Sex With Emily - Penis Problems, Solved

Episode Date: June 4, 2022

Whether it’s erectile dysfunction, premature ejaculation or a slight penis curve, it’s common to have penis questions – especially when they’re affecting your sex life. But where do you go for... answers? You come right here, to this informative convo between me and urologist Dr. Edward Karpman, as well as Jeff Abraham of Promescent.  On this best-of show, we’re talking to you all about penis shockwave therapy, what to do when you can get erect (but aren’t climaxing), what to do when you take ED meds (but aren’t getting hard), and much more. Plus, I take your intimacy questions! How to get out of your head during sex, how to reduce anxiety in the run-up to intercourse, and how to effectively work with your penis as you get older.  Show Notes:Missionary Sex Position - New and ImprovedFor more Dr. Karpman: Website | InstagramFor more information about Promescent: Website | Instagram | Twitter | Facebook Hosted on Acast. See acast.com/privacy for more information.

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Starting point is 00:00:00 What we found out is that these same guys are coming back about five years later and telling us they had their first heart attack. And it wasn't that the viagra was causing the heart attack, it's that we weren't recognizing back then that these guys are really suffering from cardiovascular disease and that we were treating it as though like if a guy came in and said, hey doc, my chest hurts when I exercise and I said, okay, here's a biagrapal. That's not the right thing to do. You should go get checked out, get a cardiologist,
Starting point is 00:00:28 check your blood vessels to see if there's anything wrong with them. 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. Whether it's a rectal dysfunction, premature or a slight penis curve, it's common to have penis questions, especially when they're affecting your sex life. But where do you go for answers? Well, come right here.
Starting point is 00:00:55 This informative combo between me and yourrologist Dr. Edward Karpman, as well as Jeff Abraham of Promessant. On this best of show, we're talking to all about what to do when you can get a wrecked, but you aren't climaxing. What to do when you take ED meds, but aren't getting hard, and much more? Plus, I take your intimacy questions like, how do you get out of your head during sex, how to reduce anxiety in the run-up to intercourse, and how to effectively work with your penis as you get older? Intentions with Emily join me in setting an intention for the show. I do it. I encourage you to do the same.
Starting point is 00:01:28 It will help you ground in this material and think of like, what do you want to get out of this episode? Well, my intention is to help demystify your penis health. Whatever you or the penis owner in your life is currently experiencing. I can assure you it's common. And on today's show, Dr. Cartman and I provide solutions for all your pressing penis issues. Please, please, rate review, sex with Emily, wherever you listen to the show, do it now, totally helps us, do more episodes, and more quality shows.
Starting point is 00:01:54 I appreciate you. My new article, Missionary Sex Position, new and improved, is up on sexwithemily.com. And check out my YouTube channel for more sex tips and advice. And also, follow me in TikTok. It's sex with Emily and it's all gonna be happening there soon. If you wanna ask me questions, leave me your questions or message me at sexwithemily.com slash ask Emily or call my hatline 559 Talk Sex or 559-825-5739. Always include your name, your age,
Starting point is 00:02:23 where you live and how you listen to the show. And I'm totally cool if you want to change your name to remain anonymous. Alright everyone, enjoy this episode. Dr. Ed McCartman is a board certified urologist with a background in male reproductive medicine and surgery, microsurgery, and male sexual dysfunction. He's currently the medical director of the Men's Health Center at El Camino Hospital, Los Gatos, and the California Vasectomy and Reversal Center. And has appeared on NPR, NBC News, and more, talking about male fertility and penis health.
Starting point is 00:03:04 Learn more about Dr. Karpman at healthy-male.com or on Instagram at eCartmanMD. You're amazing. Welcome to the show, Dr. Cartman. Now we've established you know all things penis. Penis challenges I feel have been on the rise lately. What's going on? Like I know that it affects 50% of men over the age of 40,
Starting point is 00:03:27 some kind of penis challenge, but why do you think it's becoming more of a problem now? Or is it just that we talk about it more? I think it's a little bit of both. I always tell people that in 1999, when Viagra came out, it was a sexual revolution in Renaissance for us. And we finally had a drug that could effectively treat
Starting point is 00:03:43 a rectatus function. And we started talking about it. Remember there were commercials that we finally had a drug that could effectively treat erectile dysfunction. And we started talking about it. Remember there were commercials for a biagra famous senators like Bob Dull were going on TV saying that I'm using this. And it became socially acceptable in our Puritanical Society to talk about sex. And I think it's only been 20 years since biagra came out. And we've seen this evolution. And we're seeing new products come
Starting point is 00:04:06 to market, things to treat crooked penises, more hormone replacement products and we're seeing a lot more attention to it. So that's one of the things. I think we're just bringing more attention to the issue of sexual dysfunction. Our society is not getting healthier so we're getting more problems at the same time. Let's just talk about erectile dysfunction real quickly. Because I think people sometimes get confused with what it might mean. So what is it, and how would you define it, and how does it affect a person psychologically?
Starting point is 00:04:33 Well, affects a person's psychological tremendously. Okay, I'll just get that out of the way. But erectile dysfunction is defined as the inability to obtain and very importantly, maintain an erection adequate to complete sexual intercourse. So many guys think that, oh, I can get it up for a minute, 100%, I don't have a problem, but even though it goes down before I can reach climax
Starting point is 00:04:55 or satisfy my partner, I don't have a problem. That's a problem. That's a problem for everyone. Yes. Evolved. And in fact, that's a form of erectile dysfunction is called a venous leak, where guys can get a good erection, but they just can't maintain that erection. And this is a very devastating form of erectile dysfunction because it affects young men.
