E.138 | SxS | Dr. Paul Gittens | FINAL
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Leah: Hello, welcome to the Sex Reimagined Podcast. My name is Leah Piper. I am your tantra expert here on the show, and I am with.
Willow: Dr. Willa Brown, your Daoist expert.
Leah: And I wanna thank so many of you who have commented on the hidden truth about male intimacy that no one talks about Episode #124. Uh, you guys have just loved that conversation, and it's a really important conversation for Willow and I in particular because male intimacy and that ability for men to connect on such a deep, profound level is such an important conversation.
Leah: And please, if you haven't listened to it yet, go check it out. We'll have it in the show notes for this episode. But we've got something really special up for you today.
Willow: That's right.
Meet Dr. Paul Gittens: Sexual Medicine Pioneer
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Willow: We interviewed Dr. Paul Gittens, who is a leading sexual medicine and male fertility specialist, board certified urologist. He's got [00:01:00] three practices in New York and Philadelphia and Leigh Valley. Um.
Leah: Allen Town.
Willow: Allentown. There you go. And he is treat. He treats men and women. He helps so many people with sexual function in so many different ways.
Willow: I mean, this man is a wealth of information. You are going to love this interview. It's gonna open your mind in so many ways, and you'll be reimagining what's possible with your sexuality.
Leah: it might just be an answer to a prayer folks, so please tune in a turn on and fall in love with Dr. Paul.
Announcer: Welcome to the Sex Reimagined Podcast, where sex is shame-free and pleasure forward. Let's get into the show.
Willow: All right, so today we are here with Dr. Paul Giddens and we, we were just chatting with him for pressing record, and this is gonna be a great interview, everybody, because Paul is just a wealth of information around sexual [00:02:00] health, everything to do with it. I mean, we could take this conversation about 20 different directions it sounds like. but why don't you tell us. Dr. Paul, you are a medical doctor. How did you get interested in, um, sexuality as a sort of more niched part of your medical practice?
Dr. Paul: Yeah, so I am a board certified urologist. and then I did a, fellowship in sexual medicine and male infertility. I treat men that are having some issues with fertility where I. Their sperm counts might be lower. The other part of my practice is we treat men and women for sexual dysfunction, and that can range from anything from men having problems with erections, hormonal issues, so low testosterone, premature 3jaculation, not ejaculating, uh, pelvic pain, you name it.
Dr. Paul: Anything that goes wrong in the bedroom we take care of. And then for women, the same thing. So women that are going through menopause, [00:03:00] we have a whole hormonal program for that. Um, women that are having pain with sex or pelvic floor dysfunction, we take care of that for them. Issues with arousal, libido.
Treating Sexual Dysfunction
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Dr. Paul: And another part of my practice I'm really proud of is that we, um, also help men and women that are going through cancer treatments, like women that are going through breast cancer treatments, or women or guys that have prostate cancer and helping them to enhance their sexual function. Um, in that respect.
Dr. Paul: So really happy about that. I mean, my origin story really is when I was a urologist, um, at the time, you know, I'm dating myself, it's a long time ago, but nobody cared about sexual function at all, right? Nobody cared about it. Um, women that were undergoing breast cancer therapy, nobody talked to them about sexual health.
Dr. Paul: Nobody talked to them about what happens after you've gone through chemotherapy or you're on Lupron and you're on Tamoxifen for breast cancer, um, or for women that just have low libido, just out of the blue. Right? And then for men as well, you [00:04:00] know, nobody talked to men about, um, what happens after prostate cancer or radiation to the pelvis, or what is this natural thing of aging?
Dr. Paul: Why, why are guys getting er3ctile dysfunction? Like what's happening in their twenties, thirties and forties? That's leading up to er3ctile function. So. And then hormones as well on both ends. Um, what happens to your hormones over time and everything declines. I've been in practice since, um, well, I've been doing this since 2009.
Dr. Paul: I. But I've opened up my own practice since 2014, so we're at 10 years and I have three practices, one practice in Philadelphia, in Allentown, which is upstate Pennsylvania and um, in Manhattan, New York. So I go between those three locations to help, um, men and women from all over the world really. We have patients flying from, you know, Dubai, from Europe, from California, or just they're local.
Dr. Paul:
Willow: Wow, I love this. So you've created like an empire of sexual function, health and wellness.
Dr. Paul: There you [00:05:00] go. Yeah. I never thought of it as an empire.
Willow: You are an emperor of sexual health and wellness,
Dr. Paul: I'll take that.
Willow: Anyway.
Dr. Paul: I'll take it, I'll take a compliment when I can get one, you know.
Willow: That's pretty remarkable. I mean, really what a service to the world. And yeah, when you started doing it, just the, the, you know, low levels of conversation that were happening and, and now there's so much more conversation
Dr. Paul: so much more there. But you know, we need shows like, you know, podcasts like you, like you guys have, because there's so much more information that needs to be out there about these things. You know, just as simple as something as simple as menopause. You know, like women don't, have an idea of what happens to the body after menopause or guys as they get older, what happens to their er3ctile function and some of the things that we can do to kind of abate those, um, the symptoms that they're having.
Dr. Paul: So, yeah. So
Willow: much you can do. I mean, God, I was just talking to someone last night. He's like, my girlfriend's having the worst time in perimenopause. I'm like, well, she doesn't have to. [00:06:00] She could be having a great time in perimenopause.
Dr. Paul: She can.
Willow: Yeah.
Willow: Give her my number. You know, like it is really just about educating people and, and showing them what is possible. we were also chatting before we pressed record. Um, Dr. Paul, not only do you help pri well fertility, I'm sure on both male and female side, but lots on the on male side.
Dr. Paul: Yeah, fertility is all the male side. The um, yeah, so in medicine, the urologists kind of take care of, that's fellowship training. They'll take care of the male fertility end. And the OB-GYNs that are fertility trained, they take care of the,
Willow: female.
Dr. Paul: the female patients. Yeah.
Willow: But you also do vasectomies, so you're creating a nice balance
Willow: around, um, the, the humans who are making more humans in the world.
Dr. Paul: the ying and the yang, right? I mean, so we do vasectomies, but then we also do vasectomy reversals. So we do both. So for guys that it, um,
Willow: Which are very successful, the reversals.
Dr. Paul: Well, yeah, I mean, I like to say that, I mean [00:07:00] for sure, like in our hands, we have a very high success rate. Um. Yeah. So for men that, um, that have had their vasectomy and they have a change of mind, they have a different partner or, you know, in, interestingly enough and sad enough, you know, obvi obviously everybody's dealing with kind of the opioid epidemic and everything.
Dr. Paul: So we've had a, a couple of patients where there's daughter or son might have passed away and they're still young and they had a vasectomy and they wanna have another child. And so we do, um, a reversal for them. I'm always a little bit emotional when I, when that happens, you know, when, you know. And everybody's emotional and everything and um, and oftentimes we get a good result.
Dr. Paul: So it's great.
Leah: Wow.
Understanding Delayed 3jaculation: Causes and Solutions
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Leah: You know, one of the things you said that, um, sparked my interest with your long list of wonderful things that you are helping people with. I'd love for you to comment on men who have a hard time ejaculating. I have a couple students right now, and I have over the years, it's more, it's more uncommon.
