MAJOR SEX TALK WITH DR PAUL GITTENS

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Speaker 3 For those of you guys new to Cat on the Loose, welcome to our fast-growing worldwide community, our cat kingdom, where we can speak freely about sex, dating, and relationships with no judgment or filters.

Speaker 3 This podcast is a little bit different than your usual podcast because it is 100% organic, meaning we do not edit our interviews at all. It's never scripted.
It's a very real conversation.

Speaker 3 And it's not always always in the studio.

Speaker 3 Many times we record in real life, sometimes at the homes of our guests, sometimes in places where we interact with our guests, such as events, restaurants, etc.

Speaker 3 It is truly a window into our lives and it is meant to open up conversations and invite everyone to join in.

Speaker 3 We have 24-7 open lines of communications for you guys via WhatsApp 1305-332-0338, via email contact at catondaluz.com and and Instagram RioCat on the Loose or my personal Instagram catzamuto.

Speaker 3 I hope you guys enjoy it. My guest today, Dr.
Paul Gittens MD, is one of the leading sexual medicine physicians in the country.

Speaker 3 He's an expert in the treatment of sexual health for men and women and a specialist in male and female menopause and male infertility. Dr.

Speaker 3 Gittens is also one of the country's leading specialists in sexual function for men and women, hormone replacement therapy, male infertility, and wellness.

Speaker 3 I try to cram in as many questions as I possibly could about this very important subject, our sexual health and wellness. And I really hope you guys enjoyed this super important episode with Dr.

Speaker 3 Gittens.

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Speaker 3 Dr. Gittens, it's such an honor to have you on Cat on the Loose all the way from Philadelphia.
Thank you so much for doing this.

Speaker 5 Thanks for having me on Cat on the Loose. I am so excited to finally meet you.

Speaker 4 I am.

Speaker 3 I am so excited to have you because we were trying to find an expert when it comes to sex and sexual health. And obviously, you are on the top of the top of the top of your game.

Speaker 3 And as I was saying before we started, we have 10 million questions. I want to try to squeeze in as much as possible.
And we only have an hour.

Speaker 3 So are you ready to rock and roll?

Speaker 4 I am ready.

Speaker 5 I am ready.

Speaker 5 I've been waiting for this for the last week and a half, and

Speaker 5 I just couldn't wait to get on the show.

Speaker 3 Wow, amazing. I'm very honored.
Thank you. The first question might seem silly, but this is my question.

Speaker 3 And a lot of my listeners agree with me, but I want to know your opinion as a doctor, as an MD, and as a man. And tell me if you think this is just my perception, if you think this is a myth.

Speaker 3 When we talk about sex, sex, I'm a woman talking about sex, right? I do a sex podcast. I feel

Speaker 3 this is still such taboo. It's still a subject that people cringe.

Speaker 3 And because of that,

Speaker 3 it's so hard. So many people

Speaker 3 many times don't seek sexual, don't seek a doctor's help, have horrible sexual lives, don't even listen to a podcast

Speaker 3 because they're so embarrassed even talking about sex. Do you have the same perception?

Speaker 5 No, I totally agree. I think that

Speaker 5 especially like when in the United States, you know, and it probably has to do with our Puritan, like how the United States was formed and all these other things, but you know, we see sex all the time on TV, you know, it's everywhere.

Speaker 5 You might hear it on the radio, we see billboards, but it's when it's time to settle down and talk about sex. We do a horrible job

Speaker 5 doing it. And

Speaker 5 I think it's kind of like the American culture,

Speaker 5 but we need to do a better job. And so that's why

Speaker 5 I'm just excited to have someone like you

Speaker 5 that's talking about it, that's educating.

Speaker 5 the people out there.

Speaker 5 And so if people are having problems with sexual function, either male or female, they can listen to you and say, hey, listen, like I heard this cat on the loose.

Speaker 5 This is something that I'm dealing with. And maybe that empowers them a little bit to move forward and advocate for themselves and to

Speaker 5 get help.

Speaker 5 So I totally agree with you. I think that we do have a problem in this country of talking about sex for sure.

Speaker 5 I mean, sexual dysfunction.

Speaker 3 Yeah, no, absolutely. And we're going to get to that very soon.
And I completely agree. It's a huge problem in the United States.

Speaker 3 I come from cultures, Brazil and France, that it's not that big of a deal. And I feel it's my job as a communicator, as an artist, to open up these conversations.
I get a ton of backlash.

Speaker 3 I get called all kinds of names. I get called a whore.
I get called this and that and that because I'm talking about women living happy, fulfilled sex lives.

Speaker 3 I actually think the world would be a much better place if more people were having much better sex. You are a doctor that specializes in sexual health and wellness.
Do you agree?

Speaker 3 Do you tell your patients that? I think it would solve so many problems, world problems. And I'm not kidding right now.
I'm that serious. Do you agree with me?

Speaker 5 Well, I think that when you talk about sex and you talk about all the great benefits that it gives to, that it happens in the brain in terms of like dopamine and good serotonin and norepinephrine and all these great things, it does make someone feel a lot better.

Speaker 5 But also, when you talk about sexual dysfunction and you see how it can compromise someone's self-esteem and their self-confidence and

Speaker 5 how they feel about their partner and their relationship, and so that can boil over to kind of a lot of negative feelings and a negative attitudes that we may see.

Speaker 5 So, sex is just not about just the act. It's about about kind of, it's about the hormone release.
It's about the communication with your partner. It's about the relationships.

Speaker 5 There's so many great attributes or great things that happen after

Speaker 6 sex. Yeah.
So I totally agree.

Speaker 3 It's a medical thing, right? It puts, and I'm not a doctor, but I always talk about that on the podcast.

Speaker 3 It has been proven over and over and over again that it puts so many wonderful chemicals on your brain that it literally makes you feel better.

Speaker 3 It's better than stuffing yourself with antidepressants and all that crap.