Starting point is 00:05:15 And how does it affect young men? Where is it? Is it something that's genetic? Is it something that's? Well, it's just it might be something that they acquire from some trauma or some injury or something like that. But a lot of guys, it's a genetic problem., it's just it might be something that they acquired from say some trauma or some injury or some Something like that, but a lot of guys it's a genetic problem and it's the inability of them to just hold that blood in their penis and the analogy that I always get my patients Is that imagine you had a faucet and you had a bucket and someone said hey, you got to carry a bucket of water from the faucet over to that point B faucet works great water flows in great, but someone drilled a hole in that bucket. So by the time you get over to point B, half the water is leaked out already. So obviously, you're not going to have much water in that bucket.
Starting point is 00:05:52 So that's the kind of ED that younger men get, and a lot of older men get as well. Okay, so that's one kind of, but essentially we're just talking about, I always say that it's the umbrella of penis challenges. Like it's just, you can't get hard, or they can, you get hard, you can't stay hard. And it's a problem. And then it says there's pain involved. It's a form of pain. I mean, it's painful. It's a painful relationship.
Starting point is 00:06:14 Well, it's painful. So let's talk about it. How much of these penis challenges are mental and not necessarily physical? Small percentage. We're talking about 10% of erectile dysfunction is due to some psychological causes. And there's things like stress, anxiety, those will contribute to erectile dysfunction,
Starting point is 00:06:35 expectations being inappropriate. Those will contribute to erectile dysfunction, but it's really a small percentage, about 10% is due to what we call psychogenic erectile dysfunction. The vast majority is truly inorganic problem that there's something wrong with the guy, and we can usually identify and fix it. Just to make the distinction here, that people with premature ejaculation, which has
Starting point is 00:06:58 you come to quickly, your heart, and then you're not hard very long, that could be mental more mental in many ways. It can be. And a perfect example is a guy who has a venous leak, realizes healing has about a minute or two of hardness before it goes soft. So just like Pavlov's salivating dog, he trains himself to come quickly
Starting point is 00:07:16 in order to reach climax, because orgasm is why we have sex, right, Emily? No, not the only reason. Well, that's the... It's a drive, it's the carrot, I guess. But there's other things that happen. You're right. I don't want to minimize the whole process. The door plays important.
Starting point is 00:07:29 The process... The door plays starts after the last orgasm. Exactly. I saw you notice my sign with you, gay men. I love it. Love it. Love it. So, yeah.
Starting point is 00:07:37 So, I think that we strive for orgasm because if we don't achieve orgasm, then we feel like we didn't complete our sexual act. And so these men who have these momentary erections then almost train themselves to have premature ejaculations, they develop another problem because they don't address their underlying problem. Okay, so this venous leak thing is a new information for me. Are you telling me then that there's a lot of younger men that could have this venous leak and not know it at all because not many doctors know about this is Western.
Starting point is 00:08:05 You go into your regular urologist, you might not know what the Venus leak. Well, no, urologist will know about it, but a lot of people... But a regular doctor, your general physician. Yeah, you go into your doctor and if you're 20 to 30 years old and you say you have a problem with your erections, they automatically assume it's in your head. And they neglect you, they say you're having stress, you don't need to see anybody, and then the patient becomes embarrassed
Starting point is 00:08:27 because you're like, oh yeah, maybe I'm just crazy, maybe it's on my head, and they don't wanna go anywhere else because they don't wanna be embarrassed to second, third, fourth time by another doctor telling them the same thing. So they just leave it at that. But it is a big problem in our society
Starting point is 00:08:39 and it's under-addressed. I've seen some devastating life experiences and patients who didn't know they had venous leek when they were young, but then when they turned 40, 50 and they already went through a ruined marriage and they're having depression, all these problems, they finally come to somebody who can address that issue and explain it to them and treat it effectively. Well, is there any way what are the symptoms of... I know you explained to me with the bucket and there's a leak, but how could you... is there any way you could know? Like, when I do my call show, people call in. Is there any way what are the symptoms of I know you explained to me with the bucket and there's a leak
Starting point is 00:09:05 But how could you is there any way you could know like when I do my call show people call in is there any way I could say like that? Sounds like a Venus leak or do they actually have to go see you? No, I mean essentially if a guy could get a hundred percent Erickson like hard firm is right that's not gonna table And then but it doesn't last so. So you're having sex with your partner. You're into it. You're hot and sweaty, and you wanna be there. You don't wanna be anywhere else. You're in the moment.
Starting point is 00:09:33 And then out of nowhere, this thing's just sort of going soft. You're like, what's going on? I'm not thinking about anything else. I'm thinking about you, you're naked in front of me, you're beautiful. I'm turned on, but why is he getting soft? So that is a physiologic organic problem that out of the control of the guy,
Starting point is 00:09:48 has nothing to his head. He's into it, he's in the game. He wants to have sex without woman or man. But that describes, this sounds like most erectile dysfunction then. You get hard and then you don't. So the traditional garden variety, as called garden, yeah. is an arterial problem where called garden variety. It's called garden variety.
Starting point is 00:10:05 It is an arterial problem where a guy can't get a full erection. So, because of blood flow and that. Yeah, you don't need a full, you don't need a 100% rigid erection that sucks to have penetration. Right. You get penetration with about 50% rigidity. So, and it doesn't go from 100 to 50% overnight. It goes from 100 to 95 to 90 to 85. So there's, but the Venus link is like hard and then soft.
Starting point is 00:10:28 Hard and then soft. It goes soft. So they'll get up to 100 and I'll be there for a minute and then it starts getting soft in the midst of it. Okay. Got it. The penis calls are lining up for you, Dr. Cartman. We're going to go to Amy.
