The Diary Of A CEO with Steven Bartlett
Sex & Infertility Expert: You Need To Grow Your Sex Span! This Is Killing Your Fertility! This Daily Habit Transforms Your Sex Life!
Thu, 09 Jan 2025
Over 300 million people worldwide are affected by erectile dysfunction, and Dr Mohit Khera has the scientific solutions you were afraid to ask for Dr Mohit Khera is a Professor of Urology at Baylor College of Medicine specialising in male and female sexual dysfunction. He is also the co-author of the book, ‘RE-COUPLING: A Couple's 4-step Guide to Greater Intimacy and Better Sex’. In this conversation, Dr Mohit and Steven discuss topics such as, the benefits of healthy testosterone levels, how erectile dysfunction impacts your mental health, the link between obesity and erectile dysfunction, and the 4 components of female sexual dysfunction. 00:00 Intro 02:17 Who Is Mohit and What Does He Do? 02:47 What Is a Sexspan and Why Does It Matter? 03:58 Is It Possible to Make Sexspan Last as Long as Lifespan? 05:15 Mohit's Professional Experience and the People He's Worked With 07:14 The Most Popular Things People Ask Mohit and Why They Come to See Him 11:26 Most Common Reason for Low Libido: How Much of It Is Related to Compatibility? 15:35 What Is Libido? 15:54 Connection Between Erectile Dysfunction and Low Libido 18:53 What Are the Side Effects of ED Pills? 21:34 The Biggest Side Effect of Cialis 22:00 Who Shouldn't Take Cialis? 23:42 Treatment for Sexual Dysfunction in Women 25:52 Connection Between Stress and Dopamine 27:21 Types of Activities That Raise Dopamine Levels 29:37 How Much Does Pornography Contribute to Low Libido? 31:08 Why Do People Have Less Sex Nowadays? 32:30 Role of Pornography in Shifting Sexual Behaviors 36:42 Connection Between Obesity and Sexual Dysfunction 39:23 Losing Weight Boosts Testosterone Levels 40:29 Impact of Testosterone Therapy on Sexual Activity 42:37 Should Someone Like Steven Be Taking Testosterone? 44:31 Testosterone Therapy in Women 47:25 HRT for Women 49:05 The Decline in Testosterone 50:38 What Lifestyle Changes Should We Make to Increase Fertility? 55:53 If a Couple Came to You With Sexual Problems, What Would You Focus on Naturally? 01:00:11 40% of Men at 40 Will Have ED 01:01:38 The Stigma Around ED 01:03:31 Personal Experiences With Sexual Dysfunction 01:06:07 The Impact of Kids on Sex Lives 01:07:03 Premature Ejaculation 01:10:15 Is Testosterone Dangerous? 01:11:41 Will Taking Testosterone Injections Reduce My Lifespan? 01:13:53 Links Between Depression and Testosterone 01:15:14 The Importance of Communication for Sex 01:16:18 Improving Sexual Dysfunction in Men and Women 01:17:13 Pain During Sex for Women 01:18:47 How Do We Improve Communication in the Bedroom? 01:20:58 Are There Any Risks to Vibrators? 01:23:54 Abnormal Curvature of the Penis 01:25:20 Cures for ED That Aren't Pills 01:27:11 The Role Trauma Plays in Sexual Dysfunction 01:28:08 Erection Devices 01:32:43 Is There Anything You Cannot Explain? Follow Dr Mohit: Instagram - https://g2ul0.app.link/L3Z03S4WqPb Twitter - https://g2ul0.app.link/JlcpMx8WqPb Website - https://g2ul0.app.link/T7gIUo6WqPb You can purchase Dr Mohit’s book, ‘RE-COUPLING: A Couple's 4-step Guide to Greater Intimacy and Better Sex’, here: https://g2ul0.app.link/xExobrcXqPb Watch the episodes on Youtube - https://g2ul0.app.link/DOACEpisodes DOAC Community Notes: drmokhere.tiiny.co My new book! 'The 33 Laws Of Business & Life' is out now - https://g2ul0.app.link/DOACBook Join the waitlist to be the first to hear about the next drop of The 1% Diary! https://bit.ly/1-Diary-Megaphone-ad-reads You can purchase the The Diary Of A CEO Conversation Cards: Second Edition, here: https://g2ul0.app.link/f31dsUttKKb Follow me: https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Linkedin Jobs - https://www.linkedin.com/doac PerfectTed - https://www.perfectted.com with code DIARY40 for 40% off Learn more about your ad choices. Visit megaphone.fm/adchoices
Chapter 1: What is a sexspan and why does it matter?
His groundbreaking research has significantly contributed to improving sexual health and fertility. Millions of men and women are suffering from sexual problems like infertility and sexual dysfunction. For example, in the U.S., roughly 43 to 48 percent of women suffer from female sexual dysfunction, which involves four components that we're going to talk about. But we also know that premature
Chapter 2: How can we make our sexspan last as long as our lifespan?
But... The issue is that people don't talk about their sexual problems. They suffer in silence and they start avoiding sex, but it's curable. And I have two ways to raise their testosterone techniques to significantly improve the quality of your erections and natural ways to improve sexual function in men and women. So number one, most important is.
