The Better-Sex Doctor: The Link Between Masturbating & Prostate Cancer! This Is The Perfect Amount Of Times To Have Sex! Strong Pelvic Floor = Better Sex! Dr Rena Malik
Dr. Reena Malik, a board-certified urologist, debunks sexual health myths and offers actionable advice. She covers pelvic floor health, communication, desire, natural testosterone boosters, and the impact of lifestyle and trauma on sexual well-being.
Deep Dive Analysis
26 Topic Outline
Dr. Rena Malik's Mission: Accessible Sexual Health Education
Defining Sexual Health and Common Misconceptions
The Pelvic Floor: Function, Importance, and Issues
Why Doctors Should Address Sexual Health
Pelvic Floor Dysfunction and Its Link to Erectile Dysfunction
Myths About Sexual Frequency and Pain During Intercourse
Vaginal Physiological Changes During Arousal
Improving Sexual Communication with Partners
Strategies for Rekindling a Struggling Sex Life
Age-Related Differences in Sexual Desire
Hormonal and Stress Impacts on Libido
Natural Methods to Boost Testosterone
Global Decline in Sperm Counts and Environmental Factors
Increasing Semen Volume and Pelvic Floor Role
Technology's Effect on Male Genital Health
Masturbation Myths: Testosterone, Excess, and Benefits
Post-Nut Clarity and Its Physiological Basis
Ejaculation Frequency and Prostate Cancer Risk
Pornography's Impact, Problematic Use, and VR Future
Trauma's Influence on Sexual Health
Orgasms, Clitoral Stimulation, and Female Pleasure
Scheduling Intimacy and Mindfulness for Better Sex
Discrepancy Between Perceived and Actual Sex Duration
Vagina and Penis Size Myths, Aging Effects
Labiaplasty and the Phenomenon of Squirting
Importance of Sexual Health for Overall Well-being
8 Key Concepts
Sexual Health
Sexual health is an individual's ability to have sex, orgasm, experience pleasure, and achieve the benefits of sexual activity. It encompasses physical, emotional, mental, and social well-being in relation to sexuality, beyond just the absence of disease.
Pelvic Floor
The pelvic floor is a bowl of muscles located in the pelvis that supports organs such as the bladder, rectum, vagina, uterus, and urethra. It is crucial for stability, normal urination and defecation, and plays a significant role in orgasm and sexual function for both men and women.
Spontaneous Desire
Spontaneous desire is sexual desire that arises immediately upon seeing someone attractive or without any prior stimulation. It's an immediate feeling of being turned on and wanting to have sex, often experienced more by men.
Responsive Desire
Responsive desire is sexual desire that develops gradually through physical intimacy, touching, or romantic interaction, rather than being immediately present. One might not initially be thinking about sex but becomes aroused as intimacy progresses, often experienced more by women, especially in long-term relationships.
Post-Nut Clarity
Post-nut clarity is a phenomenon, predominantly reported by men, where after ejaculation, the desire for a previously attractive person or sexual activity significantly diminishes. This is theorized to be linked to rapid brain quietening and hormonal changes like increased prolactin and decreased dopamine post-orgasm.
Orgasms
An orgasm is a moment of maximal tension and release, characterized by powerful, pleasurable sensations where one is completely unable to think about anything else. Physiologically, it involves involuntary pelvic floor muscle contractions and various brain and hormonal changes, lasting typically from five to 60 seconds.
Clitoris
The clitoris is the female equivalent of the penis, developing from the same genital tubercle in a fetus. It is highly sensitive, with a shaft extending deep into the pelvis around the vaginal canal, and is the most reliable route for orgasm for 85% of women.
G Erogenous Zone
The G erogenous zone is an area on the anterior (top) wall of the vagina, about two to three centimeters in, underneath the urethra. It is rich in nerve endings and contains the female prostate (Skene's glands), making it a highly erogenous area that can contribute to orgasm.
18 Questions Answered
Sexual health is defined as an individual's ability to have sex, orgasm, experience pleasure, and achieve the benefits of sexual activity, encompassing physical, emotional, mental, and social well-being related to sexuality.
Discussing sexual health is crucial because difficulties can lead to shame, relationship issues, depression, and anxiety. For men, erectile dysfunction can be an early indicator of serious cardiovascular problems like heart attacks.
Prolonged sitting can cause the pelvic floor muscles to tense up, potentially affecting blood flow and nerves to the penis, which can contribute to erectile dysfunction in some men. It can also lead to pelvic floor discoordination or tightness, causing urinary urgency or pain.