Speaker 5 Yeah.

Speaker 10 Well,

Speaker 5 it's definitely beneficial for the brain and self-esteem and our relationship. So I totally agree with you on that.

Speaker 3 Okay, so let's break down because people have so many questions, so many issues. This would be like a 10-hour interview.
So let's try to squeeze the most important ones.

Speaker 3 A lot of people say, and especially like as they age, which honestly, I don't know if it's true or not, because in my case, as I age, I feel more comfortable with my body, I feel more comfortable with myself.

Speaker 3 I'm always feel like I'm having the better sex as I age. So, to me, it's the opposite.

Speaker 3 But most people complain, my listeners from all over the world, they send messages like they lose interest in sex, lowly be though, right? Men, like you said, erectile dysfunction, like their penis.

Speaker 3 I feel like I have to be respectful because you're a doctor, but I feel funny saying penis because I always say like the dick, the dick. But I want to be respectful in front of you.

Speaker 3 Their penis doesn't work properly. And for men, their penis is like the trophy, right? It affects their ego.
It affects their emotion. If it doesn't work properly, it messes up their life.
And then...

Speaker 3 It causes divorces. It causes people to cheat on each other.
It messes up the whole system of their lives. So that's usually the number one complaint, like that as they age, it causes chaos.

Speaker 3 So what do you say for a woman or a man that is having that problem? What is the first step?

Speaker 5 So just like as you said, I think that

Speaker 5 as women and men grow older, especially women as they grow older, I do find that a number of women, they do feel more comfortable with their bodies. And so I think that's a plus.

Speaker 5 And that's an advantage. Whereas

Speaker 5 when I have younger patients, they're just not sure about masturbation and like how they should feel and if someone else should be giving them orgasms or should they be giving themselves orgasms, et cetera.

Speaker 10 But

Speaker 5 as we age, we do,

Speaker 5 our hormones actually decrease, right? And so as women go through menopause, their estrogens go down, their testosterone goes down. And with that, that can lead to issues with libido, right?

Speaker 5 It can have some, some of our patients have problems with pain with intercourse. It can also lead to either delayed orgasm or no orgasm at all, right?

Speaker 5 So as women age, we have to make sure that we are paying attention to their hormones.

Speaker 5 And so some of the treatments that we use is our biogenic hormonal treatment that will allow their testosterone to go up or their estrogen to go up.

Speaker 5 And we manage their progesterone as well, which can help with their libido, but it can also help with the difficulty that they may be having with sex in terms of pain or what have you guys the same thing happen right so as guys get older their testosterone goes down right

Speaker 5 their estrogens go down as well and because of that they can have some issues with libido

Speaker 5 but also with men in particular when you look at the vasculature to the penis right they can have some issues where they're not getting enough blood flow to the penis or too much blood flow is leaking out of of the penis which can lead to erectile dysfunction.

Speaker 5 So, you know, for both sexes, you know, there is a decline in hormones and there could be a decline in sexual function, but that doesn't mean you should give up.

Speaker 5 There is hope at the end of the tunnel, right?

Speaker 5 There's so many things that we can do to amplify the effects of, or we can substitute hormones and to get men and women to be able to perform the way they want to.

Speaker 3 Okay, so you said two really important things there. The first one, I love, you said, it doesn't mean you should give up because a lot of people give up.

Speaker 3 A lot of people are like, eh, whatever, okay, I'm not going to have sex anymore. I personally think that's a huge mistake.

Speaker 3 I think if you give up on having quality sex, the quality of your life decreases. Do you agree?

Speaker 5 I think that

Speaker 5 for many people, I think that the quality of their life may decrease. I think it depends.

Speaker 5 You know, I think that there are some people who are just not sexual as they get older and then they find other reasons to or other ways to kind of fill that void, right?

Speaker 5 But I think for a number of people, when they do have sexual dysfunction, it can affect their relationship and how they feel about themselves for sure.

Speaker 3 Oh, yeah, totally. And another thing is, which is a huge debate.
I don't know, because you're on the East Coast in Philadelphia. I'm in California.

Speaker 3 I know cultures can be very different, but here in California, some doctors and some hospitals, and I'm not even going to name names, but they are completely against testosterone replacement therapy for men.

Speaker 3 They say, oh, it can cause cancer, there are like complications, blah, blah, blah, blah, blah.

Speaker 3 And so, and I have guy friends that they go to the doctor, they're like in their 50s, in their 60s, and the doctor's like, here, take Viagra and go home, which is kind of like putting a band-aid on the problem, right?

Speaker 3 It doesn't really fix the problem.

Speaker 3 And on the other hand, there's like a lot of great clinics, like super expensive clinics with good doctors all over Beverly Hills, all over California, that they say, no, just take the testosterone shot, na, na, na, and you're going to have great sex.

Speaker 3 So can you give us your opinion regarding the testosterone replacement therapy? Because so many guys ask this question.

Speaker 5 So, of course, and I get this question all the time. Is testosterone the key to sexual health? You know, is it? And the answer is it depends, right?

Speaker 5 And and so it's so important that if a guy is having some problems with

Speaker 5 erections or a little libido or what have you is they go through a full workup they gotta go through a full workup because

Speaker 5 then you can really truly then you can truly figure out what's going on with that person right for some guys the testosterone is a factor for other guys it's not right And if you give testosterone to a person that doesn't need it, nothing's going to happen.

Speaker 5 He's not going to have any result, right? So in our practice, what we do is we have everyone come in. We do a great physical exam.

Speaker 5 We look at all their medications because medications can also cause some issues with libido as well as with erections, right? We do nerve testing to make sure it's not a nerve issue.

Speaker 5 We do an ultrasound to make sure that we know how much blood flow is either going to the penis or leaving the penis.

Speaker 5 right and then we kind of figure out a plan in terms of what to do So in general, testosterone is fairly safe.

Speaker 10 Right.