Quick one before we get back to this episode. Just give me 30 seconds of your time. Two things I wanted to say. The first thing is a huge thank you for listening and tuning into the show week after week. It means the world to all of us. And this really is a dream that we absolutely never had and couldn't have imagined getting to this place.
But secondly, it's a dream where we feel like we're only just getting started. And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app. Here's a promise I'm going to make to you. I'm going to do everything in my power to make this show as good as I can now and into the future.
We're going to deliver the guests that you want me to speak to and we're going to continue to keep doing all of the things you love about this show. Thank you. Thank you so much. Back to the episode. Dr. Mo Herron.
Who are you and what have you spent your life doing? So I'm a urologist and I specialize in male and female sexual dysfunction, testosterone replacement therapy, and infertility. For the past 17 years, I've been working as a professor at Baylor College of Medicine, Houston, looking at ways to improve sexual health, improve testosterone, and improve fertility.
And we talked just before we started recording about this term sexpan, which I've never heard before. What is a sexpan and why do you care about it?
Yeah, so Stephen, you know what lifespan is. It's how long you're going to live, right? And you also know what healthspan is, how long you're going to live in a healthy lifestyle. But you may not have heard of the concept of sexspan. Sexspan is the ability to engage in sexual activity, satisfying sexual activity, and
And so how long you are able to engage in sexual activity is important to most men, right? So let's give you an example. The average lifespan in the United States is 77 years old. The average health span in the United States, believe it or not, is 67 years old. In fact, if you look at the CDC and they talk about how long you'll live without a disability, it's actually 63. So there's a delta here.
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Chapter 3: What are the common reasons for low libido?
There's at least 10, 15 years where you will be in some kind of disability and cannot live to your fullest. Now think about the concept of sex span, how long you'll have the ability to engage in sexual activity, satisfying sexual activity. We, most men, most women, want their sex span and their health span to last as long as their lifespan. Yes. So I think it's important.
And there's things that I can do to make my sex span last as long as my lifespan.
There's many things you can do. And I call it the four pillars. The first is diet, exercise, sleep, and stress reduction. I don't have a pill on the planet stronger than diet, exercise, sleep, and stress reduction. And each one of those can significantly improve a man and a woman's sex span, but also their health span and their lifespan. The other is hormones. Testosterone, extremely important.
Testosterone supplementation can significantly improve a man and a woman's sexual function. And unfortunately for women in the United States, we don't have very many options. Actually globally for women, there's not many options. But I think it's important, hormone replacement therapy. And one more thing, I think about the couple. Think about sex ban as a couple's disease.
Let me give you an example. Tomorrow, Stephen, are you married or? Well, I'm in a long-term relationship. Your partner. So let's say your partner tomorrow says to you, I am no longer going to have sex with you unless you cheat on her or you leave her. you're not going to have sex again, right? Think about the importance of the couple. So I talk about this quite often. Keep your partner engaged.
Keep your partner healthy if you want to prolong your sex span.
So I've got two questions here. The first of which is, who have you worked with in your career? And the second question is, what is your CV? Give me a rundown of your professional experience.
Yeah, so I started my residency in 2000. And I did my residency in 2000, one year of general surgery. I did five years of urology training. And then I did one year of a fellowship in men's health. As soon as I finished my training, I joined the university at Baylor College of Medicine.
And I started a basic science laboratory where we do basic science research in sexual medicine and testosterone for the past 17 years. And I just started a clinical trial. So I have a clinical arm. We do clinical research. I see approximately 150 patients a week every week. I do approximately six to eight surgeries every week. And I still work at the VA hospital.
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Chapter 4: How does pornography contribute to low libido?
With my partner, I cannot get an erection, but when I'm by myself, everything works fine. Psychogenic. Psychogenic ED. It's a big component. What is psychogenic? Something in the mind that's bothering you or inhibiting you from engaging in sexual activity. And that's where the sex therapist comes in, right?
Because if someone tells you, I get great erections by myself, but with my partner, I'm not able to get good erections. Psychologically, when they're with their partner, they're not able to achieve a good erection. Sex for men and women has a huge psychogenic component, a huge psychogenic component. So I think it's very important to get detailed history. Are they able to get erection?
What did they try? What medications have they tried? You know, you have to query about depression. 66% of men who come in with ED have some degree of depression, 66%, right? And that's important. Anxiety, 35% is very important. And more importantly, we'll talk about this. ED is the first sign of other major adverse medical problems.
For example, if a man comes into my office today, 15% of them will have a heart attack or a stroke within seven years. 15%, the day they get ED, 15% will have a heart attack or a stroke within seven years. It's the first sign. Other studies, Dr. Montorsi showed that if a man presents to the emergency room with a heart attack, On average, 39 months earlier, that's when the ED started.
So it is the first sign. Now, there are many reasons for this. One theory is called the arterial diameter theory. The penile arteries are the smallest arteries, 1 to 2 millimeters. The coronary arteries are 3 to 4 millimeters. The carotid, 6 to 7 millimeters. So if you remember from physiology, if you're going to block an artery, 50% occlusion of an artery causes damage.