Leah: I see more people [00:08:00] who are struggling with er3ctile dysfunction and premature 3jaculation, but on occasion the struggle to reach climax, um, is really prevalent. And I'm curious what you do to treat that.
Leah: I.
Willow: And piggyback on that before you answer, also to add in like those who are having a hard time ejaculating with a partner versus just at all.
Dr. Paul: Oh yeah. So, um, as you mentioned, you mentioned three things, right? So you mentioned premature 3jaculation, you mentioned er3ctile dysfunction, and then the delayed 3jaculation. So premature 3jaculation is the most common sexual function that guys have, right? I mean, you know, when you're younger it's more prevalent.
Dr. Paul: It's usually a guy that, is ejaculating within about two minutes or so and there is causing some distress. And then you have ed, which is also really common, right? Ed, affects about 50% of 50 year olds, right? Really common. And you can have issues with, initiating and maintaining the erection, [00:09:00] right?
Dr. Paul: And then delayed 3jaculation. You know, we try to give a definition of like two standard deviations around 20 minutes or so, right? So about 20 minutes unless they want to go for 20 minutes. But 20 minutes is kind of the definition of delayed 3jaculation. Um, but it has to cause some disturbance to that person.
Dr. Paul: So if the person is happy with 20 minutes. and they, some guys wanna go 30 or 40 minutes, you know, then it's not a problem. Right? But delayed 3jaculation is something that is more common as guys get older, to be honest. So, premature 3jaculation, you see this subset of guys that are younger, but delayed 3jaculation
Dr. Paul: It becomes more and more common as you get older. And there's a number of reasons for that. Some of it is 'cause of hormones, some of it because of the receptors in the pen!s just become less sensitive. Every time we have an orgasm, it's usually like the symphony of events that have to happen.
Dr. Paul: It's not just like one thing, like you move your arm and or you move your finger. It's like you have to have the right serotonin levels, prolactin levels, dopamine levels, all these things that [00:10:00] we take advantage of when you're younger because org@sms just happen, right? But when you're older, it's thing when you're older, um, a lot of things happen.
Dr. Paul: So there's a lot of theories. There's some psychological theories why guys got delayed 3jaculation, like how they feel about sex as they get older. Also, masturbatory habits. Some guys that when they were younger, they might have masturbated, kind of lying flat on their bed and they're kind of humping the bed a little bit.
Dr. Paul: Those guys are more likely to have it as they get older, possibly because of just the, the friction of the pen!s and kind of the underside of the pen!s. So there's a number of things that can lead to it. Um. Unfortunately, there's no direct therapy for delayed 3jaculation. There's just not, there's no medication that you can put someone on, that strictly deals with, delayed 3jaculation.
Dr. Paul: But in sexual medicine, there's a number of things that we do that we may regulate dopamine, we may regulate, um, prolactin. To try to decrease the threshold to get that [00:11:00] orgasm for men. sometimes if it's just a sensitization issue. We'll bring in like vibrators and things like that.
Dr. Paul: Sometimes it's a hormonal issue, so we may have to increase their testosterone or do something with their thyroid. So, you know, delayed 3jaculation, it's complex and it's really the art of, of sexual medicine is, is really treating that person specifically to get them over whatever their problem is.
Leah: Hmm.
Willow: And then sometimes it, it happens for younger men too. Like it's not
Dr. Paul: It does. It does, but it's much more common in older men, but it can happen in younger guys, but it's just much more common, I would say. If you look at a guy that's like 20 or 30, the likelihood of having him having delayed 3jaculation is pretty low, but the premature 3jaculation is pretty high.
Dr. Paul: When you get in the fifties and sixties, we start seeing more and more delayed 3jaculation. Also the pen!s isn't as hard, right? So if you're not having a hard pen!s, then you're not gonna have the sensitization. You're not gonna have like the pleasure. You're gonna be thinking about other things. My pen!s gonna go down right now.
Dr. Paul: Am I gonna be able to make this [00:12:00] session? You know? And so that can also cause some issues and, and the delayed 3jaculation. So it's so many things that I always tell guys that when they come to my practice, you're gonna have the highest rate of me fixing your delayed 3jaculation then if you go probably in most to most places. But it's still not gonna be super high.
Dr. Paul: You're not gonna get to be a hundred percent. You know, I would say most practices, if you go to a urologist or primary care doctor, the success rate's probably about 5%. I always tell guys who are about 40%, um, when you come here and. And that 40% means that every time you get into, every time you have sex doesn't mean you're gonna ejaculate.
Dr. Paul: But if I can increase you by 50% of where you are, or 30% where you're, then we have a win. So I always have to set up my expectations for delayed 3jaculation just because of the therapies that we do and the medications that we use. Nothing's gonna ever get to somebody a hundred percent. But, um, but what always happens is a guy's not ejaculating at all, right?
Dr. Paul: He's like, doc, whatever, 50% you can, let me do like [00:13:00] 30%. I'm happy. Right? And then you get him to that rate and then you get into 40% and they're like, oh, I want more, and I always want more. You know, it never fails. And so.
Willow: well, isn't it true that their bodies would then like ha, have a greater capacity for, for more to be possible?
Dr. Paul: Well, we would hope so, but we do see a point of diminishing return. We do see a point where we can't get them past a certain amount because we can only do so much to kind of enhance what's going on with the medications that, or with the therapies or whatever that we have. it's.
Willow: to go down that rabbit hole a little bit. Like what, what, what do you attribute that 40% in your practice to like, are obviously you're, you know, looking at hormones, you're looking at potential medications. Are you also doing, um, psychological therapy, hands-on therapy, anything of
Dr. Paul: So I don't do any psychological therapy. I'm a medical physician. So when? When a person, yeah. Yeah. So when a person comes in. They get a full exam. Right. And, and most of the time when [00:14:00] they, um, they're talking about delayed 3jaculations. They, they've had this for a long time and they've been to multiple people most of the time that's when they're seeing me.
Dr. Paul: And like during the exam, we'll do nerve testing, to make sure it's not a nerve issue. So we'll do some nerve testing to the pen!s in the office. We'll check reflexes as well to see if that's a problem. And then we'll check hormones. and we do a gambit of hormones, which range from a lot of hormones.
Dr. Paul: And then, we're checking their er3ctile function. We talk about what's going on in their life. Like, is it situational? Is it with your wife? Is it not with your girlfriend? Or what have you. Right? And is it just occurring like, during stressful situations?
Dr. Paul: So we go through all of that. And then we kind of bring everything together. And to be honest, there's no direct pathway for everyone. UsuallyIt's something that's developed for that individual. And so, yeah, so we have sex therapists that we refer to.
Dr. Paul: And then if we feel like they need sex therapy, then we'll, send them to a sex therapist or we'll treat 'em in the office depending on what we find in, [00:15:00] their labs or what we found on the exam. So we do incorporate, I mean, sometimes it's pelvic floor physical therapy that we'll bring in as well.
Dr. Paul: It just depends on that individual. Like when I check their pelvic floor, if I feel their, their pelvic floor is really tight, then all right, so we have to do this. I wish, you know, like everyone comes in and everybody asks me like, what do you do for this? And um,
Willow: It is different for every person. It
Dr. Paul: different, but it doesn't really give me like, you know, it's nice to say like, you know, the Eagles are gonna win the Super Bowl and that's it.