There's no ideal number, but studies suggest partnered individuals have sex about once a week on average. The quality of sex and the pleasure derived from intimacy and orgasm are more important than the frequency.
No, sex is not supposed to hurt. Pain during sex, especially for women, can be due to insufficient lubrication, lack of foreplay, hormonal changes, pelvic floor dysfunction, or underlying conditions like endometriosis, all of which warrant evaluation.
During arousal, the vagina self-lubricates and can lengthen and widen by about double its size to accommodate penetration. This process typically takes around 18 to 20 minutes on average.
The first step is open and honest communication. Partners must know what they like and want, and be willing to discuss it outside the bedroom, using "I" statements, and understanding that it's an ongoing process, not a one-time talk.
While hormones like testosterone are crucial for desire in both men and women, low libido is not always solely a hormone problem. Chronic stress, which elevates cortisol, can significantly lower testosterone levels and impact libido, making stress management a key factor.
Yes, both testosterone levels and average sperm counts have declined significantly over the last 50 years. This is attributed to more sedentary lifestyles, increased metabolic conditions, and exposure to endocrine-disrupting chemicals and microplastics in the environment.
No, there is no convincing high-quality evidence that masturbating or abstaining from masturbation significantly increases or decreases testosterone levels. A single small study showed a minor temporary increase after 21 days of abstinence, but it's not considered conclusive.
Masturbation is generally safe unless it becomes problematic, such as choosing it over sex with a partner, work, or being unable to sleep without it. It can also cause issues if one habituates to a specific type of stimulation that cannot be replicated with a partner.
A well-conducted study found that men who ejaculated 21 times or more per month were less likely to develop prostate cancer. This is hypothesized to be due to the "prostate stagnation hypothesis," where frequent ejaculation helps clear prostatic fluids.
Pornography itself is not inherently bad; it's a form of entertainment. However, issues arise with children being exposed to it at young ages (average 13), leading to unrealistic expectations about sex. For adults, problematic use can occur if it becomes an addictive coping mechanism for stress or rejection.
Yes, absolutely. Having sex while pregnant is generally safe and will not cause preterm labor or harm the fetus.
Scientific studies using stopwatches have found the average duration from penetration to male climax to be about 5.1 to 5.7 minutes, varying by country. This is often shorter than what men and women ideally desire.
No, the vagina does not get "loose" from having more sex. Vaginal laxity or a weak pelvic floor is typically caused by childbirth, neurological conditions, collagen disorders, or prolonged standing, not sexual frequency. In fact, orgasms can strengthen pelvic floor muscles.
According to one Japanese study, nose length was correlated with penile length, but hand length or foot length were not. Penis size is largely genetically determined.
Squirting is the emission of a clear, colorless, odorless fluid from the urethra during orgasm. While some studies suggest it contains dilute urine, women who experience it often report it's not urine. The exact origin of the fluid is still debated, possibly involving water imbibition in vaginal/uterine walls.
15 Actionable Insights
1. Prioritize Sexual Health as Overall Health
Recognize that sexual health issues can profoundly impact mental well-being, relationships, and signal serious underlying physical conditions like heart disease. Prioritize open conversations and professional evaluation to address concerns early.
2. Address Erectile Dysfunction Early
Erectile dysfunction (ED) can be an early warning sign of cardiovascular problems, preceding heart attacks by up to seven years. Seek medical evaluation for ED to assess underlying vascular health.
3. Strengthen Your Pelvic Floor
Perform pelvic floor exercises (Kegels) by squeezing and relaxing muscles (like stopping urine or holding a fart) for five seconds each, starting lying down. This improves orgasm, semen propulsion, and addresses issues like ED, urinary urgency, and pain.
4. Practice Open Sexual Communication
Learn to communicate your sexual desires and preferences using ‘I statements’ with your partner in neutral settings, outside the bedroom. This fosters understanding and prevents misunderstandings that can lead to relationship issues.
5. Schedule Intimacy, Not Just Sex
Set aside dedicated time for intimacy with your partner on a calendar, focusing on physical closeness and connection without the pressure of immediate sexual performance. This can help cultivate responsive desire and reconnect sexually.
6. Increase Testosterone Naturally
Optimize sleep (7-8 hours), engage in resistance exercise (especially large muscle groups), and adopt a Mediterranean-style diet rich in healthy fats while avoiding processed foods and sugar. This naturally boosts testosterone levels.