So if you're going to block an artery, you're going to block the penile arteries before the coronary arteries. You're going to block the coronary arteries before you block the carotid, right? So men will get ED before they get a heart attack, more likely to get a heart attack before they get a stroke. That's a theory, but it makes sense.
So I worry when a man comes into my office, could this man have occult cardiovascular disease? In fact, there was a wonderful study that came out of Greece. They looked at 50 men that walked in, and they gave them an echocardiogram or stress test. If it was positive, they went on to a coronary angiogram.
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Chapter 5: What is the connection between obesity and sexual dysfunction?
What they found is that roughly 20% of men, one in five, actually had some occlusion in their heart, whether it was one vessel, two vessel, or three vessel disease. So I think to myself every time I'm writing that prescription, is this one of the five that could have some occlusion? And is there an opportunity to intervene at this point?
So it's really important to think about cardiovascular disease as well.
One of the big subjects that I hear a lot about, even in my friendship groups, is about libido. I've got so many stories in my friendship group of either one or both partners losing their libido. So on this subject matter of libido, it's kind of where I wanted to start this conversation. What is the most frequent and popular reason why men and women struggle with libido problems?
And how much of that is about compatibility?
Yeah, good question. Libido is multifactorial. There are many pieces of libido. It's very complex. And I'll give you some important components. First, it could be hormonal. And the mnemonic I teach the residents is PET. The four hormones that can affect someone's libido are prolactin, estrogen, thyroid, and testosterone. So you have to check the PET.
If the prolactin is elevated, the libido goes down. If the testosterone is low, the libido goes down. So maybe it's a hormonal issue, which could be it. And particularly many women who go through menopause suffer from hormonal issues, and it could be a hormonal issue. The second is something called neurotransmitters. So in other words, serotonin, norepinephrine, dopamine.
Dopamine goes up, libido goes up. Serotonin goes up, libido goes down. So these all regulate how someone's libido will function. So one of the biggest culprits for low libido are antidepressants. What do antidepressants do? They increase serotonin and they decrease libido. So sometimes it's a medication or something that a patient's taking that will shut down their libido.
For example, a medication that men take for urinary function called finasteride shuts down their libido. So there are certain things that you have to look at. The other components are lifestyle, diet, exercise, sleep, and stress reduction, particularly fatigue and stress.
If a woman is tired and she's exhausted and she has to choose between sex and sleeping at night, many times she may choose sleep.
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Chapter 6: How can lifestyle changes improve fertility?
Chapter 7: What are the treatment options for sexual dysfunction in women?
Dopamine goes up, libido goes up. Serotonin goes up, libido goes down. So these all regulate how someone's libido will function. So one of the biggest culprits for low libido are antidepressants. What do antidepressants do? They increase serotonin and they decrease libido. So sometimes it's a medication or something that a patient's taking that will shut down their libido.
For example, a medication that men take for urinary function called finasteride shuts down their libido. So there are certain things that you have to look at. The other components are lifestyle, diet, exercise, sleep, and stress reduction, particularly fatigue and stress.
Chapter 8: What role does testosterone play in sexual health?
If a woman is tired and she's exhausted and she has to choose between sex and sleeping at night, many times she may choose sleep.
Me as well.
I'm just saying. So fatigue is important. Stress. And there's this cliche, this mnemonic, this saying that with stress is kind of interesting. Typically, if a man has a very stressful day, he will want to have sex to relieve his stress. Women have to relieve their stress to engage in sexual activity. It's kind of the opposite. You know what I mean?
So I tell men, if you really want to have sex with your wife… Do the dishes. Take out the trash. Do everything you can to tuck the kids in bed early. Relieve her stress because that will significantly increase her desire to engage in sexual activity. But the other one is psychogenic. So we talked about that earlier. Sex has a huge mental component, your relationship with your partner.
how close you feel with your partner. So sometimes patients come to me and they're in an abusive relationship and they say, give me the pill that improves my libido. I say, it's not going to work. I mean, the essence, the core, the foundation is not working. And therefore, it's really important for them to see a sex therapist.
One thing for men that actually shuts down their libido is when they start developing erectile dysfunction. So if a man starts getting erectile dysfunction, let's say he gets a good erection 50% of the time and he's starting to have some problems.
And it's 10 o'clock at night and he says, look, I can try to engage in sexual activity, but it may not work and it may be frustrating and embarrassing or I can just go to sleep. he's probably just going to go to sleep, right? And it becomes a vicious cycle because the less sex he has, the more difficult it is to engage in sex activity later on.
And so you may interpret this as a low libido, but he's really just avoiding it because he doesn't want to deal with it, right? But the partner also looks at this as maybe I'm not attractive anymore. Maybe there's something about me that's not appealing. and it becomes a vicious cycle.
So one thing you can do is significantly improve the quality of the erections in a man, and that actually helps improve his libido. So for example, I tell a man, if every night you have a great erection, and every morning you wake up with a great erection, what are you going to probably do? You're probably going to use it, right? So libido inherently goes up, right?
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