Ep 3: Sexual performance vs sexual dysfunction and what to do about it

In this episode, Louie and Jess interview resident Dr C on the difference between sexual dysfunction and sexual performance,

1 Apr 2022 PODCAST

In this episode, Louie and Jess interview resident Dr C on the difference between sexual dysfunction and sexual performance,

An uncomfortable conversation for many men yet it is considered very normal and experienced by 1 in 3 men in Australia. Louie and Jess interview resident Dr C on the difference between sexual dysfunction and sexual performance, what happens if you leave the problem for too long, when you should start to take action and possible solutions to solve it. 

Episode Resources:

The information shared on this podcast is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only - please discuss any information in this podcast with your health care professional before making any changes to your current lifestyle.


Jessica: Welcome to Flip the Script podcast, where we flip the narrative on issues that affect men's health.

Louie: Our aim is to talk about the weird, the wonderful, and perhaps the unspoken issues that affect men, so you can feel empowered and back to living your best life.

Jessica: Let's get into it.

Jessica: All right, hey guys, hey Louie.

Louie: Hey Jess, how are you today?

Jessica: I am very good. How are you enjoying being out of lockdown?

Louie: Oh, it was great. I actually had a wedding on the weekend, no restrictions, there was dancing.

Jessica: Oh, love it.

Louie: It was really fun. It was an old uni friend, so it was really good to actually catch up with him and a lot of friends, haven't seen them in years, actually, so it was really, really nice.

Jessica: It's so nice to be around people, but I actually have, it's so crazy to think, I have a bit of a fear around too many people now, because going to the shopping center, or just being in traffic I'm just like, ah, as much as I love being around people, friends and family, you've got the flip side as well.

Louie: I do definitely don't miss the traffic, during COVID it was actually quite nice to drive around. But yeah, no, I understand what you're saying, it's not like this is behind us yet.

Jessica: No.

Louie: There's so many unknowns with COVID, and yeah, it would cause people to feel a bit anxious to leave the house.

Jessica: Yeah, maybe a bit uncomfortable at times, but I guess it's kind of a segue today, we are talking about things that may be a bit uncomfortable to talk about, maybe something that is it a bit anxiety provoking, and we're talking about sexual dysfunction, and to some people maybe sexual performance, and we're so grateful today to have our amazing resident doctor, Dr. C. Hey, how are you?

Dr C: Yeah, not too bad, trying to live with life after lockdown.

Jessica: Yeah, life after lockdown. So you have a long span of experience working with men, you're obviously a certified qualified doctor. Tell me a bit about your experience with working with men in all facets.

Dr C: Yeah, so go have, look, they have no shortage of problems that happen to them with their health, with their day to day living, but one of the big things that makes things harder for guys is how a lot of us have been brought up, and that usually relates to what kinds of things we're comfortable talking with, talking about, who we're going to talk to them with, and even what topics we think are even worth bringing up.

Dr C: People will talk about the old male stoicism as the very strong patriarch who's at home and barely raises an eyebrow at anything that happens unless it's something that he needs to fix. The issue that comes with this is that if that person has any kind of issue, and they're not used to asking for help or talking to anyone about it, it's really, really hard to get to talking about any kinds of issues, and when it comes to issues around life in the bedroom, that's even more so. We as guys get little to no guidance of issues being a common thing, definitely not the kinds of things that you hear these days, and that's about one in three guys having issues, and one in five having recurrent issues.

Louie: What kind of issues exactly are you talking about?

Dr C: So the common things that we'll talk about are issues with your erections, whether that's how firm they're getting, or how long they're lasting. How long it takes you to ejaculate, whether you feel like that's happening too quickly. But then you also have people who just feel like they're not enjoying sex, and that their partner isn't enjoying sex, and they'll lump all of these things together. And people's perception of how much you've enjoyed sex definitely plays a big part into the other two categories.

Jessica: Yeah, especially if no one's talking about it of course it's not going to feel normal.

Dr C: No.