Dr. Paul: You know, like it's just so much easier and people grab
Willow: wants to know the future.
Dr. Paul: People gravitate towards that. They want to know. Right. But in reality, and I, you know, I was having this discussion with my friend, in reality it's, I wish it was like that, then it would be a lot simpler. And then, you know, I, I'd get all the, like, the clicks and everything, but it's never like that.
Dr. Paul: You know, it's, it's, it's, it's never, it's, it's just the way humans are. It's, it always depends and nobody likes sending
Willow: always depends.
Leah: It's
Dr. Paul: it, it always
Leah: a combination. I mean, we have to [00:16:00] also remember that we are these complex organisms. You know, like when in life it's pretty rare that we get just a simple question, a simple answer to a complex question.
Leah: But at the same time, when we're really taking a look at a, a holistic approach of how, because when I look at sexuality, it's never just one thing. If, if there's, you feel like your sexuality is problematic, it's affecting a lot of other sectors in your life too, not just what's happening in the
Leah: bedroom. So we have to kind of take a look at all these various combinations to try to find the right treatment, and that really requires someone to be very patient. And a willingness to be influenced and to try different things and to stay the course.
Customized Treatment Plans and Patient Success Stories
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Leah: How often are you getting people in your office who are dedicated and committed to staying the course, or do they just get frustrated because our attention spans are so
Willow: limited
Leah: days.
Dr. Paul: No, I'll tell you, like I'm, I've, I've been fortunate. I think it's, it's hard [00:17:00] if you're like a primary care doctor and you're treating like high blood pressure and it's a chronic disease that's been going on forever. It's, it's sort of a silent disease. It's, it's one of those things, you take medications all the time and I feel like people can, sometimes they stop taking their meds.
Dr. Paul: They go back on their meds. I've been pretty fortunate and because I've been very specific in terms of what we do in the office. So most of my patients, um, have already seen, uh, like two or three people, you know, on average before they get to me, for some reason, and I
Willow: And when you say
Dr. Paul: I'm.
Willow: two or three people,
Willow: are you talking about other medical doctors?
Dr. Paul: Sexual medicine. Yeah, yeah, yeah. I mean, I'm a self-pay physician, so I don't take any insurance and because of that, like everybody tries to exhaust like everything they can. Right. So they've seen everyone. It's funny, when I'm in New York, like all my guys, they've already been to Columbia, they've been to Cornell, they've been to all these high, and then they find their way over to me.
Dr. Paul: And so they're ready. They're really, they're, they're [00:18:00] engaged. So, um. And I've had people that have, like I said, we talked before, that people will fly over and they'll come to see me. So they're engaged and, and they want to get better. So I feel like I'm fortunate, uh, in that respect. Um, so I have their undivided attention and they're listening to what we have to say.
Dr. Paul: But it starts with our interview with our patients. Like my first uni was about an hour. So within that hour, like we're going through a number of different things as well as going through a battery of tests to just try to figure out what's going on with that particular person.
Dr. Paul: Uh, be it male or female.
Willow: Is there anything that you give people that you have to give people like, you know, right away, let's say maybe they've had a prostatectomy, they now have ed, it's been years, they, uh, want to reawaken their sexual energy and feel their virility again and, and have, have a heart on again, and they're maybe leaning toward a pen!s pump or a surgery of some kind. [00:19:00] Is there anything that you would give a person that they could, like start doing on their own right away?
Dr. Paul: Oh, I love how you said like they want to just have sex. I love how you.
Willow: Yeah. They wanna fuck, I
Leah: Yeah.
Willow: don't we all.
Leah: Yeah. Confident.
Willow: Yeah. Yes.
Dr. Paul: But yeah. So yeah, they wanna do that. Um, and as you were saying before, there's so much more that goes into having sex with someone. It's that emotional attachment. It's like having that togetherness. It's just, it's a sense of power for some individuals and it's so many things that go into sex and for somebody that had, a prostatectomy, you know, there's a number of things we can do before they get to the point where they need a pen!s pump.
Dr. Paul: Many patients that have had prostatectomy, especially if it's bilateral nerve sparing, that means they spare the nerves, for some of the guys, we get them to use pills. We can get them to use injections, prior to getting a penile implant. Not to say a penile implant is horrible.
Dr. Paul: I [00:20:00] don't place them anymore. I used to do tons of penile implant, but my job really is to try to get guys to function again that we can function.So, yeah. what do we do? I mean, once again, it depends on that person. So for some people they may have more of a vascular issue, then we would do one thing.
Dr. Paul: If they have more of a nerve issue, we would do another thing. Are they responding a little bit to Viagra and cls? Are they not responding at all? You know, what are their hormones? If their testosterone's really low, we used to think it was this horrible thing to give testosterone. But we know if their PSA's been down for a number of years, we can still give testosterone under the right consent, under the right person.
Dr. Paul: You know? So if a person has been, has PSA's been, you know, extremely low for five years? No evidence of cancer. You know, when they did the, um, when they did the surgery, there's no other extension anywhere else. I mean, you know, it shows in a number of studies that you can give that guy testosterone. But you still have to say, all right, your testo, your, your prostate cancer may come back and all these other things.
Dr. Paul: But we usually don't see that, [00:21:00] you know, but we have to consent and say. You know, the old thinking was that if you gave testosterone it would come back. But in general we don't really see that. You know, in studies it shows that. In studies that guys on that have prostate cancer that are watchful waiting, so there's a subcategory of guys that um, have a low grade prostate cancer and you're just kind of watching.
Dr. Paul: 'Cause you know, they don't want it to go surgery, it's not the great isn't high enough. So even in studies with that, when, when you give those guys testosterone, if they need it, if it's symptomatic. We don't see an overwhelming increase in the progression of prostate cancer. So it's a number of things that I think the general public kind of, I think there's a lot of old information that's still out there.
Dr. Paul: Um, whereas like, you know, physicians in that are in the field and sexual medicine that do this on a daily basis, we know there's nuances to how we treat these guys.
Willow: That's great. Uh, I was also, sorry, Leah, I was also curious, um, if there was something [00:22:00] that you would maybe give them to do, like at home right away, that they could just start doing, like increase their, you know, electrolytes or their salt intake
Dr. Paul: Oh, oh yeah.
Willow: or something that they can really just like really start empowering themselves to
pen!s Pumps and er3ctile Recovery Methods
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Dr. Paul: Yeah. I like pen!s pumps. Does that count?
Willow: Okay. Yeah, that pen!s pumps are great. That's something they could do at home. Yeah.
Dr. Paul: I'm fan of pen!s pumps. I really, I think they really help. I think when you look at studies, it shows that there's a benefit. It might be a psychological benefit, but it's also a, a blood flow of benefit. There's a number of different theories of why pen!s pumps work. So I think doing that for exercise is, is key.
Dr. Paul: so I have that, in most of my programs that I do for eds, we add a pen!s pump and we have them use it during certain times and, you know, different, certain situations. So we'll do that. But yeah, I think that, you know, we always talk about kinda the men's or women's health. In terms of really trying to get in tune with, [00:23:00] you know, your, your spiritual side, if your spiritual, you know, yoga, like all these things that you mentioned I think are so important.