7. Extend Foreplay for Female Orgasm
Recognize that women typically take around 14 minutes to orgasm, often requiring direct clitoral stimulation, compared to men’s average of 5-6 minutes of penetration. Prioritize sufficient foreplay (around 18-20 minutes) to ensure female pleasure and orgasm.
8. Use Lubricant and Increase Foreplay
If sex is painful, increase foreplay to allow the vagina to naturally lubricate and expand, and use external lubricant. Persistent pain warrants medical evaluation.
9. Minimize Endocrine Disruptor Exposure
Reduce exposure to microplastics and endocrine-disrupting chemicals by avoiding plastic water bottles and warming food in plastic containers. This can help protect sperm quality and testosterone levels.
10. Keep Devices Away From Genitals
Avoid placing phones and laptops directly on your lap or near your genitals, as the heat generated can increase testicular temperature and negatively impact sperm production.
11. Manage Chronic Stress for Libido
Chronic stress elevates cortisol levels, which can suppress testosterone production and significantly impact libido. Implement stress management techniques to support healthy sexual desire.
12. Vary Masturbation Techniques
If you masturbate, vary your techniques and the types of erotic content you consume to prevent habituation. This helps maintain adaptability and responsiveness for sexual encounters with a partner.
13. Seek Trauma-Informed Therapy
Unresolved trauma can profoundly affect sexual health and cause physical symptoms like pelvic floor dysfunction. Seek therapy or professional help to process and resolve past traumas for improved sexual function.
14. Understand Pornography’s Unreality
Recognize that pornography is entertainment and not an accurate representation of real-life sex. Educate younger individuals on this distinction and use porn mindfully as an adult, avoiding problematic reliance.
15. Increase Ejaculation Frequency
Men who ejaculate 21 or more times a month are statistically less likely to develop prostate cancer, potentially due to the ‘prostate stagnation hypothesis’ of fluid clearance.
8 Key Quotes
Sexual health is health.
Dr. Reena Malik
It's not the quantity of sex that matters, it's the quality of sex.
Dr. Reena Malik
The large majority of young people, I mean, this data shows that at least one in four adolescents are learning sex from porn. And it's probably more than that.
Dr. Reena Malik
The secret is you have to know what you like, right? You have to know what you want and you have to communicate it with your partner.
Dr. Reena Malik
If you have a relationship that you value and that person you're with values their relationship, then it's worth keep trying.
Dr. Reena Malik
Testosterone in women is more predominant than actually estrogen. We have more testosterone in our bodies than we do estrogen.
Dr. Reena Malik
Men who ejaculated 21 times or more a month, were less likely to develop prostate cancer.
Dr. Reena Malik
Your labia is unique to you and it is not, there's no script of what it should look like.
Dr. Reena Malik
2 Protocols
Rebuilding a Healthy Sex Life
Dr. Reena Malik- Avoid discussing sex in the bedroom, especially right before or after sexual activity.
- Choose a neutral setting for conversations, such as a car or during a walk, to reduce direct eye contact and awkwardness.
- Use "I" statements to express personal feelings and desires (e.g., "I feel...", "I would like...") instead of accusatory "you did this" statements.
- Be prepared for your partner's potential initial negative reactions, understanding they may stem from their own shame or biases.
- Recognize that effective communication about sex is an ongoing process, requiring multiple conversations over time, not a single "talk."
- Consider seeking professional help from a sex therapist if navigating these conversations proves too difficult.
- Schedule dedicated time for "intimacy" on the calendar, treating it as a priority like other important appointments, without the explicit expectation of sex.
- Approach scheduled intimacy with no performance expectations, focusing solely on being physically together and connecting.
- Over time, this consistent effort can help rekindle the emotional and sexual connection, leading to renewed joy in the relationship.
Improving Pelvic Floor Strength (Kegel Exercises)
Dr. Reena Malik- Identify your pelvic floor muscles by trying to stop your urine stream mid-flow, lifting your penis off the ground without touching it, or holding in a fart.
- Perform the exercise by squeezing these identified muscles for five seconds.
- After squeezing, fully relax the muscles for five seconds, ensuring a complete release, similar to resting between sets at the gym.
- Begin practicing these exercises while lying down, as it's easier to isolate the muscles without gravity's influence.
- Once proficient lying down, progress to doing the exercises while sitting up, and then eventually while standing or in any position.
- Avoid overdoing the exercises; consistency and proper technique are more important than excessive repetitions to prevent harm.
- If experiencing significant pelvic floor issues or difficulty performing the exercises correctly, consult a pelvic floor physical therapist for personalized guidance.