Speaker 5 We do know with newer studies that it doesn't cause prostate cancer. So we do know that.

Speaker 5 But we do also know that if you give too much testosterone, then you can have side effects.

Speaker 5 Your red blood cell count can go up and you can have some issues with stroke and blood clots and all these other things. So it should be used.

Speaker 5 When you use it, you have to be able to use it safely and know the kind of the side effects and what to look for.

Speaker 5 So I'm a proponent of testosterone if a patient needs it.

Speaker 5 But testosterone is not the key most of the time to erectile function. Usually, it supports erectile function, but then we actually have to treat the penis itself, right?

Speaker 5 So, we're doing usually a combination for guys that have low testosterone that also have erectile dysfunction. And that's what a proper workup will allow us to discover.

Speaker 3 Okay, so when you say treat the penis, can you be more specific? What else would you do? Because I know so many guys out there, I have a massive male audience.

Speaker 3 I know this is a very, very delicate subject.

Speaker 3 I know so many guys are embarrassed talking about it to their partners, seeking help. Like I said, it affects their ego, it affects their lives.
This is an opportunity that they can actually listen.

Speaker 3 and maybe feel encouraged to seek help. So, what else could they do?

Speaker 5 Okay. So, the first step is always

Speaker 5 lifestyle. You know, I always tell guys,

Speaker 5 exercising,

Speaker 5 eating right is the first thing to providing good health to your penis. So the better your heart is, the better your penis is going to be.
That's the easiest. That's something that anyone can do.

Speaker 5 Anyone can go outside. They can walk.

Speaker 5 They can try to run. They can get on a cycle.
They can swim. Whatever.

Speaker 5 It's free. You know, exercise is free, right?

Speaker 5 Also, eating properly is so important. Like if you're, if you're eating fast food every day, it's not going to help your penis at all, right? So we want to make sure we're eating the right foods.

Speaker 5 We want to make sure we're eating healthy, right? We want to make sure that our weight is under control, right? If you have diabetes, we want to make sure our sugars are under control.

Speaker 5 If you have high blood pressure, we want to make sure that's under control.

Speaker 5 But if you think about it, you know, all these things, diabetes, hypertension, high cholesterol, all of these things, most of them, not all of them, some of it is obviously hereditary, but if you diet or at least you eat healthy and you exercise, most of those things are gonna get better or they'll improve, right?

Speaker 5 And so by making them better or improving, then what's gonna happen is your penis is gonna get better. Or at least your penis isn't gonna have that speed decline in erectile function, right?

Speaker 5 It's gonna, it's gonna happen slowly and gradually as opposed to kind of dropping off a cliff. So that's really, really important.

Speaker 5 And then after we talk about exercise and we talk about diet and after we do a workup, maybe it's hormonal support right we want to make sure we're giving hormones to the right person at the right doses we don't want to go crazy that some of the problems with these hormone clinics is you come in it's the same dose for everyone they get everybody really really high and guys can have some problems so we want to make sure that we're kind of you know we're tinkering with their hormones so we're getting it just right for that particular person

Speaker 5 Right, because hormone levels may be different for each person. Maybe somebody does well at 500, where if we're talking about total testosterone, where another person may do well at 900.

Speaker 5 So we got to figure out what's going to be the best for that person. And then in our practice, we have a lot of advanced things that we do.

Speaker 5 We use something called core wave therapy, which is focused, low-intensity shockwave therapy. We use PRP.
We use Botox.

Speaker 3 But these things hurt a little bit, right? And a lot of men are very intimidated by that.

Speaker 3 By needles, like all these other treatments that hurt.

Speaker 5 No, you know, I'll tell you that,

Speaker 5 i mean the pain is it's very minimal oh yeah these treatments yeah there's not a lot of discomfort at all if you go to the if they're using the right machine

Speaker 3 um you know i would say like the there's not a lot of discomfort at all i mean my guys don't complain about that oh okay so your guys are tougher than our guys here on the west coast no no no no it's not it's not true it's not true we're you guys are tough on the west coast i'm in i'm in new york too so you know how men are right the minute you talk about needles and shock and everything they're like, well, wait a minute.

Speaker 3 On my penis?

Speaker 4 Are you sure?

Speaker 5 The shockwave doesn't, our shockwave machine, our focus shockwave machine and core wave therapy, it does not hurt. I'll tell you.
Some of the other shockwave, like the radial shockwaves, where

Speaker 5 it kind of feels like a jackhammer, we don't have that because we have a different machine.

Speaker 5 But guys really want to invest in their penis. You know, it's something that is important to them.
Like you mentioned, it's so important to their ego.

Speaker 5 It's important to their self-confidence. It's important to their relationships.
I have guys that

Speaker 5 will rather sleep on the couch as opposed to going upstairs with their partner because they don't want to deal with this stuff.

Speaker 5 They don't want to deal with not being able to have a consistent, firm erection. It's a big, big deal.

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Speaker 3 And I understand that for men, if they cannot perform, if they have an issue, it's a big deal. And I think it's important to talk about it.

Speaker 3 And many times it's hard for a guy to open up. They get very embarrassed, they get very ashamed.
There's a lot of shame surrounding these subjects.

Speaker 3 And this is why it's so important for me to bring guests such as yourself to dismystify these conversations, right?

Speaker 3 Because if we have like a headache or anything else, like if we want to lose weight and everything, it's not an issue.

Speaker 3 But all of a sudden, when it comes to talk about our sex lives, it's like, oh, hush, hush, like it's something dirty. Like, oh my gosh, just talk about even for women, it's even worse.

Speaker 3 Like, I have girlfriends

Speaker 3 that never even had an orgasm or think that, oh, you know, I'm not sexual. I'm never going to be sexual.
It's okay. And it's not okay.

Speaker 3 Seek help.