Starting point is 00:10:39 She winds the question for you. Amy, 40 in Orange County. You have a question. Hi. Hi. Thanks for calling. I, 40 in Orange County. You have a question. Hi, thanks for calling him here with Dr. Cartman. So what's going on with your boyfriend? We want to help you. Tell me everything. So he has trouble reaching orgasm when we have sex. Sometimes it just takes a really long time and sometimes we just dance up and we can't at all. We just stop and then sometimes he can, we stop and then he'll just like finish himself
Starting point is 00:11:11 off masturbating and then he can. Okay. So I just wanted to know what you can do. It's becausing it and if I can do anything. Okay, great question. So it's a delayed ejaculation is what it sounds to me. What do you say about delayed ejaculation when typically a man Last longer than what it 30 45 minutes. So some guys with premature ejaculation, which is the most common problem
Starting point is 00:11:33 Say are saying why are you complaining? Right, but it is a problem and my first question to you Amie's is is your boyfriend on any medications for depression? Okay, he doesn boyfriend on any medications for depression? No, he's not. Okay. He doesn't take any medications. None of them. Okay. Because the reason is is that a lot of people take anti-depressants like
Starting point is 00:11:57 prosa, paxle, lexapro, all these medications and and they're, they have a known side effect of delaying ejaculation we actually use them off label to treat men who have premature ejaculation which is the most common sexual problem them and have but if that's not the case for your boyfriend and he doesn't do any drugs okay he drinks alcohol but this happens if he drinks or if he doesn't right and he's probably oh if he said This has been a thing that's always been an issue or a challenge for him Um, I have been really gone there to probe that I don't know how long it's been going on
Starting point is 00:12:36 But he we're both divorced and he told me the reason he thinks that happens is because with his ex-wife The whole time the whole relationship they never used for control and so he always had to pull out and he thinks they just like developed like a nervous thing from that and that part for his therapy was fast so I don't know if that's the case or not but that's what he attributes it to. Huh, I mean could be, could he watch porn too? Like if he has a tight grip around his penis when he's watching porn that could be it too Well, that's that that was gonna be my next question does he watch porn do you guys watch porn together or does he watch porn alone? We can watch it together and not that I know of that he does but
Starting point is 00:13:19 From what you're saying of the tight grip like when I when he does do it He's still like a really loose grip when he does it. So I don't think that's it. There's a lot of things when we think of any kind of a jack-tory problem like that, we're always thinking what's going on in the brain. And so one of the things, and I would explore this a little bit more with him
Starting point is 00:13:38 is how much porn he does watch, because there's this thing called porn-induced ED, but there's also a desensitization that happens with watching too much porn he does watch because there's this thing called porn-induced ED but there's also a desensitization that happens with watching too much porn. So you can imagine if you're a guy and you watch porn and you watch your favorite genre, you can pick any genre but it's like a three women with big breasts and taking turns on you. So that becomes your new threshold for reaching climax. And then you come back
Starting point is 00:14:05 to your relationship where, you know, it's kind of normal sex. You know, I'm sure you guys experiment, but it's nothing like that what you see in the in the movies. Yeah. So I mean, I would just have more like we, I think we just give you a few ideas of what it could be, but I think in talking to them and kind of getting more history and saying, Hey, like, I'm just curious, is this always happened? Can you tell me the history of this? I mean, if it is a learned response from his marriage, that's also possible. But what Dr. Karpman was also saying about this ability to think your way to orgasm and
Starting point is 00:14:39 kind of like learn to orgasm without ejaculation, is that where, which is a practice? Yes. And it's true. It could be also a form of depression that's manifesting as delayed ejaculation, which is very possible. So depression and the treatment for depression both can cause delayed ejaculation, but then it goes back to the point that I was making. It's in the brain. Yeah. Yeah. Amy, I would just get clear with it and start to talk to him and there is some more
Starting point is 00:15:06 information we have information on our site about learning how to orgasm without ejaculation. We can get into that. But let's get some more history from this and then call me back. Call me back with him. Okay. Thanks, Amy. Let me help. Okay.
Starting point is 00:15:19 Let's talk to Ken 55 in New York. Hi Ken. What's going on? How can we help you? Hi, Dylan. Having trouble maintaining and getting an erection and even after taking Cialis. OK, 55 in New York. All right.
Starting point is 00:15:36 Ken, OK, so even after taking Cialis, how long were you taking Cialis for? Oh, it has needed. I mean, it doesn't seem to work. Did it ever work? Not really. No. Well, how are you taking it, first of all? I'm still. Well, no, are you taking it 20 minutes before sex and then you sit there watching sports center until something happens? Or do you take it on an empty stomach an hour and a half before intercourse and then you go stimulate yourself? How do you take it on an empty stomach an hour and a half before intercourse and then you go stimulate yourself.
Starting point is 00:16:06 How do you take it? Well, that's, you know, like an hour before. You know, I haven't tracked exactly what I've done. You know, I've waited, but I'm not seeing results. So, salus is the one different one out of all the drugs that we use, like Viagra, LaVitra, Stendra, those are all quick acting 30 minutes after you take it, if you take it on an empty stomach, they kick in the only last for four hours though.
Starting point is 00:16:33 Sialis or the generic name is Tadalafil, works a little differently and it's been dubbed the Weekender because a guy could take a pill on Friday and and potentially it can work all through Friday nights, Saturday mornings, Saturday night, and even maybe into Sunday morning, because it has a 24 hour, 24 to 36 hour duration of action. But you have to take that one an hour and a half before intercourse, and if you take it with food in your stomach, it'll take longer to absorb.
Starting point is 00:17:03 So the most common You know consultation I get for failed, you know, the viagra I'll just use the viagra as a name But any one of these drugs they don't work on me anymore The most common reason I find is that people just aren't using them correctly and they're prescribed by their primary care doctor Nowadays you can even get them online without even a real consultation. My doctor explains how to use them and nowadays, you can even get them online without even a real consultation. A doctor explains how to use them. And people just take them the wrong way. And so the first thing to do is make sure you're taking them the right way. You re-challenged yourself, and then you're in the right situation.