Dr. Paul: Eating the right foods, trying to stop smoking and, you know, all those things that, um, we know that are, uh, detrimental to our sexual health. We promote all of those things.
Stem Cell Therapy for Sexual Health: Fact vs. Fiction
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Leah: Are you doing anything with stem cells?
Dr. Paul: Ooh, stem cells. Oh man. You talking
Willow: Ooh, stem cells. Here we go down the rabbit hole.
Dr. Paul: Everyone know. So stem cells, we can't call them stem cells anymore. So if anybody says they're getting stem cellS.
Willow: PRP?
Dr. Paul: Well, PRP is different from stem cells. We do PRP, I can say that. stem cells, you can't really say stem cells anymore. You can say like biological product. You can say all these other things. But
Dr. Paul: I think that the, what most people are, most people are not informed. They have a theory of why stem cells work, but they don't really know how it works. It's pretty interesting. Most people think that you put, you get stem cells from like the placenta, your bone marrow, your fat, and you can do all that.[00:24:00]
Dr. Paul: And, those stem cells then become your pen!s cells. Wouldn't that be great? Or it becomes like your blood vessels. That's not how it works
Willow: That's not how it works
Dr. Paul: No. So what happens is they, the stem cells actually die in culture. When you look at it in culture, it actually dies. But what, what that stem cells are doing, it's really the, it's really all the surrounding, stimulatory cells that are supporting those stem cells that are really doing the work.
Dr. Paul: Right? And that is called a milieu or like it, the, all the stuff that, that stem cells, it's bathing in, that's really the signaling pathway that's causing you to have the result that you're having. It's not the stem cells. Right? And so some of the cell cells you can get from placenta, um, or bone marrow, what have you.
Dr. Paul: Like I said, the stem cells die. But all those stimulatory cells are there, which are kind of like this orchestra that's helping to remodel and restore,
Willow: I am not totally gra grasping. So is it like the, the [00:25:00] cells around the stem cell, like almost like the
Dr. Paul: the soup that it's in. It's like if you have chicken, if you have like chicken soup, right? And chicken, the chicken is the stem cells and you have all that other soup that's around that tastes really good. And then what happens is you remove that chicken, but you still got the soup right,
Willow: got really good broth.
Dr. Paul: the broth, and that broth
Willow: the nutrients.
Dr. Paul: all the nutrients.
Dr. Paul: You got it.
Willow: that. By the way, y'all, if you're making bone broth, be sure to put some kobu in there, some kelp so that you get good iodine for your breast health, your thyroid health in your womb health if
Dr. Paul: I love that.
Willow: and probably your pen!s if you're a man.
Willow: I'm not
Willow: sure, but
Dr. Paul: too. I'm sure your,
Willow: yeah. Yeah.
Dr. Paul: will benefit from a little bit of broth.
Leah: Okay,
Willow: you go.
Leah: I, I, I have a prostate question. What is your stance on prostate massage for health and wellness and for possibly, um, diminishing the potential for things like high PSA [00:26:00] scores?
Dr. Paul: um.
Leah: Regular
Dr. Paul: so prostate massage. I think, um, for some people I think it's fine. You know, I think that you gotta feel comfortable with somebody feeling your prostate and massaging your
Leah: Going up your butt.
Dr. Paul: yeah, some guys, cause a little
Willow: see, we'll say it
Dr. Paul: you know?
Willow: Dr.
Willow: Paul. Don't worry.
Leah: Some people love a little bit of a, um,
Dr. Paul: Some people, you
Willow: love a lot.
Dr. Paul: some people love it a lot. Prostate stimulation is, um, for some people it's their, it's their erogenous zone. I don't really go either way on prostate massage, to be honest with you. I think that if you're ejaculating, I think it's probably doing somewhat of the similar thing.
Dr. Paul: I don't really have a comment on that to be honest with you. I don't really, we don't really deal with prostate massage as much. obviously we want guys to be able to ejaculate and, you know, and we want, if they're masturbating, that's fine.
Willow: in, in all of the, the vast modalities and therapies that you [00:27:00] offer your clients, if you do ever kind of refer, I know that you would refer to like a sex therapist, but if you ever refer to people who just do hands-on like tantric healing work as well. Do you
Dr. Paul: You know, it depends on it. It really depends on what the, uh, patient's comfortable with, to be honest with you. And, you know, if somebody says that, you know, that they would like to try that, I'm like, I'm all in. You know, if it's acupuncture, if it's, um, any of the other therapies like I am, um, 100% in on that.
Leah: so I am open to almost everything, that's beneficial for that person because I realizeyou're not just healing the person's like by like medicine or anything. You also have to heal their brain too.
Dr. Paul: And, um, I find that, you know, if somebody brings it up, it's something that they probably want to try anyway. unless it's something that I think is de detrimental, detrimental, then I, I'm all for it. Like, we've had patients that have undergone, like acupuncture for a number of, of things like pelvic floor, acupuncture, [00:28:00] um, you know, Pilates, yoga, any of these things can help.
Dr. Paul: I will support my patients if they're, um, if they're interested in that for sure.
Leah: What? What are some of the interventions that you recommend that
Conquering Premature 3jaculation: Modern Approaches
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Leah: Have a higher success rate when it comes to premature 3jaculation. And are you finding any correlation between a tight public floor, which could be possibly cau idle to premature 3jaculation?
Dr. Paul: Yeah. So we do. For some of our patients I do a pelvic floor exam on my, patients, um, male or female. And, if they have a hypertonic, so a tight pelvic floor, then we would refer 'em to a pelvic floor physical therapist. Not all patients, but we do for some patients.
Dr. Paul: If they have that, then we will refer them for sure. Um, and then also like with. Premature 3jaculation. There's like, um, there's a number of reasons why men will have premature 3jaculations. You know, is sometimes It's episodic. Sometimes it's if they're in the back of the car and they're having [00:29:00] sex, they'll have it, but not in the bedroom where they're more comfortable.
Dr. Paul: Sometimes if, you know they have a multiple partner, sometimes it's with one partner and not another partner. So it varies in terms of the treatment for that. But oftentimes, you know, medications can help, you know, obviously you start with some numbing sprays and things like that.
Dr. Paul: That's usually the first thing, along with sex therapy or pelvic floor physical therapy, um, to help with that. And then there's other medications that we use the side effects of to help with, um, the premature 3jaculation.
Leah: Okay, so the, the majority of the treatment is like those sprays, pelvic floor release work and um, medication. What kind of medication?
Dr. Paul: So you can use some of the side effects of, like, antidepressants, um, low dose antidepressants you can use for it. And, um, amazingly, like for some of the men, most of the men, they don't have the side effects that you get with some of the other medic when they're on a medication that, and they have like depression or anxiety.
Dr. Paul: The, the, um, the side effects are very, very low. You just have to [00:30:00] choose the right one for that patient. Um, and then there's other things. Sometimes we'll use like 10 units. Sometimes we'll use Botox. There's a number of other things that we can use for the, the pen!s.
Dr. Paul: Sometimes we'll use filler to place in the, uh, in the pen!s. So there's a little decreased sensitivity of it. Um, we do a lot of girth enhancement procedures
Leah: was gonna follow up with that. Yeah.