Speaker 5 Go to a doctor such as yourself but they think it's completely fine because they're so embarrassed talking about it yeah it's it's very embarrassing you know and and what happens is that if it's a male or a female like we lose that intimacy you know you really lose intimacy because at the end of the day i mean our penises and vaginas um they're kind of doing the work but it's really our brains it's like they're you know we always say i always say like our biggest sex organ is between our ears, you know?

Speaker 5 And like, so it's, it's like, and we kind of lose that because we focus on our penis and our vagina, but it's, it's the intimacy.

Speaker 5 Sometimes it's like the hand holding or it's like, it's kind of talking about intimate things, which we lose sometimes because we're so frustrated about our penis and our vagina.

Speaker 5 And so we can't lose focus on that,

Speaker 5 on that part.

Speaker 3 Just the intimacy part and just kind of lying there and just being with your partner and just sharing kind of your day right yeah um is also really important absolutely and we talked about men so let's talk about women a little bit because as i was saying i get shocked how many women have issues with their sexuality with uh seeking pleasure with having orgasms and they have no idea that it's an issue or even how to seek help.

Speaker 3 And you help women, right?

Speaker 3 Can you tell us a little bit about that? Like, let's say a girl out there is listening,

Speaker 3 and there are millions that never even had an orgasm or have a hard time reaching an orgasm. And many times they're embarrassed telling their partner.
They lie, right?

Speaker 3 They lie, or they have shitty sex, or whatever it is.

Speaker 3 How do they take the first step to come to a doctor with so much experience such as yourself?

Speaker 5 So, So

Speaker 5 when they come into our office,

Speaker 5 once again we do an extensive history, right? We want to make sure that they're not on medications that are preventing them from having orgasms, right? So

Speaker 5 really common are SSRIs. So when we look at Paxil or we look at some of the antidepressants, we know that could be a cause.

Speaker 5 We also know that birth control, oral birth control can also cause women to have pain with sex, low libido, issues with having orgasms. So we want to to look at their medications.

Speaker 5 When they come into the office, we do a physical exam where we're doing nerve testing because for some women,

Speaker 5 their nerves aren't intact and it's preventing them from having an orgasm, right? And then we want to be able to define orgasms. So are they not having a clitoral orgasm or a penile orgasm?

Speaker 5 So we know with vaginal intercourse, right?

Speaker 5 It's difficult for a lot of women to have orgasms, but the majority of women can have a clitoral orgasm, right? So we want to make sure we're defining orgasm and like what it means to them, right?

Speaker 5 And then we do hormones. So we do know that, as I mentioned before, like hormones are a big deal when it comes to orgasm.

Speaker 5 And so, especially with birth control pills, we do know that testosterone gets bound up, right? And if it gets bound up, it doesn't get into the system and it could prevent you from having an orgasm.

Speaker 5 So we want to make sure we get a full amount of information before we can start treatment. And then from there, it can range from

Speaker 5 hormonal therapy,

Speaker 5 some medications that we use also to help to enhance orgasms.

Speaker 5 We use something called fentensity, which is sort of like a low-intensity shockwave for the clitoris and the vaginal bodies, the clitoral bodies, to help to kind of increase blood flow to the area as well.

Speaker 5 So there's a number of things, we use PRP, there's a number of things that we use to help women kind of achieve that orgasm with their partner.

Speaker 5 But obviously, there's other things that are involved, right?

Speaker 5 For men and women, there's social things, there's stress, and all these other things that we want to make sure we kind of dive into to make sure that that's not preventing them from having an orgasm or better libido.

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Speaker 3 One question that you guys ask me a lot is: how do I record cat on the loose? Where do I do it? Is it complicated? Do I use expensive equipment? And the answer is, I do it with Spotify for podcasters.

Speaker 3 With Spotify for podcasters, you can easily upload and manage manage your podcast, track your performance, and connect with your audience like never before.

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Speaker 3 So if you're a podcaster looking to take your show to the next level, or if you are a beginner that just wants to give it a try and start your own podcast, give Spotify for podcaster a try trust me you will love it and yes best of all it's completely free all you have to do is download the app and get going no need for complicated podcasting equipment nothing at all just come up with a team and get going let's get those downloads and streams up good luck have fun Do you think it's always the case that now I'm talking about women, but also I want to ask the same question when it comes to men, but do you think it's always the case that sexual desire and sexual libido decreases with age?

Speaker 3 Because lately I hear that a lot. Like, oh, you know, I'm in my 40s, I'm in my 50s, but lately I hear from younger and younger and younger people.

Speaker 3 Like I literally get messages from girls in their 30s, like in their late 30s.

Speaker 3 I had a kid. I'm 38, I'm not as interested in sex as I was in my 20s.
I'm like, you're 38 and you're not interested in sex. And guys, like, oh, I'm 58, I'm 60, and they think they're past their prime.

Speaker 3 And to me, I don't think you should be past your prime at these ages.

Speaker 3 Is my perception wrong?

Speaker 5 And I think there's always room to increase someone's sexual desire if they want it to be improved.

Speaker 5 You know, it's, you know, the patients that I see are, and that are women, they want to have a better libido, right? You know, I don't see the patients that

Speaker 5 have low libido and they don't care about it. I see the patients that want to be proactive and they want to have a have a higher libido.
So

Speaker 5 does age affect

Speaker 5 libido? It does, you know, to a certain extent, right? Because we talked about hormones, we talked about experiences, we talked about pain with sex.

Speaker 5 So if somebody's having pain with sex, they're not going going to want to have, their libido is going to be down, right? Because they're having pain, they're having vaginal pain when they have sex.

Speaker 5 So, you know, the key is really, as I mentioned, it's just teasing through all these things and trying to figure out how we can make them feel better. And it's different for everyone.
It really is.

Speaker 5 And so

Speaker 5 that's the hard part of my job that I really enjoy is trying to figure out how we can make someone feel better, either libido-wise, orgasm-wise, what have you.

Speaker 3 And I think it probably goes the same thing you were saying for men. Like, if you have an active

Speaker 3 lifestyle, if you exercise and you eat well, probably for women it's the same.