Starting point is 00:17:33 So with psialis, it's an hour and a half before sex, empty stomach, sexual stimulation after an hour and a half. All right. Can you want to try it that way? Yeah, I tried crushing it, too, you want to try it that way? Oh, yeah, I tried crushing it too with that help. It can, but it will make that big an effect. Again, if you have a stake sitting in your stomach from dinner, and no matter whether you crush it,
Starting point is 00:17:55 you take a hole, it's not going to get absorbed adequately. Okay. What could be the problem physically if I wasn't, if I was taking it correctly? Okay, so let's talk about that. So first of all, real quickly, do you have any medical conditions like high blood pressure, diabetes, heart disease? No. Okay, so you're otherwise completely healthy. Yeah, for the most part, yeah. Okay, and is it more of a problem getting it up or is it more of a problem keeping it up?
Starting point is 00:18:22 I'd say getting it. Getting it up. Okay, so when we, when guys say getting it up or is it more of a problem keeping it up? I'd say getting it. Getting it up. Okay. So, when guys say getting it up is a problem to me, that sounds more of like an arterial problem, means you can't get enough blood flow into your penis, okay? And that could be due to the most common reasons, would be disease in your blood vessels, that things like heart disease. And erectile dysfunction is really now considered like a form of a manifestation of cardiovascular
Starting point is 00:18:48 disease. And so I would recommend if you haven't, get checked out by a cardiologist. In fact, I'll tell you an interesting anecdotal story when a viagra came out in the late 90s, we started giving it out like candy as urologists and we were rock stars. We had the first FDA-approved oral medication that actually worked and people loved us and we were giving it out and and guys were having great sex finally with a pill and What we found out is that these same guys were coming back about five years later and telling us they had their first heart attack And it wasn't that the Viagra was causing the heart attack,
Starting point is 00:19:25 is that we weren't recognizing back then, that these guys are really suffering from cardiovascular disease, and we were treating it as though, like if a guy came in and said, hey, Doc, my chest hurts when I exercise, and I said, okay, here's a Viagra pill. That's not the right thing to do.
Starting point is 00:19:39 You should go get checked out, get a cardiologist, check your blood vessels to see if there's anything wrong with them. And the ultimate thing to do is to get a penile ultrasound by somebody who knows how to do those and interpret them. All right, Ken. Thanks for calling Ken. Have a good night.
Starting point is 00:19:54 The guidelines have changed now that we're almost obligated to ask these guys, these questions about their heart when they come in and say, hey, Doc, I just have ED just write me a prescription for the pill out of your office in no time. I'll let you go see the next patient. And I say, sure, I'll write you the prescription, but you got to do this for me. You got to go get your heart checked out. And so I work very closely with a lot of cardiologists because it's very important if you're dealing with sex, especially if you're dealing with erectile dysfunction, is to understand this relationship and make sure that these guys aren't coming in
Starting point is 00:20:27 and you're just giving them a pill or a treatment and not recognizing the underlying problem that's going on. Yeah, that sounds like makes so much more sense. Holistic approach, just giving a pill to solve it. Okay, we've got Rick, 46 in Ohio. Hey Rick, you're on with Emily and Dr. Cartman. How can we help you? Hi Emily and Dr. Cartman. How can we help you? Hi Emily and Dr. Cartman.
Starting point is 00:20:48 Hi. I have a question about, I gotta dissect me about almost 10 years ago now. Okay. And ever since I got that dissecting me, my ejaculation is so different. I mean, it feels the same, but you know, I used to be able to spray everywhere.
Starting point is 00:21:03 Now it's just a little bit drizzles out. I was wondering why is that and is there anything I could do to get that back? Love it Rick. Thanks for the question. Okay. Hold please. We got. What do you think, Dr.
Starting point is 00:21:14 Carpman? How long was the time from when you had your vasectomy? How long of time went by after you had your vasectomy before you noticed this problem that you're will call the money shots right away, Right away. Right away. Right away. Okay. So this requires a little physiology to bear with me here. Okay. So your ejaculation, most of it actually comes from your, no pun intended, but it comes from your prostate and your semolvesicles, which are way downstream from where we do a vasectomy. And the only thing that the testes contribute to your money shot is the sperm and that makes up about by volume only about by 5%. So most guys don't notice a change in their volume of ejaculate after the get of a
Starting point is 00:22:02 vasectomy nor do they praise me when I reverse their vasectomy and say, oh my god, I got this huge load now that's coming out. We just don't hear that. Now, whenever you have a procedure done on your body, okay, you become more in tune to what's going on. And so sometimes it's just a question of like observation and being alerted to it. And I've had guys come in and tell me that in my office after I've done a vasectomy and they said,
Starting point is 00:22:28 well, it's barely anything comes out. And I said, well, let's check it out. And I have them do a seamen analysis right there in my office. And I show them like the volume is really unchanged. You can't really perceive a change. So the vasectomy doesn't, like I said, doesn't take away more than 5% of your ejaculate volume
Starting point is 00:22:46 if you get one done. So if you do notice a decrease in your ejaculate volume, you should be looking downstream at the prostate or the seminal vesicles. It could be a hormonal problem. Maybe your testosterone is low and you're just not producing as much fluid anymore because your testosterone is low and that's what drives your prostate and your semolvesicles. I wasn't that makes sense. I wasn't in my mid-30s when I did that.
Starting point is 00:23:13 So I guess that'd be the time when you might start losing testosterone. I guess you'd start losing it in that time. And then I had one more follow-up question if I may. Sure. I have a younger wife who's about 15 years younger than me likes to have sex a lot. And I find that I have to take, I usually take about a half of Viagra like 80 milligram. Just so it's nice and erect and I don't have any issues because when I don't take that I can get an erection. It just isn't as firm and hard it doesn't stay and last as long.
Starting point is 00:23:53 I mean I exercise, I would tell you to stay on a little overweight but I'm certainly not, you know, it's not out of control or anything. So I'm certainly not, you know, I mean, it's not out of control or anything. And so you're wondering. All right. Yeah, Rick, good question. What do you think, Dr. Cartman? I talk guys, as you get older, you're gonna have some decrease in your rigidity.