Leah: So what is that? Fat injections
Dr. Paul: No, we use filler. We use filler like, uh, people, like men or women use for the face for volume. So we'll use that into the pen!s and we get really good results with that.
Dr. Paul: My patients are extremely happy, um, with.
Leah: but that's not permanent, right? So they come in a couple times a year to
Dr. Paul: No, no, no, no, no, no. Usually like, you know, depending on how much filler we place, um, sometimes, even though I always tell them, all right, the filler's gonna last about a year. So I have guys that are still three years out and their filler looks great. So I always tell guys it's not, you're not using it as much as you use and, and like you're using your [00:31:00] muscles in the face all the time.
Dr. Paul: I mean, even though guys would love to use their pen!s probably as much as they're using their
Leah: Yeah.
Dr. Paul: muscles, but, um.
Willow: They'd never get anything done.
Dr. Paul: I know. Tell me about it. So we just find that it last, we find that it lasts a little longer, you know? Um, but I do tell them, because the product says it's a year. I always say it's about a year, but we, we squeeze a lot more out of it.
Leah: do you also cut the tendon? I don't know the name of the tendon
Dr. Paul: Oh, for penile longer. No, I don't do any, um, that's for making the pen!s longer. I just don't, I don't, I mean, at this point I don't do that.
Penile Enhancement: Natural Results with Fillers
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Dr. Paul: Um, sometimes you get some scarring and some other issues with that. So I just, um, I, I like the way like the, the filler really looks, I think it looks natural and guys are, are really happy with it.
Dr. Paul: It's funny 'cause the guy's like, I want a pen!s, this big doc. I want a pen!s this big. And I'm like, all right, let's just make it look natural. Let's like make it look good. And then, you know, and I'm like,
Willow: been watching too [00:32:00] much porn. They're
Willow: like, I wanna look like
Leah: I know
Dr. Paul: oh my God. You know how like, uh, like women, when they get some women, when they get their hair done, they'll bring in a picture of like a famous person.
Dr. Paul: All this is like, I want, I want this hair done.
Willow: I wanna look like this person. Can you just change everything?
Dr. Paul: So funny.
Willow: That's an inside job, most likely.
Dr. Paul: I had a guy that came in the other day and he brought like a clip from a porn and he is like, I want my pen!s to look like this.
Willow: Hilarious. I'm
Willow: surprised that doesn't happen all the time actually.
Restoring Intimacy After Cancer Treatment
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Willow: Um, I, you know, I loving, loving this conversation and I also wanna make time and space to talk about the, you know, the work that you're doing with cancer. Um, people who currently have it and people who are survivors
Dr. Paul: Yeah, so I, I'm really proud of that. We have a, a sexual health after breast cancer program here for women that, have had either some of them are on Lupron or Tamoxifen, or a number of these medications that, or [00:33:00] chemotherapy that sped up their menopause. and it's hard and obviously with hormones, you have to be very careful with hormones in, um, in those patients.
Dr. Paul: we have a program that helps them with their vaginal health, they're libido. And just some of the issues that they're having after they've gone through breast cancer therapy. And then on the, on the other side for men, men that have had like pelvic floor surgery, I mean pelvic surgery like prostate cancer or even some radiation to the pelvis for, for colon cancer and some surgeries with colon cancer where you can get some ed.
Dr. Paul: We have special programs for them as well where we, we take all that into consideration and, um, we can really focus on their eed and try to get, try to maximize, um, everything we can out of their, their sexual, for their sexual function.
Willow: What does a program look like? Like
Willow: is it
Leah: What are some of the
Willow: of time? What's going on in the program? Who do they see? I.
Dr. Paul: um. Yeah.
Tailored Programs for Post-Cancer Sexual Wellness
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Dr. Paul: So for the, for women, it's really, we, we always discuss their cancer. Um, some cancers are estrogen [00:34:00] positive, progesterone positive. We get into that. We get into their particular side effects that you, they've gotten from their therapy. Not, not all women have low libido, or not all women have issues with, um, vaginal health or, um, vaginal atrophy.
Dr. Paul: A lot of them do. So we kind of target in on terms of whatever they're in need of. And then we kind of focus on those problems. But you know, obviously when we're focusing on the problems I mentioned before, you know, we have to be very careful in terms of what we give them for their therapy, right? So sometimes we're using laser therapy for their vagina, or sometimes we're using medications to increase their, um, libido, that that's not gonna affect their hormonal,
Dr. Paul: you know, their, their hormones. Oftentimes we, we send them to sex therapists. We work with a bunch of sex therapists or if it's pelvic floor physical therapy. So we really tailor our programs particularly for that person.
Willow: Got it. So it's not like a one size fits all.
Dr. Paul: No, like I am saying, I wish it
Willow: pick and choose. Yeah.
Willow: Depending on the
Dr. Paul: And then even for [00:35:00] some breast cancers, depending on what you have, you could still use a little bit of topical estrogen.
Dr. Paul: In terms of the data, we know that most of the estrogen is not getting into the system. It's staying very topically, but that's a conversation that we have with the patient, but also their oncologist.
Willow: That is such an interesting phenomenon. I've always wondered about that. 'cause I mean, you put estro, you know, estriol or estradiol on your belly, your breasts, your arms, your legs, and it goes into the bloodstream. I wonder why, I've always wondered why, maybe you can enlighten me. Why when you put it in the vadge or on the vulva, it doesn't quite hit the bloodstream the same way.
Dr. Paul: Yeah. I mean, we know that it gets, it does get in a little bit.
Willow: A little bit. It's like drinking a decaf. You
Dr. Paul: Yeah, but you got Exactly, but like that, that tissue is very estrogen sensitive and it wants to really, I mean, the easiest way of putting it, it really wants to soak it up,
Willow: it just wants to soak it out. It's like a
Dr. Paul: yeah, it's, it just really wants to.
Willow: Lot of receptors there.
Dr. Paul: Yeah, it really wants to, proliferate
Dr. Paul: in terms of like the [00:36:00] vaginal health, it increases like the collagen, lubrication, everything. So we just don't find that it gets into the levels. And, and, and it's also the amount that we're giving, you know, when you're putting it on the skin, it's usually a higher amount, higher concentration of estradiol or estro l whatever you're using, as opposed to what we're placing in.
Dr. Paul: For estrogen, it's usually for the vagina, it's a lot less and the concentrations are decreased, um, than if you would place on the skin.
Willow: Okay. Okay.
Bioidentical Hormones: Benefits and Testing Protocols
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Willow: And do you guys use Bioidentical
Dr. Paul: We do, yeah, we do bioidentical hormones. I stay away from like progestins and the, and anything with the ends on the end of it, just because of some of the studies.
Willow: And then what kind of testing do you guys run? Yeah.
Dr. Paul: Oh, we do blood testing. it's just it, to be honest, there's like saliva testing, urine testing, all these testing.
Dr. Paul: Um, I just find that, you know, when patients come in they all have insurance. They want to use their insurance. And so we'll, we'll send them to one of the major lab companies and then we'll [00:37:00] go from there. And I don't find there's a difference between, you know, we used to do all this other testing, but you know, the outcomes for me are the same in terms of what I'm looking for.
