difficulties with erections. Now, that can be prone masturbation, meaning lying on your stomach and masturbating, like, toward... like, maybe hitting the bed or, you know, other hard surfaces. Um, and-

    3. MRMel Robbins1:05:05

       Like, hitting your penis on the bed?

    4. RMDr. Rena Malik1:05:07

       Mm-hmm. Yeah.

    5. MRMel Robbins1:05:07

       Okay.

    6. RMDr. Rena Malik1:05:08

       So that, and then- (laughs)

    7. MRMel Robbins1:05:09

       I was just saying, like, if you saw me, yeah, if you're watching-

    8. RMDr. Rena Malik1:05:12

       (laughs)

    9. MRMel Robbins1:05:12

       ... if you're listening, you didn't see my facial expression on YouTube 'cause my face scrunched. I'm like, "Masturbating as you're laying on bed? That makes... Oh, I get it. Okay."

    10. RMDr. Rena Malik1:05:21

        Yeah, yeah. And- (laughs) and then, um, also they call it, you know, death grip, where having a very firm grip on the- the erection can put you at higher risk. Now, does it mean that everyone who does these things is gonna have problems? No, not necessarily. But ultimately, if you start noticing that... And the reason they have problems, right, is because say you get used to... And women can get habituated to certain types of masturbation too. We just don't have the data on that, right? If you're doing the same thing every single time when you masturbate and you can't replicate that with a partner, right-

    11. MRMel Robbins1:05:52

        Mm.

    12. RMDr. Rena Malik1:05:52

        ... either through vaginal or oral sex, then you're not gonna get the stimulation you need to climax because your body's habituated to that one thing, right? And so that's sort of, like, where you're like, "Okay, I need to keep variety in my life when I'm masturbating." Like, uh, they found that using lubricant for men actually helps. So, um... Or is correlated with less issues, so using lubricant or, like, making sure it's just not a very firm grip. And so that's what I usually tell people. If they're having trouble and they're masturbating a certain way and they think that might be the culprit, is just stop for a little while. Stop masturbating for a little while. And then when you resume, start masturbating with, you know, different sort of lighter techniques and see... and different positions potentially and- and see if, like, you can sort of train yourself to enjoy different types of stimulation.

    13. MRMel Robbins1:06:39

        Is it normal, Dr. Rena, for somebody who was once vibrant, no issues, to suddenly have problems getting an erection?

    14. RMDr. Rena Malik1:06:45

        It's actually very common. It's very common. So 52% of men over 50 will have issues with erectile function, and that just keeps increasing. So 60% of 60-year-olds, 70% of 70-year-olds, 80% of 80-year-olds, and, you know, it's more common in people because of vascular issues. So we know there's lots of people with high blood pressure, diabetes, high cholesterol, and these can all affect blood flow to the penis. So what I tell people is the blood flow to the penis, the arteries to the penis are about one to two millimeters, whereas the arteries to the heart are about three to four millimeters. So before you see problems in your heart, like chest pain, you're gonna see problems with your erections.

    15. MRMel Robbins1:07:21

        Oh.

    16. RMDr. Rena Malik1:07:21

        And so if you have troubles with erections, please see your primary care doctor to get evaluated because you wanna make sure you don't have an underlying health issue. So I will usually screen my patients with, uh, hemoglobin A1C, like, to check their blood sugars. I will screen their cholesterol. And I can't tell you the number of times I've found high cholesterol or, you know, maybe prediabetes in a- in a man who has erectile dysfunction.

    17. MRMel Robbins1:07:45

        So erectile dysfunction become a- can become a- is, like, a symptom-

    18. RMDr. Rena Malik1:07:50

        Mm-hmm.

    19. MRMel Robbins1:07:50

        ... that there are, that there may be developing heart issues?

    20. RMDr. Rena Malik1:07:53

        It could be a sign, yeah.

    21. MRMel Robbins1:07:54

        Wow.

    22. RMDr. Rena Malik1:07:54

        Yeah.

    23. MRMel Robbins1:07:55

        And what are the treatments available?

    24. RMDr. Rena Malik1:07:57

        So there's lot, there's lots of treatments available. Um, you know, there's other types of causes of ED too. I wanna make sure we don't, um-

    25. MRMel Robbins1:08:03

        Let's talk about 'em.

    26. RMDr. Rena Malik1:08:03

        Yeah. There's psychogenic ED. So that can be, like, some of the things we've talked about where your performance anxiety becomes an issue, right? You're stressed about, say, you have one episode where you have an erection that is lackluster or maybe you don't get one, right? Maybe you drank too much. Maybe something happened that day. You were stressed. You couldn't get an erection and then you're stressed about it, right? And then you think about it. You ruminate about it. The next time you have sex, you're like, "Am I gonna have an erection?" In your head, right, you're thinking that and then you get, you don't get one because you're so stressed, right? You're like, you're impossible to relax and enjoy, and then again, not having an erection. And then it just cycles into this horrible vicious cycle and I tell people everyone who has issues with sexual function has some psychogenic component, right? Because you're like always thinking like I'm... Like even for women, am I gonna climax? Is it gonna happen? Am I gonna have an orgasm? Is it gonna be okay? Am I gonna squirt? Am I gonna squirt right? Like all these things, um, sort of they, they stress you out. And so everyone has a little bit of that for sure, but there's some people where that's the only cause, right? So that's, that's one thing. There's hormonal causes, so lack of testosterone. It's actually a very small percentage of ED, so men think, "Oh, it's always testosterone." It's only about 3% of people who only have hormonal causes. So they may have hormonal plus other things, but a very small percent have just hormonal causes. And then there's nerve problems, so like if you have diabetes that can affect the nerves as well as the blood flow, so longstanding diabetes, or if you've had surgery like prostatectomy or other maybe pelvic surgeries for cancer, things like that that can affect those nerves. Um, so those, those are neurologic issues and then medications we sort of touched on a little bit. Those, uh, antidepressants can cause ED. Um, there's other medications. Some blood pressure medications can cause ED very commonly. Those are the most common ones, but there are others of course. So those are the different causes. Now in terms of treatments, we have sort of... Of course if it's psychogenic, we gotta work on that, so usually, um, I would recommend seeing a psychologist or sex therapist, and then also sometimes we can use some of these treatments to help boost your confidence. Uh, but everything else sort of-

    27. MRMel Robbins1:10:01

        Can I pause on that for a minute?

    28. RMDr. Rena Malik1:10:02

        Yeah.

    29. MRMel Robbins1:10:02

        Because I just wanna see if I can make the reason why the rumination is problematic a little bit more tied to the physiology.

    30. RMDr. Rena Malik1:10:15

        Yeah.
24. 1:11:58 – 1:15:32

    Three ways to boost testosterone.

    1. RMDr. Rena Malik1:11:58

       be related to low testosterone.

Episode duration: 1:18:03