Starting point is 00:24:17 Now, it's not anywhere close to being classified as say ED that you can't complete the sexual act and satisfy yourself and your partner, but you notice a little change as you get older. This is part of the aging process. that you can't complete the sexual act and satisfy yourself and your partner. But you notice the little changes you get older. This is part of the aging process. I talk guys, these drugs are like performance enhancing drugs. It's kind of like the steroids that people use.
Starting point is 00:24:35 Barry Bond was a great baseball player before he took steroids. He became an exceptional baseball player when he started taking them. It's kind of like the way these drugs work. And yes, in a guy who's old, getting older, you're not old, okay? I don't want to, I'm older, we older than you, okay? But it can happen. You can start noticing some decrease in function. And so these drugs do help park you up a little bit.
Starting point is 00:24:59 And we also don't know, Rick, if she's, she might be fine with your penis, where however it is, but you are thinking like it's got to be harder, it's gotta be bigger, it's gotta be all these things. And I'm gonna bet that your wife is pretty satisfied as it is right now. That's true, that's true, that's very true.
Starting point is 00:25:14 It's an ego thing, yeah. Okay, well, you know, so, all right. Our work here is done with you, Rick. Thank you very much. Anything new penis issues that I haven't, no, I don't know about. You wanna hear the weirdest requests I've ever got? Yes, please. So I had a guy call me and ask me if I could split his penis into two.
Starting point is 00:25:32 Okay, you've got me. What? So the penis actually has two chambers, two corporal bodies. And there's just one of these fetishes or parapherials that people have. And this is, I think we talked about this last time, and I said this to you, there's no way to train and prepare for this kind of stuff because I could not find that in textbook anywhere.
Starting point is 00:25:54 And I had to, actually I heard from one of my colleagues who does a lot of this stuff also. And he told me once a long time ago that he had a patient that actually asked him to do that and he did it. And when this guy called me, I said, oh my God, I wouldn't even know where to turn to, but thank God I remember my buddies told me this story. And we were, I think it was like, just when I was conversations, you have it a bar and you never believe what I did. And, uh, and had to call him and ask him, how do you do this?
Starting point is 00:26:21 How, where do you put the other agon confuse, Explidate in half so it's two penises? You could have like two horns coming out. And like double penetration? There's actually two chambers. And theoretically you can split them in half and then you have two erectile bodies. And whether it's like a forked penis, you wanna call it or like a forked tongue,
Starting point is 00:26:42 something like that, I don't know what you do with it. But. So did you do the surgery on them?. I don't know what you do with it, but. So did you do the surgery on them? You did it. He never followed through with it. My friend who did it, when I was talking to him, he told me that the person he did it on actually changed his mind and then he put them back together. Oh, God.
Starting point is 00:26:56 But it's not going to be the same. Right. It's not going to be the same. No, right, exactly. Wow. Man, he talks about penises as much as I do. It's so good to have you here, Dr. Cartman. We're gonna take a break, but stick around.
Starting point is 00:27:07 Afterward for our sponsors, I'll be talking all about the penis and premature ejaculation with Jeff Abraham. Jeff Abraham is a CEO of Permanent, the iconic Delays Break Company, empowering penis owners to last longer in bed as an innovator and a visionary. Jeff and his company have been featured on Dr. Oz, the Chicago Sintimes, CNN, and of course, sex with Emily. Find more Jeff at Permanent.com or an Instagram and Twitter at Permanent or at Jeff Abraham 111. How's your journey been?
Starting point is 00:27:44 Tell me. I think it's been gratifying to grow and have success from a business standpoint is obviously as a CEO. It's my fiduciary responsibility and my shareholders and my employees to do that. But I don't think anyone could ever truly understand, but you understand
Starting point is 00:27:59 because what you do for a living, when you get emails from people saying I was celibate for five years. I literally was tired of being in disappointing sexual relationships. I quit being intimate. I was so disappointed. I saw these ads for these products. They didn't work.
Starting point is 00:28:12 For some reason, I saw the medical credibility. I heard Emily, I heard Dr. Ian Kurner, I heard, you know, you're all just on a certain show and I decided to give it a chance. It's revitalized my life. When you get an email from a couple who says, we had been going through the motions literally for the last three years, five years, we were intimate on his birthday, Christmas,
Starting point is 00:28:33 and our anniversary, other than that, we weren't really excited. When you hear people and they get emotional and they go, do you know what it's like to have myself a steam back? Do you know what it's like to feel like a man again? And you don't realize until you do this something like this because the average person doesn't like you sit here all day and like I do in my jobs, it's their all day.
Starting point is 00:28:51 I talk to people. They don't realize how much of a person's self-esteem is wrapped up in their sexuality. Absolutely. And unfortunately, we wrap it up in religion. And you know, it's this taboo subject that people can't talk about. People are uncomfortable.
Starting point is 00:29:05 Oh, my kids are here. Let me tell you something. The fact that you're kids are there, something you should talk about. So they don't grow up thinking that it's the forbidden fruit that they don't get all completely caught up. And this is wrong, I can't talk about it. I want us as a society to not feel the taboo,
Starting point is 00:29:23 to not feel the shame, to not feel like, oh, this is a naughty thing. Are you kidding me? When I took over this company, I think I've told you this before, it's very important to me, if you're gonna run a company and be the CEO, you have to know what you're competing against, what people's other options are.