Dr. Paul: And what I'm looking for is I just look for highs and lows, right? So it's not, you know, when it's not a particular number, it's highs and lows. We don't want to be too high. We don't wanna be too low, right? But it's really about how that person's feeling. I just had a conversation. I, I'm, I'm in the middle of my office hours and we were talking about this, I was talking, I was talking to a physician,
Dr. Paul: he is a physician and he is like, what's the best number for me? I'm like, it's not a best number, right? It's. It's really about how you feel. It's really about how you feel. And, and so those lows, we don't want you to be below a low number because then it might not be beneficial for your bones and all these other things, but we also don't need you to be super high.
Dr. Paul: Um, and then you're gonna have some side effects. And this guy I was talking to is on testosterone. And you know, with testosterone, I always say like, this is kind of my analogy with testosterone, is that when you. if testosterone is like water and you're like a plant, right? [00:38:00] And you put that water in, you're withered plant, you put that water on the withered plant and you're gonna make flowers, right?
Dr. Paul: It's gonna blossom. But what happens if you keep putting that water on that plant? You're just gonna get water all over the floor, and that's all the side effects that you get. And people don't really understand that, that, you know, there's side effects with estrogen or your hemoglobin goes up too much, you have a higher rate of having a stroke and, and DBTs and all these other things.
Dr. Paul: All these little subtle things that. I think people miss over time, um, when they're dealing with hormones. You know, so there's all these online hormone centers and I, I see these guys that are, these levels are like in the 15 hundreds and they're like, oh yeah. But then you look at, um, they're like, oh doc, this is great.
Dr. Paul: This is great. But then I look at your metabolic stuff and you're, their panel and their estrogen levels are 90 or a hundred. Um, we had a guy that was was using one of these, online, uh, pharmacies and he had a stroke and all these other things. And so, you know, there's some subtleties to hormonal therapy that, you know, we all should be paying attention to.
Willow: Absolutely. Yeah, that's [00:39:00] really important. It's so important to have somebody who's, um, if you are doing bioidentical or not bioidentical hormones, any hormone replacement therapy to have, um, somebody who's really guiding and watching and testing and making sure that things are not too high and not too low.
Leah: I'm surprised there's even hormone products out there that just aren't bioidentical. I mean, with all the information out there about Bioidentical, why wouldn't everyone just be on bioidentical? Why would choose? Why would you choose anything other than that? Since that appears to be the safest option?
Dr. Paul: Well, I mean, I don't think it's the safest option for everyone. There's a thought that, hormones that are made by manufacturers that aren't bioidentical are just as effective. So, you know, I think it depends on the audience that you're talking to and the literature that you're reading.
Dr. Paul: If you're, I mean, to give an objective answer, um, I think that's, that's why. Because we do what we do and we understand some of the literature and this is [00:40:00] what we believe, then that's the reason why I, um, I, I, I'll deliver whatever medication it is, if it's bioidentical, if it's, if it's something that's, I'm using off label for something, but there's other people on the other end, right?
Dr. Paul: And they say, oh, it doesn't really matter as long as our estrogen or testosterone or whatever is getting to the right level. And it doesn't matter how we get there. I think that's it. I mean, for me, like if I'm giving testosterone to women or estrogen to women or anything to women, I like, I personally like bioidentical.
Dr. Paul: That's my first choice. Um, but it's not everybody's first choice. And it's just, and that's the beauty of medicine, I think. I think that there is a choice, but I think you just have to educate your, I think you should know both sides and I think you just have to educate your, your, um, your patient.
Willow: you're patient inside your programs, are you also addressing, um, nutrition. Do you talk about herbs at all with your client.
Dr. Paul: I wish I did. I really wish I did, because I think there's a whole, um, other side [00:41:00] of it in terms of nutrition, in terms of the microbiome of the gut and how that reflects to like your brain health, your heart health, how it reflects, um, on sexual health. So I wish I did, to be honest with you, I just don't, I just, um, you know, I've kind of focused on this.
Dr. Paul: Um, once again, you know, we have people that if they're interested in, then I would definitely refer 'em to, so I'm open to all that stuff and I know that all helps. It's just, I just can't do everything at
Willow: can't do everything. You already are doing so
Dr. Paul: wish, you know, but I just can't. And so, you know, that is probably an element of my practice that I wish that we can kind of build up.
Dr. Paul: In terms of the nutrition and, and like nutrition and sex. I think that's a whole like, topic of conversation.
Willow: to God, we could change the whole world if we just got microbiome and posture, right? I
Dr. Paul: Oh, I know.
Willow: would feel
Willow: so
Dr. Paul: see my posture right now. It's horrible. I should sit up right now.
Willow: Sit up, open
Willow: the
Dr. Paul: that, is that what you're telling me right [00:42:00] now is you gotta sit up? I, I get it.
Willow: I'm talking directly to you and everyone else out there who's
Dr. Paul: I.
Willow: as they listen.
Leah: So.
Dr. Paul: It's good for your vagina. Sit
Leah: That's right. That's right.
Leah: Um, alright.
Navigating Perimenopause: Proactive Planning Strategies
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Leah: I have, you know, a final question and that is, what advice do you have for women who are headed into perimenopause, who are in perimenopause, or might be even as much as five years from perimenopause? When should we start taking a look at our menopausal plan as women?
Dr. Paul: So first thing I think is that women should understand what it means to be in me perimenopause and what signs they have, like if they're having hot flashes, if they're having more anxiety, if they're not sleeping well at night. Those are some kind of key little things. Obviously you start getting irregular periods and things like that.
Dr. Paul: So I think understanding like the symptoms that you're having and understanding what is the possibility, of the, what are the sexual or other symptoms that you can [00:43:00] have with menopause? So I think having a good idea of that is like the first step, right? Um, I think that as women start to have those symptoms,
Dr. Paul: then they should reach out to someone that, understands how to treat them. Right and understands, and this is key where nutrition comes in. I think nutrition is key for perimenopause patients and menopausal patients. that's the first step. And exercising more exercise is great, right?
Dr. Paul: You're increasing dopamine. you're helping with your bone strength, you're, it does so much for wellbeing. it's great. You know, those are the things that we should be doing all the time, but especially in that period. Also understanding like what's gonna happen to your bone mass over time.
Dr. Paul: So, you know, I can see, um, Leah, I can't really see all of you, but you look fairly thin, right? And so do you, Dr. Willow, um, but also understanding what's going on with your bone health, right? Because as you get older, what's gonna happen is it's gonna deteriorate, right? Because of the lack of estrogen on the bone, you get osteoporosis.
Dr. Paul: So starting to exercise, [00:44:00] starting to use resistance training early is key. Right. Um, also eating the right foods, vitamin D, calcium, also really important. So really having a game plan of what is perimenopause, what is menopause? What does it look like, what does it look like for me as a person that might be thinner, or a person that might be heavy, right?
Dr. Paul: Because as you get older, it's harder to lose weight too, right? So for those patients, like you really want to get ahead of the game, before you get in that menopause stage, this is the time to lose weight. Because it's so much harder to lose weight as you get through menopause because of the changes in hormones and everything.