Speaker 3 Like, if you're active, if you take care of your body, if you eat well, the likelihood that you're gonna have better sex is higher than like if you're a couch potato and if you're obese.

Speaker 3 And I don't wanna be mean,

Speaker 3 but that's probably reflects.

Speaker 5 Well, I mean, the more active you are, I mean, there's so many

Speaker 5 psychological things that kind of

Speaker 5 go into sex as well. Not to say that, I mean, this body image

Speaker 5 is a real thing. And for some women, you know, if they're not feeling sexy themselves, then they don't really want to be with someone else.
And this is not all women. And guys, the same way.

Speaker 5 Guys, as they start gaining weight and they may get a little barebelly, they may feel less attractive, right? And so they may not want to be able to be like, you know,

Speaker 5 be naked in front of in front of a partner. Yeah.
So it's

Speaker 5 so it's it's so many things that goes into sex and self-image that

Speaker 5 and it's different for everyone. It really is, you know, and so

Speaker 5 So, you know, being a couch potato or something like that, if it if it negatively impacts their self-image, then yeah, of course, it's going to affect their sexual function.

Speaker 3 Yeah.

Speaker 3 I talk a lot about, I'm a big advocate for masturbation, which it's another thing that I don't understand why it's such taboo.

Speaker 4 You can't say that word on it blows my mind.

Speaker 3 No, like it's funny, like on social media, you have to be so careful, right? Because you talk about sex, they block your account, you're dirty, no, no, no.

Speaker 3 You can talk about drugs, you can sell pot, you can sell ozampic to lose weight, all kinds of crazy shit. But if you tell people to have healthier sexual lives, you're a pervert.

Speaker 3 But that's a whole other subject, it blows my mind. But I'm an advocate for masturbation because I think it's one of the most powerful natural antidepressants.

Speaker 3 It's great for your skin, it's good for your mind, it's good for your body, it's great for single people. I don't think you should wait for a partner to give yourself pleasure.

Speaker 3 Please correct me if you think I'm crazy because I'm not a doctor. But I I hear some crazy people on Instagram.
And now I want to ask the expert opinion of the doctor.

Speaker 3 They say, like, if you use a vibrator too much, you're going to lose sensitivity for the real penis, and you shouldn't masturbate too much because, again, you're going to lose sensitivity to sex.

Speaker 3 It's going to be harder for you to orgasm with a partner. I hear all kinds of crazy stuff out there.

Speaker 3 So, I want to ask your opinion if this is all a myth

Speaker 5 so i i think that um

Speaker 5 i think that understanding your body is extremely important right i don't think that um

Speaker 5 that you should rely on someone to give you an orgasm i think that it should be some some instruction right if there's a certain position that you like if you want it harder softer I think there needs to be that communication with your partner, all right?

Speaker 5 Male or female, because men can also have some problems with orgasm as well. So I think that communication is really important, but it also starts with understanding what makes you feel good, right?

Speaker 5 So that's the most important thing.

Speaker 5 In terms of masturbation, you know, I think that masturbation in general is really healthy. I think it provides like a release for a number of individuals.
I think it provides like

Speaker 5 a number of brain hormones that make people feel good and feel good about themselves and

Speaker 5 what have you.

Speaker 5 I do think that

Speaker 5 in some individuals,

Speaker 5 so we see a lot of porn-induced erectile dysfunction, right? So these are men that they watch porn, they masturbate, they have an orgasm,

Speaker 5 and then it prevents them from having intercourse with a partner. So I think that we can go from one extreme to the other.
That's right.

Speaker 4 That's what you're right. Yeah.

Speaker 3 What's that? What's that? That's different, right? That's like extreme.

Speaker 5 Yeah, of course.

Speaker 5 It's different. But I'm just saying, it's, you know, so there are extremes to anything, but I think healthy masturbation in general is healthy.
I think it's perfectly fine.

Speaker 5 And I think that most

Speaker 5 men and women should understand their bodies, especially as women as they age.

Speaker 5 Just like you said, you're very comfortable, but it took you a while, I'm sure, to get as comfortable as you are, right? And to understand what made you or any woman

Speaker 5 feel good. So I, you know, so in terms of masturbation, I'm okay with that.

Speaker 5 If it fits into your social life and everything, you know, I do have patients that come from other countries and

Speaker 5 other religions. And so for them, masturbation is a taboo.
And then if they're masturbating...

Speaker 5 and they're masturbating too much, it can cause some negative consequences, at least psychologically for them. So maybe masturbation isn't the right right thing for them to do.

Speaker 3 Yeah, no, I hear you. Make sense.
A few more questions that my listeners send a lot. Maybe you can help us out.
One that guys

Speaker 3 ask, and I think only a doctor could answer regarding Viagra.

Speaker 3 A lot of guys take Viagra, and most of them take the generic because apparently the actual Viagra is much more expensive than the generic.

Speaker 3 So they take the generic and they say they don't feel that great. Like, I don't know, they have a headache, or I don't know, they feel dizzy, whatever.

Speaker 3 They have some side effects that I don't even know what it is because so many guys say different things. So the question is: is it normal that most people have side, most guys have side effects? And

Speaker 3 if they did buy the actual Viagra, is it different

Speaker 3 from

Speaker 3 the generic, or is the generic the same formula as the blue Rio Viagra?

Speaker 5 Yeah, so

Speaker 5 PD5, so phosphodiesterase inhibitors, it's a group of medications that we use as erectile dysfunction aid.

Speaker 5 So that so what goes in that category is sialis, Viagra, Lavitra, and there's a newer one, Stendra, that's out, right? It came out a few years ago.

Speaker 5 So these medications can cause some side effects, right?

Speaker 5 So it can cause some issues with muscle aches, it can cause some blue-tint vision, it can cause some guys that have some reflux, it can kind of just make guys feel uncomfortable.

