Sex With Emily - Am I Normal? w/ Dr. Maria Uloko

Episode Date: June 12, 2021

Ever wonder if your penis/vulva/genitalia are normal? In this episode, I’m joined by urologist Dr. Maria Uloko who’s revolutionizing sexual healthcare. We get into why vulva-owners need testosterone, what happens when penis-owners masturbate too aggressively, how shame can interfere with getting the care you need, and how common it is to experience sexual dysfunction.I also answer your questions including when it’s time to date again after a toxic relationship, what to do when your partner’s porn preferences look nothing like you, how to be dominant in the bedroom and toy recs to amplify oral sex on a vulva. Show Notes:Bellesa - Ethical Porn Yes No Maybe ListJe Joue Uma G-Spot VibratorJe Joue G-Spot Bullet Vibrator Glass Dildos at Good VibrationsFor even more sex advice, tips, and tricks visit sexwithemily.com Hosted on Acast. See acast.com/privacy for more information.

I spent so much time one destigmatizing to let telling people that go of shame and then three telling them there is no normal. There is truly no normal. They're the eyes of a man obsessed by sex. Eyes that mock our sacred institutions. Bet through eyes they call them in a fight on days. You're listening to Sex with Emily. I'm Dr. Emily and I'm here to help you prioritize your pleasure and liberate the conversation around sex. Today my guest is urologist and, Dr. Maria Uloco,

who is revolutionizing sexual health care. Whether you have a penis or a vulva, you will learn so much from our expertise in sexual dysfunction, pain, and just overall sexual health. I also answer your questions about when it's time to date again after toxic relationship. What to do when your partner's porn preferences look nothing like you?

How to be a woman who actually wants to dominate in the bedroom, rather than being submissive, and my recommendation for toys to amplify oral sex on a vulva. All right, intentions with Emily for each episode. I want to set off by setting an attention for the show and I encourage you to join me and do the same. So when you're listening, what do you want to get out of this episode and how can I help you? Well, when I was creating this episode, I thought, I really want to give you insights into the most common sexual issues people face,

realize that you are normal, and also give you a glimpse into the future of sexual medicine. If you want to ask me a question, you can call my new hotline 559 Talk Sex. Just leave me your questions there or message me at sexwithemily.com slash askemily and include your name, your gender identity, location, and your age and how you listen to the show. Alright everyone, enjoy the show! Dr. Maria Uloco is the host of the Battle Cry Podcast, a comprehensive sexual medicine fellow at San Diego Sexual Medicine, a urologic surgeon specializing in both male and female sexual dysfunction, transgender care, erectile dysfunction, gender dysorfia, general pain, p-dial curvature, low testosterone, low libido, sexual rousal disorders, urinary continents,

and menopause care. Welcome to this show, Dr. Uloco. Hi. Oh my gosh, thank you so much for having me here. It's such an honor to be here and talk about a field of medicine that I absolutely love and such an important condition for a lot of people with vaginas and bulwad. Exactly. And you guys also work with penises too, right? So we're

going to get into all of that. Don't worry penises. We got you. But can you tell me so you're trained as a urologist? What bait you go into urology? I'm actually met a urologist named Dr. Hadley Wood at the Stephen Clinic who was the first urologist that I saw thatley Wood at the Stephen Clinic, who was the first urologist that I saw that was a woman. And I was like, oh, I didn't know women could do this. And she was so relatable, so well-dressed, so well-soaked, telling hilarious, ronchy jokes at dinner. And I was like, that's who I want to be. How would you define people don't even know what a urologist is? Could you just tell us real quick, what a yourrologist is? Could you just tell us real quick, what is

what is yourrology? Yes, so we're kind of like the weirdos of surgeries, we are surgeons of the genital urinary system. So we perform surgery on kidneys, bladder, the tubes draining the kidneys, which are called the uritors, anything that has to do with urinary health, urinary incontininary continents leaking, and then we also do male sexual health and andrology and infertilities. Right, that's why I think that's why I wanted to define it because most people think of urology as being a male

field. For the most part that is still the case and there are several pioneers in the field that are trying to make it more inclusive. We're excellent perineal surgeons of the perineum for those that have pioneers in the field that are trying to make it more inclusive. We're excellent perineal surgeons of the perineum for those that have a vagina or a vulva and we deal with a lot of like urinary incontinence and prolapse and all of those things but you know we don't deal with the sexual health side of things but we're trying to change that narrative and change that game. I signed up for

this fellowship knowing that I would be taking care of both men, women, and everything in between. You know, and the frequent narrative that I heard from patients was the delay of care to diagnosis. They would go through their primary care provider, they would go to their gynecologist, and these patients are just not getting treated. And so that was eye opening for me, because as a urologist, we would see public prolapse and we would treat that and then they would say, you know, also, you know, it kind of hurts when I have sex or this and that and we're like, whoa, whoa, whoa, whoa, that's your kind of