Dr. Paul: So get ahead of it. Right? And that prevents like osteo arthritis as you get older because of the, because of the weight and all these other things that weight brings inflammation and all these other things. So that's the time for that person to, to maybe look ahead and say, all right, I gotta do this now 'cause I don't have much time.
Dr. Paul: You know? And then, you know, depending on what we find, if it's hormones or what have you, then we can support with that, if you're having some issues with hot flashes or, or some women [00:45:00] start to have some decreased in lubrication, so we'll help with that. You know, I'm a big fan of like hyaluronic acid, vitamin E and all these other things to the vagina, but also helping to, um, help with, um, the lubrication or arousal or whatever issues that they may have.
Dr. Paul: I know it's a, it's all over the place, but perimenopause and menopause is all over the place for a lot of people.
Willow: Yes.
Leah: I know I said that was the final question, but I have another final question.
Mona Lisa Laser Therapy: Vaginal Rejuvenation Without Hormones
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Leah: Um, because I know you do work with the Venus, right? The um. Some laser work working
Dr. Paul: use the Mona Lisa,
Leah: the Mona Lisa.
Dr. Paul: Yeah, the
Leah: Yeah, yeah, yeah. You wanna say anything about the Mona Lisa? For those people in our
Dr. Paul: Oh yeah. I love them. I mean, it's, it's one of my favorite tools in my office. And full disclosure, I was one of the investigators on the animal studies for the Mona Lisa. So we, um, we had to do a bunch of animal studies to try to get it approved by the FDA. It's not a, it's not FDA approved.
Dr. Paul: They, the FDA actually came back and they said they needed several more million dollars and more animal trials and all these other things. So it is always used off-label. [00:46:00] Um, so I have to say that there's, um, but I'll tell you, I, I am such a fan. I actually wrote a paper on the Mona Lisa laser and what it does, so it really helps, you have to think of the Mona Lisa laser as something like microneedling or laser to the face or, and all those treatments, what they're doing is they're just stimulating your own body to kind of heal itself, right?
Dr. Paul: And so we use core wave therapy in our office for er3ctile dysfunction. Same thing, right? And so what the Mona Lisa does is stimulates the tissue and it promotes collagen. Um.
Leah: Okay. That's what I
Dr. Paul: And then it also promotes hyaluronic acid and all these other, um, proteoglycans and things that come in and they start to, um, help with proliferation of the, of, of the thickness of the vagina.
Dr. Paul: It helps with lubrication, moisture. I'm a huge fan of the modal, Lisa, I've been using it and, you know, I always have people, you know, other companies come to my office and they want me to use their laser, but I get such good results with the way I use it. You know, in most people's hands, I [00:47:00] think it works well just because I've, I've done so much research on it that we kind of tinker with a couple things to get the maximum results out of it.
Willow: Can you send us a link for your paper? I wanna read it.
Dr. Paul: Oh yeah. It's on my website, I think. Um. Yeah, I can send you a link. It's, it's old, but what we did is we looked at, women that were, it was breast cancer. We looked at our breast cancer patients and then we compare them to our menopausal patients. And then we looked at, you know, using the laser and we looked at a, a bunch of different factors.
Dr. Paul: There's like these questionnaires that we use that looked at like sexual function interest, all these things. And at the end of the Mona Lisa, we were able to get them, even if they were on. Um, even if there were breast cancer patients on hormonal therapy, we were able to, um, really have a good satisfying, you know, se sexual experience, libido, everything went up.
Dr. Paul: So, there were the same for menopause and, women that, had breast cancer. So it works really well.
Leah: Just for clarification, the Mona Lisa is good for treating vaginal [00:48:00] pain? Um, vaginal dryness...
Dr. Paul: so vaginal pain, vaginal, um, vaginal pain is a long, is a big category. We can't say vaginal pain because vaginal pain could be due to the pelvic floor and all these other things. So, so, um, vaginal atrophy, right? And, and, and so GSM is another word for vaginal atrophy and, um, it's. General syndrome of menopause.
Dr. Paul: So that's where you have the vaginal atrophy, some pain with intercourse because of that atrophy. Right? Um, and so. It's great for that. I'm, I am such a big fan of it for that. Vaginal pain is hard because that could be coming from a number of different places, right? It could be coming from endometriosis and all these other things and pelvic floor dysfunction.
Dr. Paul: So it doesn't help with that. But it helps to help with the proliferation of the vaginal lining. It helps to increase lubrication. We'll see changes in pH in the correct direction when we're using the Mona Lisa. The good thing is not hormonal. So, you know, for women that don't like, [00:49:00] taking any, um, type of, hormonal therapy or they can't take any hormonal therapy, then it's perfect for them.
Leah: Great.
Dr. Paul: But like I said, it is not FDA approved. It's off label for that. But, um, I mean, that's
Willow: it.
Dr. Paul: way,
Willow: Does it have to be administered by a doctor
Dr. Paul: um, in my office I mostly do it. Sometimes my nurse practitioner does it, but I don't know if.
Willow: It's not a home use thing.
Dr. Paul: No, definitely not. No. No, definitely not. Definitely not a home use. It's very expensive. It'll be pretty
Willow: $10,000 thing or something?
Dr. Paul: no,
Leah: I think it's more like a hundred.
Dr. Paul: It's probably more than
Leah: yeah. Yeah.
Dr. Paul: You gotta go up. You gotta go up. But it's okay.
Dr. Paul: Um, it's very expensive, but, um, it works well.
Leah: to,
Dr. Paul: No, it's not. I mean, if you, it shouldn't be painful. I mean, the first time, um, you can have a little discomfort depending on the, the thinning of the, um, the atrophy of the vagina. You know, for some of our patients, they're pretty severe. And so then we modify the technique a little bit.
Dr. Paul: We modify how we use the laser [00:50:00] depending on like the thickness of the, um, the vagina and how much atrophy
Leah: It's using sound, right? It's not
Dr. Paul: No, it uses CO2 laser.
Leah: okay?
Dr. Paul: That's CO2 laser.
Innovative Shockwave Therapy for Enhanced Sensation
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Dr. Paul: When you're talking about sound, you're talking about like core wave therapy for like er3ctile dysfunction when you're talking about, and those are focused shockwave therapy, and that could be used.
Dr. Paul: We use that for pelvic floor dysfunction. We use it for er3ctile dysfunction. It's a number that's a whole nother,
Leah: used for men and women or just men?
Dr. Paul: so we use it for men and women. We have a, we have something called fem tensity for women, where we use low intensity shockwave to help with org@sms and and, and you can also use it for pelvic floor dysfunction.
Dr. Paul: We use it for that too. It just depends on the, the amount of frequency and the energy that you're using and where you're putting it.
Leah: When it's used for org@sms with women, is it to help with clitoral org@sms, vaginal org@sms, both.
Dr. Paul: So we see that it helps with both, but it's mostly for, uh, clitoral org@sms. but, uh.
Leah: with blood flow? What, what is it?
Dr. Paul: Exactly. So it helps with blood flow, it helps increase nitric oxide levels in the, in the org@sms. I [00:51:00] mean, the org@sms is, is essentially the same thing as the pen!s, right? I mean, it's just, so as, as we're in utero, what happens is, like the, for instance, the head of the pen!s is the same thing as the head of the org@sms.