Starting point is 00:29:36 How can you properly position your product? So I said to Ron, he was a ural just the guy who invented and founded ProMessent, I'm gonna try all the other products. So the stud 100s and the man delays and risers, I used them and they completely numb me and numb my partner. Exactly. My partner, I was like, well, I think we're being intimate because I know we're moving,
Starting point is 00:29:56 but I can't feel anything and she can't feel anything. The whole objective is to feel pleasure. I mean, you could have dropped a center blog on my penis like that. I felt it. It was like, I could have lasted for two days because. That visual. Thank you very much. Exactly. That's a bad visual for me too because you can't feel anything. So I said to Ron, you know, a lot of doctors prescribe antidepressants because SSRI's which is selective satonan reuptake inhibitors. One of the side effects of that
Starting point is 00:30:20 drug is they allow you to last a lot longer. So I said, give me whatever dose as you give to people for PE that aren't depressed. So it would be okay, great. So it was something called Zola. So he gave me this low dose Zola. So the first two, three days, I'm like, well, this does allow you to last forever. By the third, fourth day, I'm like, hey, wait a second.
Starting point is 00:30:38 I have dry mouth, nausea. I swear to God, my eyes were all dry. It felt like someone took my libido, put it in a garment bag, and threw it in the back of the closet somewhere. I mean, literally like take your fantasy person, for me it's a manual shureki, remember she said, oh my God.
Starting point is 00:30:53 I mean, seriously, I get weak in a knees, I've been thinking about her. She could have walked in right now, laid on this table and they could, and went, let's go, I go, I'd rather have a ham sandwich. You know what I mean? It was like, and I'm normally, even for my age, I have a really active libido.
Starting point is 00:31:05 It was like, I'm not kidding you. I'm like, Ron, get me off of this stuff right now. He's like, well, because it has a half life and everything, you can't just get on and get right off. He goes, what we'll do is we'll start tapering. And then I go, take me down right now. Get me off of this stuff, because in my mind, I'm thinking, what if this is like permanent?
Starting point is 00:31:21 What if this stuff doesn't go back away? So it took about another four or five days, and I go, how could anyone take those? Dry mouth, nausea, vomiting, loss of libido? I go, excuse me, I'll take PE, okay? I'll deal with it. I'll get all kinds of vibrators, I'll get a simb, and I'll get every toy known to mankind,
Starting point is 00:31:38 as long as I don't feel like that, okay? And that's what people with physicians were referring people to. Yeah, they were getting, yeah, they're giving, and they also do that for, yeah, and a lot of people don't understand the hidden side effects of antidepressants. Those aren't even hidden. No, I mean, it was brutal.
Starting point is 00:31:52 I was right, sorry, no, but I'm saying, women call in, they're like, I can't orgasm, like what do you want? They're like, I guess their doctors don't often tell them or maybe they forget, they don't think it's gonna happen in for men too. It's ridiculous.
Starting point is 00:32:03 It's a matter of time. Using an SSRI for PE is like putting out a candle with a fire hose, okay? It's a little too strong. You know what I mean? It was insane. That's a good way to put it. Yeah.
Starting point is 00:32:13 And we also, so I promise everyone we were gonna close the orgasm gap tonight. Yes. And I think you've been doing that with promescent, but let's talk about it like the orgasm gap. Okay, when I say that, it's like, we know that women take longer orgasms than men. They're just gonna be a gap. The. Okay, when I say that, it's like we know that women take longer orgasm than men. They're just gonna be a gap.
Starting point is 00:32:27 The clinical trials when you look at and it's funny because I went to some of the clinics. So I went to some of these clinics because you know we do. I do my work exactly. It also satisfies the perv aspect. You go in there going, I wonder how this works. You know you go in there. I swear you go in there. I'm not kidding you. It doesn't look like a perv. And they have, I'm a pretty normal dude, I say that joke. No, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no, no a thing where they wire people up and they monitor them so they know when they're having orgasm, they have a stopwatch. If you have PE, can you manage someone standing with a stopwatch? You know what I mean? Like, excuse me, that's putting a little more anxiety here.
Starting point is 00:33:10 But they determine that the average, this isn't people with PE, these are normal healthy people. The average woman without excessive stimulation takes 18 minutes of thrusting to achieve climax. The average man... Thrusting though, even. ...actual penetration or thrusting. Okay, if she can even get there for thrusting. If she can even get there for thrusting. Okay. If she can, the actual man, healthy male, not someone with PE, last five, five average man, the actual penetration or thrusting. Okay, if she can even get there for a second.
Starting point is 00:33:25 If she can even get there for a second. Okay, if she can, the actual man, healthy male, not something would be last five minutes and 20 seconds. That's the arousal gap. So even in healthy couples, you have this giant disparity of good intimacy. That's why there's 18 trillion vibrators in the world. Guys, stop, start, switch position. Think about baseball scores.
Starting point is 00:33:45 Think about their grandmother naked. All these crazy things going, I can't feel the pleasure and go over the edge. I have to disassociate. Inemiescy is about connecting. It's about passionate emotion. Not sitting there going, Ted Scott's going to the soccer field. No, whatever.
Starting point is 00:34:00 I just can't think of what I'm doing. So that, you know, that just, it's so crazy. These methods that people use to last long enough. So we recommend, and one of the things we always tell people, if you look at our product, it's a great product. It works, but also learn to be more into four-play. Learn, get yourself a vibrator.
Starting point is 00:34:19 You know, I was shocked as I've always been a little bit on the adventures inside. How many people go, oh, I've never buy a vibrator. I go, why? Well, it would mean I can't satisfy my wife. I go, no, how about if you think of it as a way to satisfy your wife to a higher degree? Yeah. Okay.
Starting point is 00:34:34 How about if it, get out of this Puritan mindset that having toys and vibrators, for God's sake, you can get it target now. You can walk anywhere. Exactly. It's not like you have to go to some CD sex shop on the end of the street there's 47,000 websites regular grocery stores have a section you do condoms and loops and vibrators open up your sexuality connect with your partner to me there's nothing wrong with people in any relationship is being open with one another and sharing things and go what
Starting point is 00:35:02 is it that I can use to bring you to a higher level of passion or intimacy or pleasure? Exactly. I mean, that's immediately just saying that we are going to conduct, because if you find that you are in your head during sex, you're worried that you're going to orgasm too quickly. You're women out here.