polygist thing, go see them. And that's kind of the dog mass that's still in the field. Well, I often say that's why I'm so glad to talk to you because so many women that guy did that as well. I've got a problem with with anything sexual health related or you know anything with my vagina or vulva I would go to my gynecologist but then you've come to find out that gynecologist they really don't have this information especially when it comes to like hormones or

paramanopause or menopause or just all the things so when I think about the quote unquote female sexual health is kind of what the terminology is and I'm fully aware we're talking about biology at that point in time, not gender. And so we're talking solely about those with all of us. And so that can include a whole gender spectrum. But when you group that umbrella, it falls into pain, orgasm, desire, arousal. And so we deal with conditions like female sexual pain

and orgasm, or difficulty with orgasming, issues with desire, issues with arousal. And then also we deal with perimenopause and menopause care on the female side of things. And then also a really common thing that we see at our clinic were very specialized. It's something called persistent general arousal disorder or PGAD, which is also a very shamed topic as well.

And so we kind of covered the gamut of all vulvar sexual functions. It's so cool. So what's the persistent arousal? You know, the people that have 40 orgasms a day. Oh yeah, that's right. all of our sex function. It's so cool. So what's the persistent arousal? You know, the people that have 40 orgasms a day. Oh, yeah, that's what I thought it was. Yeah, and for most people, like, oh my gosh, that's amazing. But it's actually a really debilitating condition

for a lot of people. And there's high rates of suicide because it's a condition surrounded with shame, surrounded with also, again, a lack of access to care and it's a condition surrounded with shame, surrounded with also again, a lack of access to care and it's the rails their life. It's just actually put out a article about diagnosis and treatment so that we're trying to get it out there, get it out to the world that is. It is, although rare, you're going to be seeing patients with these. Right. Exactly. And I mean, here's the thing that you just, this going back to the thing you said is that

there's so much shame around it. And I feel like in thinking about all of these challenges, someone has pain or someone has erectile dysfunction or whatever pain is going on in their genitals, or problem, not only is there not anyone to go to with the right answers, but people might not even talk about it because the fear of being shamed and the fear of feeling like well something's wrong with them and so you are even just talking about it to somebody and so I think that's a huge part of this that people won't come forth and it's changing people's lives because when you have kind of pain or dysfunction it really it's hard to live a normal healthy life.

Yeah, yes, oh man, I could talk about this topic all day. That shame cycle prevents people from talking about it. And honestly, half of the treatment in any of these diagnosis is just acknowledging that what they're going through is real. It is not in their head. It is not some a figment of their imagination. It's not, you know, it is a biologic cause and we're going to find out. And I that's one thing I've noticed that a lot of people are dismissed. They're told, you know, just drink a glass of wine, just relax. Oh, it's supposed to hurt. And we aren't talking to each other, you know, those are genitals aren't really disgusting issues with each other. I've gotten to hear stories of people saying,

I finally decided to talk to my friends and turns out a lot of them are also suffering. And that's why I am so one in a forbry it socially. But I'm also trying, I do it for a reason. I do it for a reason because if you destigmatize this and just make it a normal part of a conversation, it really puts people at ease so that they can start discussing it. And I know this is a really difficult topic to even come into our office to start talking

about. And so I have very much a nothing surprising, absolutely nothing surprising. I truly just want to make sure that your quality of life is good because as a black woman in medicine I know what it's like to be dismissed. I know and I never want people to feel that and I've always kind of been drawn towards things that are taboo because my existence in medicine is taboo just in general. Right. I know and it hasn't been easy to get where you are.

Did you say you were the first black urologist at your university? Yeah, so every space I've been habited, I've always kind of been the first. Not kind of, I've been the first. And with that comes a lot of people telling you that you can't. And then I feel like a lot of people having all of these expectations, or I carry a lot of these expectations, because I know that being the first, everyone's going to say, well, we let her in.

So, and look, she didn't do well. And so, I'm kind of the gatekeeper for the people coming behind me. And so, there is a lot of pressure, but I'm super competitive. And I'm Nigerian. We are cocky, we are tough. You know, I also go to a lot of therapy and I'm not gonna pretend like it's not difficult, but at the same time, I am someone that is sees a challenge,

especially if someone tells me you can't do that, I will say that let's go. I'm so happy you're in this space right now and that we really need you in this space, the sexual health space and fighting for it. And I really hadn't heard of many people doing the kind of work that you are doing. So I always hear about like Valvedinia

or vaginismus is a very common. And I remember years ago, I was on love line with Dr. Drew and people would call in I imagine is miss Bolvodinia and I the time like I'd finished grad school but we were still learning too and it was like well it might be because you sexual trauma that's why and then we started to tell him to go to public for physical therapists but since those are very common can we just kind of break these down real quick what they are or what the cause of them are? Yeah, there are several causes for female sexual pain disorder. A lot of these conditions does actually

take a biopsychosocial approach, meaning that we address biology, but we also address the psychology behind this and the social stigma behind this, because all of these factors play into each other. Sex is a very complex thing from a scientific standpoint. Although biology is driving this, then comes psychology, then comes pelvic floor dysfunction. All of these things go hand in hand and into an order to have a successful