Dr. Paul: And then the bodies of the pen!s or the shaft of the pen!s, women have these corporal bodies, but you can't see them. They're on the inside, so they still have those corporal bodies. They're just split. Um, so it helps with both. It helps to increase blood flow in men and in women. It helps to increase nitric oxide levels in rat studies.
Dr. Paul: Um, for men in the pen!s, it actually showed some more, uh, stem cell formation in.
Willow: I wanna try it. What
Leah: know I.
Willow: if somebody doesn't really need it? And they try and they try it?
Dr. Paul: org@sms all the time.
Willow: Oh, my God. Let's fly out there. Leah. Let's
Willow: take a
Dr. Paul: like, oh, everywhere you go. Everywhere you go.
Willow: every step we take.
Closing Thoughts and Practice Information
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Leah: well thank you so much, Dr. Paul. This has been really enlightening
Willow: Yeah,
Dr. Paul: no problem.
Leah: on the show.
Dr. Paul: Yeah. Thanks for [00:52:00] having me on this show. It's been, uh, it's, it's been fun.
Leah: Cool. Well everybody stay tuned the dishes up next and we will catch you on the flip side. Love, love, love.
The Dish with Leah & Dr. Willow - Post-Interview Reflections
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Announcer: Now our favorite part, the dish.
Leah: Dr. Paul,
Willow: I love Dr. Paul. That
Willow: was so much fun. Yes.
Leah: I know you. I could tell your little medical mind was just geeking the fuck It was so good. I was just telling Leah I didn't look at the time. One time I was
Willow: just a riveted. I mean, there were so many things to talk about, so many directions to go. And you know, he's got such a vast well of information that, um we could have dug so deep on any one of those topics, but I'm glad we got like a really nice overview of everything he does. 'Cause now our audience knows about him. You can use him yourself, refer people to him who you know are having a struggle. I mean, I think that he just offers quite a, quite an array of [00:53:00] support for sexual health and wellness.
Willow: Totally different than what we do also.
Leah: Very, very different. I can see how, um, a great approach is by combining the two.
Leah: I think there's definitely places from the holistic standpoint that he's lacking in terms of, um, kind of just having that whole holistic approach. I mean, he can't do But he is open to it. Yeah. enough, you know, and I, and he seems really like open-minded about,
Leah: you know, all the things.
Leah: So that's great.
Leah: I wasn't surprised by his answer around the men who have delayed 3jaculation. I wish there was something that we knew that could have a greater success rate, that could pinpoint, you know, things for people to try. Out of all the people that I help, um, people who suffer from delayed 3jaculation
Leah: for instance, like the satisfaction of having someone overcome 3jaculatory control and having more 3jaculatory choice due to premature 3jaculation, that is such a big win for me. Like I can help people [00:54:00] so dramatically with that. With delayed 3jaculation, it is just a real process and it's often, uh, really frustrating.
Leah: You know, a lot of times it is a desensitization. That's been my experience. The other direction I've been trying to bring people towards exploring is some of these hidden corners of desire. Where are the places that are uninvestigated that might turn your desire onto greater heights? But we've been ex, we've been afraid to look at it because of our judgments about what it
Willow: Too
Leah: turned on in a more taboo direction.
Willow: And I'm finding that's even a difficult process to guide someone too. There's still so much resistance there, even though that could really unlock some things. Um, interesting to hear uh, I'm trying to remember now what some of his interventions were.He was talking about hormonal replacement and
Leah: Yeah. Looking at the
Willow: and
Leah: hormonal stuff? Yeah.
Willow: Yeah. Yeah. And, and I think, [00:55:00] um, one thing he kind of alluded to and mentioned around that, which I'm really big on right now is, you know, if somebody's been laying on their back on the bed
Willow: masturbating for years,
Leah: When you're, when you're rubbing your pen!s up against the sheets,
Willow: humping on your
Leah: of stimulation.
Willow: he said on your back. But yeah.
Willow: either, either way. I
Leah: make sense on the back. It's
Willow: Yeah, either way, we, we, um, you know, start to work our bodies in a certain way. You know, we all maybe always hula to the right or always hula to the left, and like,
Willow: it, it kind of,
Leah: I like
Willow: it, it kind, um, you know, it creates this, uh, this one groove
Willow: in your, in your brain to heart to gut and pen!s, you know, pathway of like what's possible.
Willow: And so you gotta get out of that groove and try something different.
Leah: Well, and I think just a reminder of like, look, you, you're never, you're probably never gonna get to the point where you just ejaculate when you want to, whenever you want to. It's gonna be [00:56:00] your increase in being able to reach 3jaculation will go up. You know, 20 to 40% and that's a success, you know, and that's an increase then maybe what you're experiencing now.
Leah: Um, yeah, so that was, I was really eager to get his answer on that. And, and I it
Willow: you did.
Willow: Yeah. Um, I, I was happy to learn about the Mona Lisa. I didn't know about that. How did you know about that? Already
Leah: Oh, because, um, Nalini Prassad it
Willow: Okay.
Leah: and does it, and I've had a couple of students in the seminars promote it because they have had it and have had dramatic results as a, as a result of diminished pain, um, due to intercourse. Um, a more tightening of the vaginal opening so that sex is more pleasurable, uh, better lubrication.
Leah: Um, all the things that he
Willow: mentioned.
Willow: I had a client who got some kind of [00:57:00] something to her vulva. I think it was laser. I wonder if that's what she got. Now her org@sms is like so hypersensitive.
Leah: Well, this isn't done to the org@sms. This is done to the vaginal opening to produce more collagen. Um, the other treatment that he mentioned was a laser that treats the pelvic floor. Um, and that is what's helping org@sms and, uh, the name of it he mentioned in the interview, I, it was one of those medical.
Leah: Things that I, I would've to hear it like eight times before I could recall it. 'cause it's not the Mona Lisa, it's something else.
Willow: Right.
Leah: But that has to do with more pelvic floor stimulation. And I think that has to do with the shockwaves
Willow: Hmm.
Leah: um, the other kinda lasers that produce collagen.
Willow: Mm-hmm. Interesting.
Leah: Yeah.
Leah: Interesting. Um, and it sounds like he, yeah, I, I couldn't, I'm not sure we got a straight answer about the, um. I wanna say blood platelets, but it's stem cells
Leah: of whether or not he [00:58:00] actually provides that as an intervention or not. To me, it was like, it doesn't matter to me whether the stem cells are doing the job or the broth is doing the job.
Leah: As long as something's doing the job, win-win,
Willow: right. Exactly. Yeah. Yeah,
Leah: anyways, tell us what you think about Dr. Paul and if you felt like you got some answers to some prayers because you've been dealing with some difficulties and some of the things that he said, uh, are inspiring you,
Willow: yeah.
Leah: get some extra support from the medical industry.
Willow: Yes.
Leah: All right. Please subscribe, comment and share this episode with someone who you know could benefit from it.
Willow: Much love.
Announcer: Thanks for tuning in. This episode was hosted by Tantric Sex Master Coach and positive psychology facilitator, Leah Piper, as well as by Chinese and Functional Medicine doctor and Taoist Techology teacher, Dr. Willow Brown. [00:59:00] Don't forget your comments, likes subscribes, and suggestions matter. Let's realize this new world together.