Starting point is 00:35:16 You're not going to worry. You're not going to orgasm at all. Then you know what that is happening. If you're having thoughts like that during sex, you're not as connected as you can be. Think about it. If you're having thoughts like that during sex, you're not as connected as you can be. Think about it. If you inject anxiety into anything, or you ever fully enjoying it, if you're having a meal and you are anxious about something, are you really enjoying the flavors of that meal? Are you sitting and letting the seed bend and
Starting point is 00:35:39 getting every bit of pleasure out of it? Of course not. No matter what you're doing, and if there's anything more important in your life than intimacy, I'd like to know what it is. Right. And that's what we all crave. We crave that connection, but yet we're in our heads worrying about how to do it right, and then we're missing the whole experience. And then life goes by. One of the things that I have found, and I'm a big believer in it. I have no objection to porn whatsoever. But people start measuring themselves to porn. A woman goes, if I don't have an orgasm where I'm flopping around like a fish, you know what I mean?
Starting point is 00:36:06 And going insane, or if a guy goes, you know, I go shoot across the room and hit someone in the forehead, you know, across the other end of the thing. Exactly. You know, I don't have a 14 inch penis, and I last an hour and a half, then I'm insufficient. Exactly.
Starting point is 00:36:18 You know, it's like, you don't watch the NFL and go, I should run as fast as the fastest running back. Why is the people watch porn and go, that's the norm? Because they think it's real for some reason. People think, oh, well, it's the first time I've ever seen sex for many people. Yes. They've seen the sexual act and they think, oh, well, then it must be real. Like, because they have nothing because their parents didn't talk to them about it.
Starting point is 00:36:36 Exactly. They've never seen anything else. They never came across my podcast and they think it's real and then they get disappointed during sex or they're worried they're not performing. And it starts at a young age. That's why you got to talk to your kid and say I know you might find porn, son, daughter, but here's the thing it's not real they're not actually really having orgasms, he was casted for his penis. Yeah that 12 inch penis with the girth of a cocan isn't the norm you know I mean don't
Starting point is 00:37:00 get upset if that's not you. Exactly yeah and I love what you're saying about vibrators to all the things, but if you're listening to this, we're talking about like, how can you satisfy yourself and your partner? So if you're tripping out about your, maybe you're lasting too long, not long enough, so people will last too long.
Starting point is 00:37:16 You must hear everything, right? Like you first of all, what, I mean, because people don't get the difference between like ED and PE, last. We have people going, well, this helped me get a direction. I go with part of our website. Did you ever get that impression? It's not it's not my agree. It's totally separate. So we have to literally educate people and talk to them and go, if that's your expectation, you're going to be disappointed. That is not what we do. We have people to go, well,
Starting point is 00:37:41 I have trouble orgasming me. Well, this helped me. I go, if you're having trouble orgasming before putting this on, okay, I get trouble orgasming. Will this help me? I go, if you're having trouble orgasming before putting this on, okay? I get news for you. You're going to have to have make loves to your woman or man, whoever you're making love to for two weeks before you're going to. If you're already having issues, this is going to only accentuate that. Exactly. So people who use porousant, what have you found?
Starting point is 00:37:58 Is there a certain demographic? Is it surprised you? Same-sex couple, like men, ages? Oh, we have. There are the people. I'll give you the typical, but then I'll give you the ranges. The typical pro-message user is a man between 33 and 50 years old. You have to understand there's two people.
Starting point is 00:38:16 33 and 50, okay. 33 and 50 is the absolute answer. It would be a lot more younger, but maybe they don't find you at a young age when they need to. Here's the thing, they don't find us, and I call this the machine gun theory, okay? When men are 18 to 33 or 16 to 32 and they become intimate, they literally have a machine gun, they can fire bullets every half hour.
Starting point is 00:38:33 Yes, they keep coming though, okay. I came in two seconds. That's exactly because I know I'm gonna go again. When you get to be my age, it's, I say when you're in your 50s, it becomes a rifle, I'm like a musket, okay? You gotta like put the powder in, put the bike, it takes like a half hour to reload,
Starting point is 00:38:45 you know the whole thing. So, men that aren't there, you laugh at me. No, it's true. It's one of those things that, if you go I can have sex again in two minutes, who cares? In the second time I last longer. When you're like me, I'm like,
Starting point is 00:38:57 I need a meal, I need to sleep, I need to work out the next day, for I'm ready, I gotta make every shot count. So I have a gun, every one shot has to be right in the forehead, okay? They look at this machine, I'm just praying, but I'll hit count. So I have a gun. Every one shot has to be right in the forehead. Okay. They look at this machine gun. I'll hit him with something. You know what I mean?
Starting point is 00:39:08 So younger men, unless they're extremely wealthy and they have all discretionary income and they're going, I'm trying to optimize every area of my life, they're like, I'll just do it again. You know, it's like, my boyfriend at 25, he could come three, four times. I'd never seen that since. So I was like, oh wow.
Starting point is 00:39:24 Just like, I don't know if I, I don't remember how fast the first one was, just keep coming. Exactly. I don't have any more. Yeah, not any more, trust me. Because people my age, I'm about to turn 62. And it's like, one of the things that blows me away is I'll go, I've been married 20 years,
Starting point is 00:39:39 we have sex literally three times a year. Like what? They go, no, we're just both kind of over it. And I go, dude, you need to re-examine your relationship. Take a vacation, you know, get back into it. You know, that kind of a thing. But for us, it's about if your performance starts waning, then your enthusiasm is going to wane.
Starting point is 00:39:59 Then you get into the spiral, you forget about it. Think about it if you have a favorite food. Do you know the time you love it and you cook it? Elsa, you just kind of quit eating it. A year later, you kind of forget about it. But then it if you have a favorite food, do you know time, you love it and you cook it? Elsa, you just kind of quit eating it. And you're later, you kind of forget about it. Yeah, you do. But then someone waves it in front of you, hey, wait a second, that's good.