sexual health practice. You have to start there and understand that all of these factors play a role into it and having a sex therapist, physical therapist. It's a team sport. We have to start there and understand that all of these factors play a role into it and having a sex therapist, physical therapist, it's a team sport. We have to play together. So when thinking about pain, the DSM-5 defines it, it's called genital pelvic pain penetration disorder or GPPD, resistant or recurrent symptoms for at least six months. So it's either pelvic pain during penetrated intercourse with associated fear, market tensing or tightening of the pelvic floor muscles with any sort of vaginal penetration, and this has to be present for six months. That's the textbook definition. So there are so many causes for it, but the most common causes are genital urinary syndrome

of menopause. So people that are a perimenopausal or are going through menopause will have a lot of vaginal pain, pelvic floor dysfunction, STIs. You can also have organ prolapse, vestibular dynia, clitoridinia, and then there's also something called genital pelvic dysesthesia, which is where you're having pain, but it's actually not coming from the genitals itself. It's coming from the spine and the nerves feeding it. And so that's been the most fun part, especially about my fellowship too, is that we do a lot with spine surgeons and a lot with neurology that neurology, nerves, and brain, and all of that, that I never thought I would be doing.

And so that's been very, very fun. Wow. So there's so many different, so we can't even say, like, oh, vaginismus is this, because for every single person with a vulva, there's a different reason why. Exactly. They're diagnosed with it.

Could be so many different things. Yep, and that's why I said. You guys like detectives. Yes, but most places don't have any of that. They don't even just, there's like, well, we don't know what to do. You can paint. Yes, that's crazy. Because there's just a urologist,

as someone of penis came in and they said, you know, my penis hurts. I'd be like, all right, let's take a look. Versus when people with volas come in and say it hurts when I have sex, they're literally just like, oh, we tried wine. No exam, no nothing. It's, and I tell my patient, if you were to come into the emergency room with chest pain, not a single ER physician would say, well, have you tried some wine? I just relapsed a little bit. They would do a workup. They would examine you because they know that that's important.

And that's just not the same energy that's given to the albazs or vaginas. We're not making this up. Like this is what happens every day. We're going to take a quick break after a quick word from our sponsors. When we come back, Dr. Uloco dives into the best treatments for rectal dysfunction, vulva pain, and other common issues she sees in her practice. Don't go away.

So what about the men that come out, the penises that come in? Yeah. I am wondering if you've seen a rise in younger men dealing with erectile dysfunction. Yes. If you've seen a rise in younger men dealing with erectile dysfunction. Yes, I tell people that the incidence of erectile dysfunction is essentially is your age. So 20-year-olds, 20% of people will have erectile dysfunction. 30-year-olds, 30%, 40-year-olds, 40. And so one, one of the, again, I am someone that I hate shame. I hate the shame of sex.

Same. A lot of the men that come to our clinic are full of shame, especially the younger ones, of this isn't something that's common, this is something that's supposed to happen to me, and I'm like, okay, true. But also 20% of the population also has this too. So you're not alone. I think telling them that and sharing that with them is so important because there is this societal pressure that men have of performing. And if they can't perform, they're not fulfilling their duty. And I'm like, all right, now we're taking that out of the equation. Like, no, that's not going to work. Again, that bio-cycle social thing. If you're not performing, you're

getting in your head, you get performance anxiety. It's just a whole cycle, and I tried to approach it from a standpoint of compassion, and also normalizing it. It actually is fairly common, and a lot of younger men why they get ED is either from trauma, and that can either be from fractures aggressive masturbation team. That's actually a thing. You can actually develop ED from that. How do you know if you're masturbating to aggressively? Yeah. Okay. So, so there's something called joking. Yes. Tell us about jelking because I've

been talked about it a while. Jelking. Yeah. You know, I'm still like, they put like a rod in their penis. Yeah, yeah. It, the things that people do with their penis is, I'm just like, all right, well, let's figure it. Like, okay, I like it. I like it. No judgment.

Yeah, no judgment. Okay. Um, and so what happens? So a lot of, um, ED comes from, uh, build up a scar tissue. Um, and so any sort of penile trauma, either micro traumas, um, A lot of ED comes from a build up of scar tissue. And so any sort of pin out trauma, either micro traumas, whether it's like you get tapped in the penis or you jelk or you, when people think of trauma, they think of a pelvic fracture or a pinile fracture.

And that's a big, big trauma, but then there's these micro traumas that can happen over time. And that causes scar tissue within the muscle penis. And that scar tissue prevents the penis from, it's called hyper relaxation. So fun fact, when you, your penis is actually always flexed. When you're flaccid, your penile muscle tissue is flexed. When you have an erection as blood is getting in that space, what's happening is that that muscle is now hyper-relaxing and causing the tissue to become wrecked. And so when you have scar tissue, that hyper-relaxation doesn't happen because it's a closed chamber

and if you're not hyper-relaxing and closing that chamber, blood can leak out. And so that's why people will either get an erection but not able to keep it or not get enough blood in there because it's just seeping right out. So it's the same systematic approach that you do with a penis who comes in. So what else are saying?