Speaker 5 So that is a fairly common side effect for a lot of the medications, but not

Speaker 5 to the point where I would say out of all my patients, if I have 10 patients that take the medications, I would say probably like 20% of them may have a side effect.

Speaker 5 And then if, but if we change to a different medication, so say they're on Viagra and we change them over to C. Allison, they're less likely to have that side effect.

Speaker 5 So we just have to find the right medication for that particular person.

Speaker 5 And because we have about four, we're okay and we can kind of slide between the four and we can find something that's right for them.

Speaker 5 So I would tell your listeners if you're having problems with Viagra, then let's switch over to Cialis. If you're having problems with Cialis, let's switch over to Stendra.

Speaker 5 If you're still having problems, we can switch over to something like La Vitra.

Speaker 3 So tell your doctor, switch, switch, switch until you figure out which one suits you.

Speaker 5 Until you figure out which one is going to work the best, could be the most efficacious, give you the best direction, but give you the less side effects.

Speaker 3 But the question is, is the actual, the real deal the same formula as the generic or not?

Speaker 5 Yeah, so I do have a number of guys where we've switched them from like a Viagra to a generic, right? And so

Speaker 5 the generic, and when you look at like the pharmacokinetics, like what's in it, right? They only have to meet the range. It's like a standard deviation.

Speaker 5 So they only have to be somewhat within that range.

Speaker 5 And because there's so many different pharmaceutical pharmaceutical companies that are fighting to get guys Viagra, all these companies, it doesn't have to be exactly the same amount, right?

Speaker 5 It just has to be within range. And so for some guys, right, they may need the top range or they may need, so they may need the Viagra.
So for some guys, we will prescribe them.

Speaker 5 just the brand name Viagra as opposed to the generic. And so it is a real thing.
So, you know, if you go to your doctor and you say, you know, he says, no, it's the same. They're not all the same.

Speaker 5 Guys that take generics they'll see that sometimes they they get a blue pill sometimes they get an orange pill sometimes they get a white pill and that's just because of the different pharmacies that are out there that are making the generics oh i see this is why i think it's so important

Speaker 3 to have a good doctor that really cares about you and is going to follow up and see how you feel, right?

Speaker 3 Not just like write a prescription and send you home like, okay, whatever.

Speaker 5 Well, I think it's about just just listening right i think that um just like you you listen to your listeners right and it's really about listening and and believing your your patient um

Speaker 5 and um following through and it's it's also a problem with like healthcare you know as you know it's it's like

Speaker 5 you know with i i'm fortunate because i have like my own practice it's a concierge practice and so i get to speak to my patients for like an hour so if you came to see me i'm speaking to you for an hour we're going through through all this other stuff.

Speaker 5 Unfortunately, in more of a traditional setting, a lot of physicians don't have that time because they just have to see patients, you know?

Speaker 5 And so, it's unfortunate. But I would say that to your listeners, be your own advocates.
You say, listen, like, this isn't working.

Speaker 5 I heard in

Speaker 5 this podcast, right, that I can maybe switch over, right? Cat on the list,

Speaker 6 switch over.

Speaker 4 And Dr.

Speaker 3 Gittins told me.

Speaker 5 And, you know, like, I can go from a sialis as opposed to a Viagra, and it might work better. Yeah.
You know, I may have less side effects, you know.

Speaker 5 And so, this is why these things are so like these, your podcast is so important to get that information out to your listeners.

Speaker 3 And guests, such as yourself, are so important because you are an expert in the subject. And we, I'm so honored and grateful that you're here answering these questions that we have no idea.

Speaker 3 There are so many sex questions. There's 10 million more.
Let me try to squeeze in a few more. This one is silly, but so many people send this question.

Speaker 3 We want to know your opinion as an expert because maybe your patients go to you with this doubt. Maybe I know a lot of couples.

Speaker 3 have this problem some of my friends have this issue the size of the equipment the size of the penis

Speaker 3 This week alone, like five people from different countries sent me this question, like girls complaining, it's too big. It's too small.
I love him, but what a tiny penis. What do I do?

Speaker 3 Do you have this issue? Do you have couples come to you with this issue? And if yes, is there a solution to the issue?

Speaker 5 So it's a tough one, right?

Speaker 12 Because

Speaker 5 you're with the partner, you love the partner, but somehow you just don't fit, right?

Speaker 3 Yeah, if it doesn't fit, what do you do? Do you change the partner because the penis doesn't fit?

Speaker 6 Well, well, I think,

Speaker 7 I mean,

Speaker 6 we can do that. So we can, we can,

Speaker 5 so first of all, like we mentioned before, right? So we said that, like, you know, when we're talking about sex, the biggest sex organ is between our ears, right?

Speaker 5 And so being able to like provide that intimacy,

Speaker 5 turning on your partner and being there intimately for your partner is really important. And then we have other methods.
If we're just talking about sex itself, there's other methods, right?

Speaker 5 We have oral sex and all these other things. We have mutual masturbation.
We have all these other things, right? And then you bring in toys, right? So I know you're a big proponent of toys, right? So

Speaker 5 toys is something.

Speaker 3 I think they spice up the life. I spice up,

Speaker 3 yeah, why not?

Speaker 5 Exactly. So there's toys and other things that we bring along.

Speaker 5 If a man's penis is too small and he feels insecure about it, there are some things that we can do.

Speaker 5 So I do like a girth enhancement procedure where we can kind of increase the girth of the penis, which would help.

Speaker 4 Really? Can you talk a little bit about that?

Speaker 3 Does it increase forever or temporarily?

Speaker 5 So what I use, I use hyaluronic acid. It's off-label treatment.
So it's the same filler that women use for the face, right, to provide volume for the face. So we provide volume for the penis.

Speaker 5 We call it the girth plus procedure. And so what that does is we place the hyaluronic acid underneath the skin, but we don't enter where you get the erection from.