Jessica: And then you're so scared to even bring it up, whereas I guess that's what we're here to do today, to demystify some of the things that are actually happening to your body when you're experiencing these types of things, and also maybe some solutions.

Dr C: Yeah, so as far as why these things happen to us, we understand that a lot of it is mediated by your stress levels, the more stressed you are the more your body tries to focus blood at the core organs, things like your heart, your lungs, your brain, and unfortunately it doesn't consider your penis as one of them. So the more stressed you are, the harder it is to get good blood flow going there, and that makes it that much harder to get good going erections.

Louie: So just a simple stress, or thinking about something else, or having a tough day, it's going to cause it. So how common is it?

Dr C: It's very common.

Louie: So if you were to say, how many men would actually experience that at least once in their life?

Dr C: About one in three, about one in three. These numbers are still something that we think, if anything, are an underestimate, they're based on people who actually have come forward and presented with these symptoms, and given what we know about men in general not being comfortable bringing these issues up at all, it's probably likely to be much higher than just the one in three that we see.

Louie: Mm-hmm (affirmative). So why do you think they'll be reluctant to maybe speak to someone about the issue?

Dr C: It comes down to several things here. First is how normal people think it is or isn't. The reason people are generally very okay with going to see their doctor for a broken arm, or having a really bad migraine, is that that is something everyone assumes everyone can get, it's not abnormal to have these issues. However, as far as issues in the bedroom go, from school age you're not taught that you can have problems in the bedroom. Women get a whole heap of information on things like endometriosis, period issues, pregnancy issues, guys get next to none of that. If that's your starting point of not having information, then when you go forward in life and start to see things in TVs, movies, porn, and you see these amazing displays of performance, it very quickly warps what you think is normal.

Louie: Yeah, well that's true because if you're in school, and you're in health class, I'm assuming, I'm sure you talk about all the diseases that are out there, what can fix them, what type of antibiotics we have, basically we do go through how the body works and what can go wrong, but there just seems to be a bit of a gap there.

Dr C: There's a definite gap, especially when it comes to sexual education. It's a really worrying thing, especially for people like myself, where a lot of guys will be lucky to have even covered basic STDs at school, let alone any kinds of issues that they might be having personally. It's a worrying trend, but I do know that things are starting to improve now, but if they're only start to improve now, that's still going to be a generation or two before we see people actually feeling a bit more comfortable about these issues.

Jessica: I guess we just need more people to talk about it.

Dr C: Definitely.

Jessica: And it's the same thing with endometriosis actually, it was only since a couple of key influences and big brands, and things like that, started to really take it by the horns, because it does affect a lot of women.

Dr C: Yeah.

Jessica: And a lot of people are suffering in silence, and that's what we've found, obviously you've found a lot in your clinic, a lot of men coming to you haven't spoken to a single soul, no one would ever know about it, and we're here to tell you guys, it's not a big deal, a lot of people are dealing with it. But I wanted to just circle back into sexual dysfunction and sexual performance, there is quite a difference, isn't there?

Dr C: Yeah, so how you perform in any given one situation is specific to that one time.

Jessica: Yeah.

Dr C: Where dysfunction suggests this is a recurrent issue that's happening again and again and again. Again, it's a lot like if you were going to the gym and you tried to lift a weight once, if you struggle one time, that doesn't necessarily mean you will always be struggling, but if even after trying to do some work on that you still keep struggling to lift that weight, that's a sign that there's something more going on.

Jessica: So I guess if it's to do with sexual performance, maybe circumstantial things have happened, you just had a completely off day, or like you said, alcohol, you've had a big night out, et cetera. But sexual dysfunction is a reoccurring thing, that's probably where you need to start thinking about maybe asking for help, right?

Dr C: Yeah, definitely. Look, asking for help is one of the biggest cheat tools we have in life, really. It doesn't matter whether you're talking about sexual issues, or issues at work, or issues with your kids or how to fix things around the home, we all jump very quickly onto YouTube to Google how to fix this, that, or the other, that's nothing but asking for help, and there's lots of different people who are around to try and provide that help. You don't have to do this alone, basically.