So that was aggressive masturbation. You're saying medication can also cause a D. Yeah, yeah. And anything else that we don't anxiety, true, right? Yes, that's the psycho social factors. Exactly. Wow, it's hard because sometimes people, I'm not seeing people, true, right? Yeah, yeah, yeah. That's the psycho social factors. Exactly. Wow, it's hard, because sometimes people, I'm not seeing people,

but when they call in, it's like, and then I'm like, well, go to your urologist, but not your everyday standard urologist might isn't probably going to the treatment of care that you do at the clinic. Yeah, there you go. What we do differently in our clinic is that we spend a lot of time on diagnosis

and figuring out what the degree of scar tissue is present. Are you getting good blood flow to your penis? Are you trapped in blood within the penis? And then from there we can tailor a treatment plan because not all of the treatment options that are out there works for everyone and not everyone wants surgery. And so it's again, the beauty of quality of life is that you have options. And in order to know what the best option for you is you have to know what the degree of erectile dysfunction is. And that's, so we spend a lot of time on diagnosis with ultrasound, sensation testing. Yeah, it's really, really.

That's so amazing. But there's probably some patients go into clinics or they go into their doctors and they're dismissed. So what would a standard urologist in, I'm from Michigan, let's say, so in Michigan, perhaps, or somewhere might not have the standard of care, right? They wouldn't have this information.

Most would we say that the majority of penises who have erectile dysfunction just take a biagra or they just silently like suffer with it or that's kind of what happens, right? What's the equivalent of the wine of women saying you've pained every glass of wine? What are men getting a blue pill? Yeah, men are getting a blue pill and then when it doesn't work for them, they're stressing, you know, and they're being told that once that doesn't work for you, you have to move on to other things. And the other options work well, but some people don't like the idea of having to stick a needle on their penis to get a direction.

Some people hate the idea of having to do surgery. As long as you're informed about truly what's going on, it's again that the beauty of showing them science, showing them, okay, this is your degree of scar tissue and this explains why you're having this problem. And obviously we have them see our sex therapist too and it's just such a, it's a synergistic relationship between those two of, you know, combating the performance anxiety and actually addressing the biology. Because, you know, most men can just go to a urologist and just get the pill and it works for them

great. Then they'll try the injections and that works for them, they stick with that, and then come surgery. And if that works for them great, but some people, these therapies aren't working, I mean, surgery is always going to work. Prostatic is always going to work, but some people are just not ready for that. Right. Or, you know, just are so surgically averse.

And one thing we also do at our clinic is that we do a lot of regenerative therapy where we not only treat the symptoms of ED, but we also try to reverse the scar tissue that is present. So how do we do that? So we use two regenerative therapies, low intermittent shockwave therapy, which is acoustic sound waves, which stimulates stem cells within the penis.

And those stem cells then help to regenerate tissue. So another fun fact, everywhere in your body has stem cells. It just matters how active they are. So your skin, eyes, liver, heart, lungs, those metabolically active organ systems, their stem cells are constantly turning things out. Versus the genitals, they're kind of a little slower, a little lazier, they're not really doing much. And so what happens is that when you use the shock wave, it stimulates the stem cells to wake up and start doing their job. That's amazing.

I've heard about some of these therapies for men. And they ask me if it's safe, and I feel like it makes sense, right? Because it helps stimulate the blood flow. Yeah. Again, helps stimulate the blood flow, helps with also taking away that scar tissue that's preventing the hyper relaxation. Okay. How do they get the scar tissue coming from an injury or we were saying aggressive masturbation

or is it just scar tissue also accumulated over time? It can be broken down into trauma and then it can be broken down into systemic diseases. So the one of the reasons why long term that 60% of people with penises will develop scar tissue at 60 is because most likely they're going to have also systemic diseases like diabetes, hypertension, high cholesterol. And so those things are also causing, you know, micro traumas to the penis and that penile tissue as well. Another plug that I do, and I tell every single patient that comes in with the penis and ED is, phenol health is heart health.

ED is one of the first signs of vascular dysfunction and heart disease. And so, unfortunately, in this country, men are conditioned that they don't go to the doctor. They're not in charge of their health care. And but what does drive them to the doctor is erect out this function. And so that's where I captured them and say,

all right, if you want this thing to be working until you're 90 something, go to a doctor. Like let's talk about lifestyle modifications. Let's talk about changes in your overall health because you're spending all this money and your hyper focus on this one thing. This one thing is a cause of a systemic thing. So let's think big picture.

Because if you're hard to talk, we got you here for your penis. You get them by the balls literally. And then you're like, okay, we got to focus on your heart health. Yeah, it's true. What's going on your heart is going on your, your genitals, right?

You're over our health. We have to look at all of it holistically, which we just don't, because then you're like also making doctors appointments. You're like, okay, one day I go to the neurologist, six months later I go to my general practitioner, but everyone needs to be talking. Exactly.