Speaker 5 It's very important that you go to someone that does them all the time because if you enter there, it's a big problem. So we place it there and we are able to get a more girthier penis

Speaker 5 for some of our guides.

Speaker 5 I don't work with length. I work mostly with girth because when you ask most women, like what's more important, is it the girth or is it the length? It's usually the girth for most women, right?

Speaker 5 Not really the length.

Speaker 5 There's other things that you can do for the vagina in terms of kind of there's some lasers that you can use to kind of decrease the vaginal kind of depth a little bit.

Speaker 5 So there's other things we can do on that respect. But that's kind of the last resort.
So I think the first things, as I mentioned, is really to kind of provide that intimacy, see what you guys can do

Speaker 5 either with toys or with oral sex and kind of go in that direction first.

Speaker 3 So, there are solutions. We laugh and we make fun of it, but people actually complain about it.
So, if you're out there listening,

Speaker 3 before you dump the person, or if you're a guy and you are self-conscious because of whatever size your penis is, there are solutions. There are doctors like Dr.

Speaker 3 Gittens that actually can help you, right? That's the answer.

Speaker 12 Yeah, yeah, that's the answer. So, seek help.

Speaker 5 but also, yeah, but also just, you know, try to improve your oral skills as well.

Speaker 4 You know, that could help you. That would not work with me,

Speaker 4 right?

Speaker 3 Funny enough,

Speaker 3 it's funny. Every woman in the world loves oral sex, right? I don't like oral sex, believe it or not.

Speaker 3 That's a secret that I never said on the podcast before, but it's the truth. I do not like oral sex.
I don't know why every woman in the world loves oral sex.

Speaker 3 I love kisses and i like the hands on my vagina i don't know why i don't like our sex

Speaker 3 i love giving oral sex so all of the partners i have whatever whoever is my partner is very lucky because it's the thing that turns me on the most in the world is giving oral sex i love giving a good blow job

Speaker 3 but but just like you said you know what i know what i like yeah but funny enough every guy thinks that the girl likes our sex right so they come give you our sex and i'm like but i don't like it and they're like no but you like it.

Speaker 3 And they try to convince you that. And I'm like, please, don't.

Speaker 5 But that's the thing, it's that communication, yeah, that you mentioned, right? It's like you like to be kissed, right?

Speaker 6 And you like the hands, exactly. So those are things that

Speaker 5 you gotta be able to talk about these things with your partner.

Speaker 3 You need to know what you like, right? You need to know what turns you on.

Speaker 3 And this is the good thing about aging because when we are in our 20s, we're embarrassed, right, to say these things, I think, at least I think I was when I was in my 20s.

Speaker 3 And then when we are older, you shouldn't be embarrassed, like to tell your partner, oh, I get super turned on by hands. I get super turned on by kisses.
This is what I like.

Speaker 3 Oh, I love giving you a blow. I can give a blowjob the entire night.

Speaker 3 Like you said, I think communication, sex starts in the brain, like you were saying.

Speaker 5 Exactly. And yeah, I totally, totally, totally agree with that.
It's just so important to talk about what you like.

Speaker 5 And I always tell my patients that it's better to talk like in the beginning of the relate.

Speaker 5 Like once you start a relationship and you start that, you know, to have those kisses and everything and starting to kind of move through like until you have sex or whenever that is.

Speaker 5 It's like the best time to talk about the things that you like is in the beginning. Yes.

Speaker 4 Right.

Speaker 5 Set the standard. Don't wait until you're in a relationship for like six or seven or eight months.
Because then they're like, oh, you like these things?

Speaker 5 You didn't tell me or you met somebody else that's doing these things.

Speaker 5 So like from the first, the first time you guys get involved, say, hey, listen, I love when you did that, but you know what I like better? I'd love for you to do this.

Speaker 4 Yeah, the foreplay, right?

Speaker 3 Even talking about it is foreplay.

Speaker 5 Absolutely. Those are the things that you got to address up front so you're all on the same page.
And so if the person's like, listen, I don't do that.

Speaker 5 And then you might say, all right, well, it's early in a relationship. You don't do that.
And I love this. And maybe you're not the right one for me.

Speaker 12 Right?

Speaker 3 Or they may say, I love doing that this is something I love doing I'm so glad you told me because I was a little nervous I was a little nervous to kind of go forward with that and and you're like oh this is like the best person ever I you know come on in so these are all these are important conversations that we should have in the beginning and and not waiting until you're married for like 10 years or and then you look for somebody else that's doing these things for you oh my god I agree really really important and that's what I was going to say it's one of the top reasons why people end up cheating on each other right because they get frustrated sexually the partner is not giving them what they want they end up going and doing it somebody else and that's a horrible problem but now when people come to you or even people listening I'm hoping we're encouraging them to seek help if you're having any one of these issues what would you say if a couple is having horrible sex or a girl that is not having an orgasm whatever any one of these issues that we're talking about how do you encourage them as a doctor?

Speaker 3 Because it's all fine, like, like you said, you get the treatment, you take the Viagra home, or whatever, you get your penis enlarged, you do all these beautiful technical things in the office.

Speaker 3 But it's another thing to go home and then you're there with your partner. And a lot of people are very shy, right? When it comes to go and do it.

Speaker 3 Do you have any tips, any words of encouragement that you tell your patients, okay, now you go and you apply and you go have amazing sex i see something behind you there in your office have great sex and what's the end of the phrase that's it have great sex have great sex

Speaker 5 that's that's our motto here that's our motto so but how do you convince your patients to go and have great sex so it's it's one of those things that you just like you mentioned it's like the the more you avoid sex the more it becomes uncomfortable with your partner, right?

Speaker 5 So when you stop having intercourse or stop being intimate and it's been a month or a year, when you go back to doing that, then it's uncomfortable, it's weird, it's awkward because of the fact that you're just kind of out of rhythm, right?