Starting point is 00:40:10 You know, that's it. People forget they like sex, they forget they connected because there was a problem. And they're like, I don't really need it. And I feel like a lot of you have called it and said that. And I'm like, no, you just forget. You have forgotten what it feels like to be a sexual being on the planet.
Starting point is 00:40:23 And you know what I find too, and everyone gets into this is, when you get into a relationship, I don't care how explosive it is to begin with, I don't care how magical it is the first year or two years. If you pass at three, four, five year mark, you get into a routine. Once you get into a routine,
Starting point is 00:40:41 the excitement begins to wane. It's something you truly have to work at. It will happen. And it's just like, think about your favorite meal. If you eat it every single day, after five years ago, I want to eat anything but that. Okay. Give me anything but a certain way steak after all these years of loving and so you have to go, I need to find different ways to make that steak. I need different sauces, I need different presentations, different side dishes to get it a little bit of a flavor, different flavor so that I still crave it.
Starting point is 00:41:07 Sex is the same thing. Same exact thing. So the one thing in our life that we think it should just work without having any effort at all because it did in the beginning. And no one tells you that it changes over time because of what I do and you do Jeff, which I appreciate.
Starting point is 00:41:20 Part of it is we have the benefit of seeing so many people that lose touch. And then it shocks you and scares you into going, I'm not letting that happen to me. I've seen that, I don't want that to happen in my life. But I started the show because people were saying, God, sex is so amazing. I'm like, okay, I want to figure out a great sexy,
Starting point is 00:41:39 but also I saw that so many people were not having grades that sex was a culprit. People were ending relationships. They're like, oh, yeah, the sex wasn't great. Or then I saw that couple sitting at the restaurant who you tell them married for 20 years and they weren't talking to each other. And I say, never want to be that couple. I never want to be in a relationship where the sex dies.
Starting point is 00:41:58 And so because I knew, and I'm like, well, I'm going to figure out how to prevent that. And you're doing a great job of it. Don't go into restaurant and you see a couple, and the woman's text ends up, guys, reading the paper, and then you start staring at them in 20 minutes go by and there's no interaction with them. Zero.
Starting point is 00:42:14 And you know what I think now, from having been in the business, I go, those people are having horrible sex, so they're not connected. And if I go into a restaurant and you see people in their holding hands and they're joking and you see this banter back and forth. I literally say to myself,
Starting point is 00:42:28 those people have good intimacy because it's not just, it doesn't stop in the bedroom. It doesn't start in the bedroom and it doesn't stop in the bedroom. For you to have good intimacy, you literally have to be anticipating it during the day. You have to make that person feel special. And even afterwards, you can't roll over and go,
Starting point is 00:42:45 I'm done, boom, go to sleep. No, aftercare is a big part of sex, guys. Aftercare is just feeling that connection. And everyone's felt this, you have to get that feeling like you go, I don't know where I end and she begins, vice versa. It's just like you feel like you're laying there and it's just one giant connection.
Starting point is 00:43:02 There's no beginning, there's no end and you're just totally comfortable. Yes. Yes. You can only achieve that through intimacy. And intimacy doesn't mean good intimacy, doesn't mean lasting 45 minutes, it doesn't mean because there are certain couples
Starting point is 00:43:15 that go we have a great sexual relationship and the guy lasts three minutes but it only takes three minutes for the woman. It's fine. If it's not a problem, if it's not a problem, it's not a problem. It's not a problem for either one of you, it's not a problem. It's not a problem for either one of you. It's not a problem.
Starting point is 00:43:26 You know what I tell people? Because sometimes people say to me, well, because of what you do, define how long good sex is. I go, there's no such thing to define it in a time frame. It's when both couples generally are mutually satisfied. And they're both comfortable. And they both say, I'm happy with the intimacy we have. It can be three minutes. it can be 30 minutes,
Starting point is 00:43:46 it can be 40, it can be whatever. That's the most important thing. Are your expectations being met? Are you comfortable? Do you look forward to it? Do you want to do it again? Do you want to be in a situation that you just can't distance yourself from that person?
Starting point is 00:44:00 You just love feeling close to that person. Exactly, it's intimacy. I think a lot of people don't understand that, which is why we're here and why we do what we do. Look at you, Jeff, you've been doing this now for eight years. Like half the time, you're like out there too being the sex expert. Well, you're the funny part.
Starting point is 00:44:12 I love it, Jeff. I was a semiconductor engineer. And I retired after I sold my business and my next door neighbor develops a product. And the next thing you know, I feel like I'm Dr. Ross. You know what I mean? I love it. Jeff, you're the best.
Starting point is 00:44:24 People that knew me from the semiconductor day goes, what, how did you make that transition? I go, it'm Dr. Ross. You know what I mean? It's like, how do you feel the best? People that knew me from the semester today goes, what? How did you make that transition? I go, it's a long story. Because you're like, hey, what's going on with your sex? I feel like what? Okay, Jeff Abraham. He's the CEO of Permessent.
Starting point is 00:44:35 The only FDA approved treatment to help you last long, Remed. Let's just say that. That's it for today's episode, see you on Tuesday. Thanks for listening to Sex with Emily. Be sure to like, subscribe, and give us a review wherever you listen to the podcast and share this with a friend or partner. You can find me on YouTube, Instagram, Facebook, and Twitter at Sex with Emily.
Starting point is 00:45:02 Oh, I've been told I give really good email. So sign up at sexwithemley.com. And while you're there, check out my free guides and articles for more ways to prioritize your pleasure. If you'd like to ask me about your sex life, dating, or relationships, call my hotline 559 Talk Sex. That's 559-825-5739. Go to sexwithemley.com-ask-emily.
Starting point is 00:45:27 Special thanks to ACAST for powering the Sex with Emily podcast. Was it good for you? Email me, feedback at sexwithemily.com. you

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