Right. Yeah. What are the most common causes of pain during sex? Yeah. Is it ready? Could you say here's like the three most common, or is it just, I think what we see the most common causes of pain during sex? Is it ready that could you say here's like the three most common or is it just... I think what we see the most, it also depends on the age too. So, but civilidemia, if you break that down, I like algorithms a lot too. You can break it down into form only mediated and so this is something that comes from the

actually... Oh, we have a puppet. I have that puppet too. Show me, show us. Yeah, so the vestibule is actually mediated or it's kept healthy by testosterone. So those with vulva is actually have quite a bit of testosterone. Testosterone and estrogen go hand in hand and I think one common misconception is that people with vul those just have estrogen and progesterone. But there's never really a discussion about testosterone. But you need testosterone to keep a lot of

your genital tissue healthy. And so things like hormonal birth control, a lot of cancer treatments that block hormones will cause what we call hormonally mediated the Stibyladinia because it's taking away the testosterone, which keeps this tissue healthy. And then there's something called neuroproliferative, which is essentially too many nerves

and too many heightened sensation. And that can be either congenital, meaning you were born with just too many nerves there, or it could be acquired. So this usually will come after like a yeast infection, or we've had people that will have a allergic reaction to like douching or to other topical agents, and that causes this inflammation,

and that inflammation causes mass cells. And it's just the whole thing, and that just causes significant pain. The other thing is menopause. So it's called a genital urinary syndrome of menopause was people age, people with oldest age, the ovaries stop producing estrogen testosterone and so it starts that steady decline as people age. What happens then is that again, all of this tissue is formally mediated, meaning that it is all controlled by these hormones.

So when you take away these hormones, that tissue is no longer healthy. So a lot of people will report vaginal dryness, poor lubrication, pain with penetration. Also get a lot of urinary tract infections because all of the healthy bacteria within the vagina and surrounding the urethra also need those hormones. And so if those hormones aren't there, all those good bacteria go away and then all the bad ones kind of come out and play.

Those are the most common ones in the PC. And then there's something called clitoridinia too that we see, which, fun fact, the clitoris and the penis same organ, but those opineses are taught, if they're uncircumcised, how to pull back the foreskin and clean, so that they don't get infections versus and people with clitoris that's not talked about. Like, clitoral anatomy has been, I mean, I'm sure you know, not even addressed. And not even addressed. Exactly. It's just like, don't even look at the clitoris.

It's like, no, we're going to look at the clitoris. And I, one of the things that I love that we do in our clinic is that every single person with a vulva that comes to our clinic gets a bobboscopy, where they actually get to see their anatomy on a TV screen. Because when people with penis is coming, they get to see their penis. They can always see everything. And those with volvas, it's inside.

And there's a provider just in your legs saying, things are fine. Versus, no, I'm walking you through your anatomy. You're going to leave here feeling empowered about yourself knowing exactly where things are. I don't quiz them. I kind of want to. That's so cool. Well, my friend called me. She was, oh my god, after she did this, she goes, I saw my G-spot. They showed me on camera. My G-spot. She was like screaming. Every vulva owner needs to get in the take a, I always say take a mirror, take a look, but there's

just, yeah, a lot of it's internal and you can't see it. Yeah. What an incredible service that you are providing. Now, I know that you also work with the trans community. Yeah. So I'm just writing like, what kind of work you're doing right now? My take on comprehensive sexual health also includes transgender, gender reassignment surgery and just transgender health in general,

because I'm just a genital surgeon at this point in time. And so my goal is that everyone is happy with their genitals and have functional genitals that they can be very proud of and they can celebrate. And that does include transgender care. So that is part of my fellowship that I've just been very privileged to just be a part of. You're such an incredible woman.

I mean, I love the work you're doing here. What do you think about assigning gender at birth? Oh gosh. That is, that's a great question. That's gonna be one of those things gonna be really hard to change. It was that's what everyone thinks about. That's what, you know, what, where do you have it?

What is this? Gender reveal party. Oh reveal party. What would happen to that? You need to get rid of those. It's a weird party. In theory, what we're doing is we're having a huge party for your babies genitals, which I love a genital part. I do. Well, don't get me wrong, but let's not start for spiders. Right? Of course it would be. Like I think we should be celebrating genitals, as we're getting older, but that's just me. Yeah, so it is this weird thing.

We hyper-focused on this thing called gender. When, in theory, it's a social construct. And luckily, though, the voices of medicine, like the upcoming voices in medicine that I'm so happy about that this, there's a whole class of activists that are coming up that are saying no more. That you are really going to be such an incredible force. I just, I can't wait to watch your career because you're young. I mean, you are 29, 29, 29.

29, I mean, listen, and you have such a life out of you. So I can't wait to like watch you. And I believe in all the work You're doing. I think it is incredible. Is there anything that you find in sexual out that you feel like you're repeating with every single Patient that you wish that people knew. Yes. Oh my gosh. I spend so much time one destigmatizing to Let telling people that go of shame and then three telling them there is no normal. There is truly no normal. The, and I will say this story.