Speaker 5 And so what I tell patients is, at least in the beginning, I say, listen, let's set a date.

Speaker 5 Let's set a date and let's say, we're going to have sex on this date, right? Because then the awkward is kind of, it's kind of to the side. We're going to have sex on this date.

Speaker 5 My doctor said, we're going to write it, write it down. down we're gonna have sex and by doing that right you're kind of saying you're getting the other person prepared you're also being prepared

Speaker 5 and then you can kind of go through those motions a little bit better so I think that when I think that's one of the best things to do when there's like this lapse of of having sex in the relationship I love it.

Speaker 5 It's communication. It's communication.
Just like you were saying, like a lot of some relationships fail because of sex. Well, they're not failing because of sex.

Speaker 5 sex they're failing because of communication they're failing because one person isn't telling the other person their needs right or the other person is is um having pain with with intercourse and the other and they're not telling that to the other person and so there's that lack of communication so like it's all about talking to your partner about what's going on with your body what's not going on with your body what do you want them to do to your body all these things are so important i love that idea like make a plan like go on a date or put it on the calendar or make it that's right to me one idea that i give my listeners or my girlfriends or whoever ask me like we were saying on the podcast talk about it like go out to dinner not just when you're in bed like when you're in a public place or having dinner or a drink and start talking about it like what you want to do to each other you know make a plan and everything maybe that puts you in the mood you know.

Speaker 5 I totally agree. I think the wrong time is to talk about it like when you're about to have sex, right?

Speaker 5 It's not, you know, you want to talk about it before, you want to talk about, like you said, over dinner, over some wine, or something like that, and kind of start the mood from there.

Speaker 5 Don't start the mood when you're like on the couch and you're about to do something or in the bed or in the car or wherever you're doing it, you know.

Speaker 3 Yeah, absolutely.

Speaker 4 So important.

Speaker 3 Now, before I let you go, is there such a thing as too much sex?

Speaker 3 like when does a person become like you say you must have seen people that uh come to you that okay maybe you becoming a sex addict slow down

Speaker 5 yeah so we i mean we don't see that that much in the office because most of the patients i see are kind of um are having some issues with sex but in general you know it can i guess it can be unhealthy uh when people are kind of substituting sex for other things like if it's for attention if it's because of a mental illness, if it's because of, you know,

Speaker 5 some of my patients have bipolar and they're in their, and they're in their manic phase, they'll have more sex. And so it really depends.
So I guess there is,

Speaker 5 the answer is yes, there could be too much sex, but if it's unhealthy, then we have to do something or address it.

Speaker 5 But if it's not unhealthy, if you just really enjoy having sex and being with your partner, or if you're a person that likes being with multiple partners and you're safe and whatever you want to do, then I think that's perfectly fine.

Speaker 3 Yeah. So if somebody out there is too embarrassed, like we were saying, unfortunately, I agree in the United States, it's such a taboo.

Speaker 3 It's a culture that thinks sex is a dirty word and it breaks my heart because I really think sex is something that would make the world a much better place if more people were having great sex.

Speaker 3 What do you say to encourage them to seek help and start having better, more fulfilling sexual lives?

Speaker 5 Well, I think that the first thing is to

Speaker 5 really be an advocate for yourself, you know, and there's people out there like me.

Speaker 5 There's, you know, sexual medicine specialists that really will sit down and listen to you and help you. You know, this is not something that you have to go through alone.

Speaker 5 right it's something that you can find help uh it's something that um that for almost anything, you know, there's something that we can do about it.

Speaker 5 And if you don't find your answer, then find someone else, you know, that's going to be able to help you. That's what I would say, that there's definitely help out there.

Speaker 3 Thank you so much, Dr. Gittins.
You're amazing. Rockwell Centers for Sexual Medicine and Wellness.
You're one of the top experts in the country.

Speaker 3 How can people find you?

Speaker 5 So we have locations here in Philadelphia. I have a location in New York and Manhattan.
And then also a location up in the Poconos in Pennsylvania. And we're expanding.

Speaker 5 But you can find me at Dr. Gittins.
That's our Instagram that I have to post a lot more to.

Speaker 5 I think I have a couple posts that dick doc, but our website is rockwellcenters.com with an S.

Speaker 3 Yeah, you should expand here to California. We definitely could use your help out here.

Speaker 4 Anytime. Anytime.

Speaker 5 It's really been a pleasure being on the show. I'm a big fan.

Speaker 3 Thank you very much. I'm a huge fan of your work, and I hope you come back because, like I said, I try to squeeze in as much as I possibly could.

Speaker 3 And I know we're going to get hundreds more questions for you because this is a very important subject. And if we can clarify anything.

Speaker 3 I feel like I'm doing a tiny bit part of my job and it was a huge honor to have you. Thank you so, so much, Dr.
Gittens.

Speaker 4 I really appreciate it.

Speaker 5 Anytime.

Speaker 12 Anytime. And I'd love to come back.

Speaker 3 Thanks, thanks, guys. Stay safe.
Have lots of great, great, great sex. Get help, and I'll see you guys very soon.
Thank you, Dr. Gittens.

Speaker 3 And before I let you guys go, here's a great idea for Valentine's Day: gifts for a special someone that you love,

Speaker 3 very affordable gifts because I think most of us do not have an unlimited budget right now. And this is why I love Girl Yala Mode so much.
Fashion and style for everyone.

Speaker 3 Building a community for body positivity, self-love, and inclusion. Hashtag everybody is beautiful.
Super adorable, cozy, comfortable pieces for everyday life, such as sweatshirts, beanies, tank tops.

Speaker 3 My favorite, which is the reusable organic shopping tote. And now you guys gotta go check it out.

Speaker 3 The love collection with inspiring love messages such as spread love, love me more, perfect with everything crazy going on in the world right now, right? Love messages. I love them.

Speaker 3 Girlyalamode.shopping, girlyalamode dot com and give someone your love some love and help small businesses how great is that