Jessica: So once someone's made that initial step to go, all right, I'm feeling like this is a recurring thing, it's not something that I want to happen again, what is the thing that is going to happen if you do leave it too long?

Dr C: Like with a lot of problems it does definitely have the context of a stitch in time saves nine, kind of thing here. The longer you delay before you start to do something about the issue, the longer it's going to take for it to be resolved. You might be in the category of a lucky few who do, they've had an issue for a couple of years, they've done something now and it gets fixed immediately, but that's generally not what we see. Generally however long you've had issues for, it usually takes a similar period to be able to get out of having issues, provided you're doing the right things, taking care of yourself, getting some decent help talking to your partner. It does take time, and the longer you leave things, especially if there's some other medical cause behind the issue, the hard is to treat.

Louie: And how many times, I guess, would you say, if someone's had a couple about performances, what's the timeframe to think, okay, maybe there is something else happening, maybe there is another health issue I have. What timeframe should they be going and seeking that help?

Dr C: My general advice to anyone is if it happens once or twice, that's not too big of a deal. If it's starting happen 3, 4, 5 times, you should at least think about the issue. If it's kept happening to you for more than two to three weeks, that's definitely a sign that something is going on. Again, you may be lucky, it may be nothing. It may still just be something small that's happening just now to you. But when it starts to become that frequent, that's what really suggests no, no, no, there is something that's causing this rather than just a bad day.

Louie: And then when that happens, so what if they do leave it for years, and it's an issue for years, in their body specifically, because we want to be very visual here, we want them to understand what's going on, really. So in their body, why aren't they able to either, well I guess we'll start with this, why aren't they able to gain and maintain a strong erection?

Dr C: So I like to describe this in terms of plumbing, you need a certain amount of blood flow going into the penis to get the blood flow going, and your body needs to be able to increase that to maintain the erection. If you've got some issues going on with the plumbing to supply all that blood flow, you're going to struggle. If it's a small thing initially, that might be able to be rinsed out and you're good. But if it's given a long time, rust starts to build up, starts to make things a bit tighter in there, the flow is really interrupted, because it's having to push through a smaller space, and it's just not able to function well. If you leave that to an extreme, that's permanent damage that's not really easily fixed.

Louie: Okay, so at the moment, when everything's okay, you get a good blood flow, you've got very flexible arteries, they flow through quite easily and you're able to get a strong erection. Then you start to notice that you probably aren't able to maintain it for as long, or you're not getting that sufficient blood flow so it's not as strong as you want, so that's how you can start to notice.

Dr C: Exactly.

Louie: That there is something occurring here, it's not just a bad performance where I had an erection, oh I lost it halfway through, I was thinking about something else.

Dr C: Yeah.

Louie: It's more when you start to notice that there is a decline as well.

Dr C: Yes. A lot of people do find that they just feel their erections are softer than they used to be, they're not as firm as they used to be, the common line that we hear is that it doesn't feel like when I was young. And whilst some of that is age related, most of the time not all of it is. Most of the time it's a situation of there's something happening to that blood flow, that's being interrupted, that we can do something about.

Jessica: So that's really promising, because I think a lot of people just think, oh, it's old age, who cares? There's nothing I can do about it. But what you're saying is yes, okay, to some extent it is age, but there are a lot of other factors that contribute to it that you can delve into and solve. So what are those other factors?

Dr C: Healthy lifestyle is number one here.

Jessica: Yeah.

Dr C: Eating good food.

Jessica: Not Macca's.

Dr C: Not Macca's 24/7. As much as those nuggets are awesome, you do have to limit how many of them you have.

Louie: Don't blame me, they brought up the November deals.