So my, all of the textbooks that you see is just some random dude that was like, that looks like the perfect vagina and that looks like the perfect boobs. Like my best friend's a plastic surgeon and she does boob jobs and she, again, I have no shame with my friend or if anyone really and she like told me about the equation for how to make the perfect boob and so she measured me and I was just like, I have like nothing

about it. I was like, oh my god, I have perfect my up and my the other reasonable side of me was like this was just a random guy who's like mistress. He's like that's the perfect equation for us. And that's the same thing for genitals is that there is no perfect genital. There is no normal. There is nothing as normal and I spend so much time debunking all of that. It's like, that's weird. It's not weird. There's only pathology, and there's not. If it's there's no pathology, it's normal.

And so let's just debunk that. But if you're not happy, that's a whole nother conversation. And if it is really truly causing your problem, that's a whole nother conversation that we can have. But if you're just going through like, I think I'm weird. And I saw some porn and this girl looked like that. And that guy looked like this. And I don't look like that, so I'm not normal.

I'm like, you're normal. Yeah, it's very normal. Right. Gosh, we have the same job. We really do. I mean, I'm sort of saying, telling everyone, it's okay. Like, you're normal, you're okay, and not to have the shame.

Yeah, and to talk about it, but you're really you got hands on you are changing people's lives. Dr. Maria Loco I'm so thrilled to have this conversation with you today. I have to ask you now the five quickie questions We ask all of our guests. Okay, so they're just quickie. You can just you don't have to think about it So first thing comes your head. What's your biggest turn on? Thothless biggest turn on oh? Thothless biggest turn off ignorance what makes good sex Communication something you tell your younger self about sex and relationships Let go of the shame. What's the number one thing you wish everyone knew about sex? It should be fun. It should be weird. You should just enjoy it and

It doesn't look one way, make sex, whatever you want. Love it. Thank you so much for being here. Please tell us how people can find you. You can find me on several mediums. So on Twitter, my handle is Marie. You look at MD. I also have an Instagram page where I share little tidbits about information, about a certain topic every couple weeks because I'm also still a surgeon. Your accent.

And so just again, my biggest thing is educating patients and educating people that they should not be tolerating no care and they should also know that they are normal in the absence of like actual pathology. And then I also host a podcast called That'll Cry that it's a storytelling podcast focusing on black indigenous Latin X and then otherwise other or underrepresented minorities and STEM, where they just get to tell their stories and get to tell how they got into their respective fields and really just give back their voices that kind of have always been stolen by these institutions that we work in. So it's just dope people talking about dope things and it's fantastic. I love it. Everybody has to check out

Dr. Maria ULOGO. The work you're doing is incredible and a podcast on the site. I don't know how you're doing it all, but that's amazing. Thank you so much for being here. I appreciate you so much. Thank you so much for this opportunity. I will thank you again for, again, do you st thank you. You're changing lives and just making a topic that everyone does, you know, for the most part, unless you're not, but a lot of people do. Which is fine. Yeah, exactly. Exactly. And you're changing their lives too. And like, letting them know that, oh, okay, I might be normal. Or, no, I shouldn't be taking that, they're accepting that and just sharing information

and that changes lives. It really does. Thank you. Thank you. You're so kind. Oh. We're in the same business, we're all want the same thing.

Yes, exactly. All right, after the break, I'm going to get into your email questions. So don't go away. Alright, let's get into your questions. If you want to ask me a question, you have a few options. You can call my brand new Hotline 559, Talk Sex, or 559 825 5739. You can leave me your questions there or just message me, sexwithemily.com-ask-emily. Always include your name, your gender identity, location, age, and how you listen to the show.

Alright, this is from Lisa28 in Seattle. Hello, Dr. Emily. This April, I ended a 4 and a half year long, serious relationship. I'm a very affectionate person and lover and very much a giver. During the past relationship, I was really neglected emotionally and sexually from everything, like not receiving compliments to never receiving oral. It even got to the point where I gave him oral

for the fleeting moments afterwards where he was affectionate because that was the only time I ever received affection unless he was intoxicated. Leaving the relationship and moving out was really difficult, but I immediately felt my mental health improved, and for the first time in years I felt truly happy. I recently started seeing someone new, an incredible man I had a strong friendship with, and we've had a really intimate fulfilling connection

the past few weeks. He's compassionate, he compliments me, encourages me, and works hard to satisfy me sexually. I have a good feeling about us. However, I know it's probably a smart idea to be single for a while, but this new romance came out of nowhere, and I don't wanna miss the opportunity just because people might think it's too soon.

My fear is that there's an underlying emotional damage caused for my last relationship, and that I'm scared somehow it might be affecting me in a way I'm unaware of. I feel happier, but I know the breakup is really recent and issues might surface down the road. What's a healthy way to try and heal from a damaging relationship will also

navigating a new one. Thanks so much. Okay Lisa, I really like this question Lisa because you sound really thoughtful and you've fought a lot about your mental health and you got out of an unhealthy relationship. It's a really hard thing to do. And so I understand your trepidation about getting right into a relationship, but here's the thing. You get to decide when it's right for you. So I

wouldn't so much worry about what other people think, but what I would do is I would definitely get into therapy right now because four and a half years in abusive relationship, it's really easy for you to, for all of us, to kind of go towards something that feels great and try to kind of repress all the stuff that happened. But much like somebody who went through had abuse as a child, things don't go away over time. We think it does, we think time's going to pass, but it's not. The best time to work on relationship issues is when we're in a relationship with someone. So I recommend that you go into therapy and you start to work on this stuff because I'm sure you're a lot's going to come out about the

last relationship and perhaps reasons why you were in the relationship and it probably stems from a lot of things that maybe you haven't unpacked yet. The good part about being in a new relationship is you get to practice new behaviors. You get to practice perhaps expressing your needs more and letting this new partner know how things make you feel and the lessons that you've learned from your past relationship. And I'm sure things will come up when you're working

with your therapist that might still be issues. Remember, you're in the honeymoon phase. The first three weeks of a new relationship is always amazing, right? It's always a good time. I mean, listen, if you're dating someone for three weeks right now and it's not incredible, then you should just get out. So, I think that you are on the right track here. Date someone while also doing your own work because then you get to practice. Now, while you know it's good to take time in between relationships, I always think that's a good idea.

If you found someone you like, keep working on yourself. So that's the best advice I can give you. And be honest, I wish I took some of this advice. When I was in my 20s, I kept going from relationship to relationship. And I kind of knew that I should probably stop dating and take some time to work on myself. And each relationship felt so good. I kept swinging from one to the next. And I don't feel that I ever did the real work

around relationships and then brought it into the current relationship. Like I never worked on the past relationship and brought it into the current relationship. But I can tell you now that I've learned so much once I learned about my own behavior patterns and relationships, then I was able to not repeat my mistakes from the past and also enter each new relationship in a much healthier place.

I think it's really great that you are so self-aware and let me know how it goes, Lisa. Alright, this is from Heather 25. My boyfriend watches porn, which I'm fine with, but when I was on his computer, I opened the screen and there were very specific types of porn that he watches that makes me question his attraction to me. He's been searching for Indian girl porn, Asian porn, black girl porn, I'm white and he always tells me how sexy I am and how beautiful I am. I'm generally very confident, but this is sort of messing on my mind. To know what that means when he's looking at porn that's an opposite of what I am.

Alright Heather, very relatable to many of our listeners, including myself. Some of you might have heard this story before, but I was in a very say-but as Heather at 25, where my boyfriend was watching porn, and the women looked nothing like me. They were blonde, they were tall, and I felt so violated like he was cheating on me

or he didn't want me, and so, and Heather just so you know I get emails at this all the time. But what I didn't understand that and what I'm going to tell you is that part of being a sexually healthy person is having healthy rich fantasy life. And so just because we look at something in porn doesn't mean that he wants to be with someone different than you. It just means like a lot of us we we want variety, novelty, something a little bit different. And so, other things are going well in every other area of your relationship right now. I wouldn't worry about this, but if he's given you pause, reason to think that maybe he's someone that you can't trust, or he's a little disingenuous,

or he says one thing and means another, well, then I would, you know, have some talks with him if there's trust issues, but if there's really nothing, would I recommend for you, Heather? And I wish I had this advice at the time was I wish that I started watching porn at 25. I wish that I said, well, you know what? I love that my boyfriend's getting off and watching porn and releasing stress and that I started to develop my own fantasies. And if you've been looking for porn that turns you on,

I recommend Bolesa. It's my new obsession because Bolesa is ethical porn, which doesn't really sound sexy, ethical porn. But it's porn that has all genders in mind. You're seeing real body types. You're seeing sex that might be a little bit more peeling to vulva owners than just penis owners. You know, remember a lot of this porn that we see is made by men for men. You can just go to bolessa.com that's B-E-L-L-E-S-A and I don't know,

I just think it's, a lot of us in the office have been watching their porn too because I feel like it's, it's kind of what's been missing from a lot of porn. So anyway, I think you'll like it. We also, if you want to get their paid porn, which is awesome, I think that ethical porn, you know, I think that really good porn, it's okay to pay for it. And they've, that's bplus.co slash sex with Emily. Heather, another thing is, like, I also realized when I was going through this and for a lot of people, I was so concerned about what my boyfriend was into that I wasn't taking my own sexuality in my own hands. So, if you're not into pouring yourself, just masturbate.