Dr C: That's fine. But you're right, it's things like that, they bring them out and we're all tempted to do things, and if you're having them, again, once or twice here or there, that's fine. But when that becomes your regular routine diet, then you're not necessarily getting all the nutrition you need. And similarly, if you've not been able to get up and out, like a lot of us have in the last few weeks to months, good exercise is also going to a big impact. You want to start with that basic core of healthy lifestyle, good diet, good exercise, and then good communication with your partner really does play to that as well.

Jessica: So I guess you're eating for performance, you're exercising for performance, which is really, really important. And I think we will add a few links to some healthy eating starting points, as well as exercising. We all know it, lifestyle is such a big contributing factor, but if you make small changes every day, it's really going to help you, and it's really going to help with your treatment. So what if someone is making all those healthy additions to their life, they've gone, okay, summer is coming, I'm ready to turn a new leaf, and they're still experiencing that problem. What do you think that they should do? Where's a starting point, do they see a specific doctor? Who should they look to seek treatment from?

Dr C: Talking about issues with your partner is, generally speaking, one of the best places to start.

Jessica: Yeah.

Dr C: If, for nothing else, just to start a bit of a dialogue about sex. This lets you guys both figure out is what is happening because something someone is doing, because of different attitudes to it, and also can help to really build a lot of confidence in the relationship where you're not telling them that the reason I wasn't able to get it up last night is because I don't think you're attractive, you can dispel a lot of that. However, talking to your partner, whilst can help with a lot of surface level stress issues, it's not necessarily going to get you to the root of more medical things.

Dr C: If you're worried that things have been going on for a while, more than a couple of weeks, couple of months even, and you're a little bit concerned about how your health may be, your GP is usually a really good starting point. Not all GP is know absolutely everything here, but plenty of them will at least be able to try to guide you in the right direction of things you can do, again, healthy lifestyle bits and pieces, and sometimes even with medication that can be used there. There are lots of different programs and clinics out there that do hire doctors like myself who have been working in the industry for a little bit longer, and we tend to have a little bit better specific knowledge, but your GP is always a really good starting point.

Louie: So all these treatments that you're mentioning, these are all prescription medication?

Dr C: There are lots of different medications out there that you can use to treat both major issues here, both erection problems and premature ejaculation problems. Plenty of them are available online, but I would caution anyone against jumping to straight order from whatever random site from whatever Southeast Asian country is out there, partly because, as you were saying, that these are generally prescription based medication, they have specific dosages attached to them, they have specific usages and specific side effects and problems that can come from them. I would generally always advise someone to have spoken to a doctor at some point.

Louie: An Australian doctor.

Dr C: Ideally an Australia doctor, who can make sure that whatever you're getting is A, going to work, and B, be safe. Whilst things like Viagra are really commonly spoken about, most people have heard of Viagra, they've seen what it does in various TV shows, movies, et cetera, it does have its own host of problems. You can have people passing out from it very quickly because of the way the medication works, and sometimes these issues are not clearly made obvious on a lot of the cheap websites that you might find online. And so I would encourage you, if you're going to look to get some medication, to get it via a prescription via a doctor.

Jessica: Yeah, and also it's just about having the right person be able to look at your unique situation. I think, especially with this type of thing, we, as you said before, there's a lot of factors that lead someone to having these types of sexual dysfunction issues, and it's really important to have someone to be there with a lot of experience to help you through it. So I guess today we're, just in summary, we really wanted to bring to the surface that this is not a unique situation.

Dr C: No.

Jessica: A lot of men are experiencing this, and for the women out there, obviously your partners as well.

Dr C: Exactly.

Jessica: And it's not something to feel ashamed about, and it's not something to feel embarrassed about, it's just something that we can all start talking more about it so we can start moving forward and not live in silence. So thank you so much for joining me today, Dr. C, it's always a pleasure, and thanks Louie.

Louie: Pleasure, thanks for having us.

Dr C: Happy to be here.

Jessica: So if you've enjoyed listening today, please rate and leave a review. If you think anybody would find any value from this podcast today, please share it with them. And of course, send us any of your questions, if there's anything you'd like us to speak about on the podcast, please email us at info@optimalehealth.com.au

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