Figure out what feels good to you, what turns you on. And I think once we get busy with our own sexual desires and fantasies and masturbation life, that we're less concerned about what our partner is doing, and more engaged in building a rich fantasy life ourselves. Thank you, Heather, for your question. doing, and more engaged in building a rich fantasy life ourselves. Thank you, Heather, for your question. This is from Taylor. Hey, Dr. Emily. I'm a huge fan of yours, and I've been listening for a few months now ever since my sister told me

about your podcast. I actually just listened to the episode with John Wyland, Best of Hot or Deeper Sex, and I'm so glad because masculine and feminine bedroom roles is a topic that's been on my mind lately. Unlike most women, I don't particularly enjoy being this a dominant role when it comes to sex, and I'm not sure if it's a personality type thing, a limiting belief system, or what? I'd consider myself soft-spoken and introverted individual, so it's interesting to me that I prefer the opposite when it comes to sex. After talking to my girlfriend's who are mostly extroverted, very strong personality types, I learn that they're the opposite in the bedroom. When a man tries to playfully pull my hair or spank me during sex, I hate

it, and I'm honestly offended at times if there is more space for women to assume masculine roles. Sometimes dominance feels like disrespect to me. So I guess my question is, why do I feel this way and how do I address it with partners? I'm so looking forward to your feedback. All right Taylor, thank you for this question. I love this because it is true that many women,

having a majority, would like to be in a more submissive role. For many, many reasons. A lot of times it's because we are absolved of any responsibility for the sex if we grew up somewhere where we were shamed. For being sexual or being aggressive or asking for sex when we feel dominated, we sort of can have a sense of like, I'm not in charge here, but this person is just taking over. We don't have to lead, we don't have to initiate. And yes, if you have a really strong personality, sometimes in your day-to-day life,

yeah, you just want to be submissive in the bedroom. And the same thing goes for men, again, not everything is absolute, but if a man's very strong, CEO in the boardroom, sometimes those men want to be dominated in the bedroom. So I swear to you, Taylor, you will find these men out there. You just don't hear about them as much because there's a lot of men who aren't as open about it. They're more shameful about it or they feel like they can't find a woman to match it and if you've been listening to the show as you have you know that the majority of people are not even having conversations about sex. So I recommend when you start dating someone or if you already are to start talking about what they're into and what turns a mon sexually and you can say are you ever into being dominated?

I think it would be really hard to dominate you. And let me just tell you a side don't hear about today's episode of giving you all my personal experiences. But what I can tell you, Taylor, is that what I've had these conversations with men I've dated when we've sort of switched and played roles, I'd say that many of them are down to being submissive.

Because lots of men, if you think about the traditional roles, they're told to dominate. They have to initiate sex. They have to lead. They have to be in charge. And I think there's many a man who like the experience of a woman taking charge. So how I recommend you do it is, again, when you're out with somebody, dating somebody, and you start to talk about sex, ask them what they're into. Tell them you think it'd be really hot to dominate. You could do the yes, no, maybe list, because the yes, no, maybe list is awesome, because you could each download the list

and figure out what you're both into and the interesting thing it does have on there, like choking and dominating and dirty talking, has like 80 sex acts. But if you do the yes, no, maybe, you could say to them, but you said yes here about domination, have you ever thought about being dominated? There's a lot of playful ways to bring things up.

You don't have to go out and say, I need to be with someone where you'll let me dominate you, but it is great to have these conversations sooner than later. And I'm also telling you that many men is probably going to be very thrilled to try something new and to not be in charge and to be dominated. So thanks for your question, Taylor. I know that's going to help a lot of people and hopefully you as well. All right, this is from Dan, dear Dr. Emily. My wife and I have better and better sex every time we do it.

I asked her if I could get a toy and she says yes. She loves it when I go down in her and I was thinking of something to insert and pleasure her jeez-bat while I was sucking on her clit. Do you have any suggestions for toys or dillos? Yes, I do. I recommend the J-J-E-J-O-U-E. I just love their deep-rembley sensations. They're made really well. They feel great to the touch. And so there's two I'm going to recommend. There's the Uma G-Spot Vibrator, UMA. And Uma is a great targeted toy that's really great for G-Spot stimulation.

What I love about the Uma is that it's contoured for precision stimulation of a lot of different pleasure points. So I think you're really like this one, and they also make this one that I can't believe there aren't more of these. They have a G-Spot bullet vibrator meaning it's a little bit smaller than something like the Uma But it still reaches the g-spot and you can use it in all different parts of the body So that's what I recommend for g-spot if you want a dildo Which means just so you all know a dildo is a toy that doesn't vibrate There are some great ones on our site if you go to the shop page and you go to the good vibration store, there's some great glass ones in there too that are great glass still. Those are really fun to play with. So I would check out

one of those and you sound like a really loving husband and I just love that the sex gets better every time you have sex. So have fun and thanks for your question. That's it for today's episode. Thanks for listening to Sex with Emily. Be sure to like, subscribe, and give us a review wherever you listen to podcasts and share this with a friend or a partner. Believe me, if you got something out of this episode, they will too. We released two to three episodes a week, find me on Instagram, YouTube, Facebook and Twitter. It's all at sex with Emily. If you'd like to ask me a question about sex or dating relationships, email me. Feedback at sexwithemily.com or sexwithemily.com slash ask Emily.

And check out my website. We have so many great articles that I've been deep into topics like, How do I have multiple orgasms? How do I have multiple orgasms? How do I last longer and better? How do I stop thinking about my ex? What sex toys should I try? And so much more. Sign up for weekly emails.

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