Pelvic Pain, Semen Retention, Erectile Dysfunction & Kegel Problems with Dr. Susie Gronski

A podcast for men, all about sex, where we'll combine real, authentic down to earth conversations about sex with some pretty wild, personal stories and practical how-to episodes as well. To help you have the most amazing sex life you can possibly have. My name is Taylor, and I'll be your host on this journey. And in each episode, it's my goal to give you practical, actionable things that you can start doing today to improve your sex life and to improve your entire life.

So let's begin today's episode by taking a deep breath in together through the nose, An exhale with an audible sigh . Thank you friend for being here and let's begin today's episode , Dr . Susie Gronski welcome to the show. It's awesome to be here with you. Thank you for being here. Thank you so much, Taylor. I'm really happy to be here. Yeah, I've got a whole list of questions that I think are great. Uh , thank you everyone.

Who's given these questions to ask and we're gonna go into everything from like key goals . Can you do too many key goals , your prostate health, pelvic floor health, pelvic floor tightness, semen retention, possibly, and all kinds of stuff. But before we get into that, I have a icebreaker question for you if you're open to answering it.

And of course that is if you could go back in time and tell your younger self something about sex that you wish you had known, what would you have told yourself? If I could go back in time and tell my younger self about something around sex that I wish I had known, it would be that it's okay to have a pleasure date with yourself without shame. That's the most important thing, cuz I was not encouraged to explore my body or my likes or my kinks or my dislikes.

I had no idea because there was so much stigma around it. I was raised Cristo- like Catholic. So there was a lot of Christocentric messaging. Yeah . Particularly negative sexual messaging of that masturbation is bad and you shouldn't do it, especially if you're you have a V yeah . And a vagina. So I, I wish I would've had known that, that it's okay to have a pleasure date with yourself, to explore your body, to touch yourself, to embrace yourself, to love yourself with compassion and grace.

And then that makes you a better lover because , you know, you , you , you know how you like how you like to be touched, you know, what places are safe and you can clearly communicate that. And I think that's, what's really lacking for, for a lot of people. Is sexual dialogue and feeling comfortable with talking about sex instead of just doing it right. Because sex is penis and vagina. That's it. That's it . That's the only thing. Sex is nothing else. That's it ? Yep . Fit in the box.

Yeah. That's awesome. And I think that goes for all bodies, penis haves too , myself, like pleasure dates with myself have been incredibly transformational in my life. And they're key actually to rewiring certain things around sex too. Absolutely. Yeah . Thanks for speaking to that. Of course.

So you are a pelvic floor physical therapist that works specializes in working with men. Yes . Um , how did that happen? how did you get to be here? Yeah, that's a really good question that I get asked all the time and I do love this question. I started my career. So I've been a therapist, a physical therapist for over a decade. I can't believe I'm dating myself right now, but , uh , it was several years ago where I actually dove into pelvic health.

And it was because I actually rung out the challenges of varying different types of , uh, specialties within physical therapy. So I started my career as , uh , neuro in the neuro realm. So acute inpatient rehab working for a hospital. Then I went to geriatric care in vestibular care and you know, I had my fill there. Then I went to orthopedics , you know, so I kind of bounced around a lot. Yeah. But it , because that , and that's not, that's not negative.

Like for a long time, I thought like, what's wrong with me? Mm-hmm I can't stay at a job for more than a year, you know, like what's going on. And it really had nothing to do with like that there's something inherently wrong with me , but it was just, I just was not passionate, you know, about what I was doing. And I was really trying to connect with people on a , on a different level. Yeah. And pelvic health was that opening for me.

And so it was through my friend who , uh , we went to PT school together, called me up and said, Hey, you know, out of the blue, this is so random. And I don't believe in random. I do think, I do believe that things happen for a reason mm-hmm and she had called me and said, there's this person , uh , by you, who does women's at the time women's health , everything was kind of women centric and you might wanna shadow her. She's looking for someone to bring on for her private mentorship.

It's a private practice. And I was like, pelvic health women's health. I said, I don't know if I could put my finger up somebody's vagina or, or anus. Yeah . I don't know if that's for , you know, like I literally had those reservations. I'm like, yeah , really . And something just inside me was like, just go check it out, you know, check it out. And I did and I fell in love with it. And here I am.

So how I started to specialize, strictly working with men was the bravery and the courage of men reaching out for help. Mm-hmm I mean, that was, you know, I did not have , uh , male centric language on my website. Like I do now. Uh , it was really kind of gender neutral more so I think women centric, but they were, when were reaching out to me asking, I have these similar concerns, do you think you can help me? Yeah. And then I was like, yeah, why not?

You know, as Emily Naski would say, you know, one of my favorite sex educators, she would say, we all have the same part is organized differently. Mm-hmm so, so why not? And so I started to welcome men into my practice and then I started to listen to their stories, listen and hold space and re and I recognized very quickly that there is definitely a gap here as far as access to care, a safe space for men to reach out, to, and, and to get accurate medical information and advice on what to do.

If you have sexual pain. Yeah . Dysfunction, all of the above urinary complaints, you know, they didn't know who to turn to. And then it wouldn't be until several years later where they would actually connect with someone like me. So yeah , that to me is

unacceptable. That is not, that is not care as far as like a model of care. Yeah. You know, men should have spaces , uh , that reflect who they are, speak their language, feel that they can talk to you and, and that you won't be judging them or that you won't feel embarrassed. Cause you're talking about sex. I mean, how could you do pelvic health work and not talk about sex? Yeah . You know, so , or be a urologist or a gynecologist or, you know, any provider for that matter.

Do you know what I mean? I , I don't know how , I don't think it would be possible. It's like, but we're not, you know, no one it's not in the, in the educational curriculum. Yeah . You know, health providers across the board are not being taught about , uh , medically accurate sex education and that's a problem. Yeah. It is a huge problem. It is a huge problem.

And it makes me think when I was looking at your website , um , before this interview, I saw you have a ven diagram on your website that has four different things on it. There's mental, there's spiritual, physical, and then you have sexual as the fourth ven diagram and they're all interconnected. And I thought, holy, I don't know that I've ever seen this on a medically based provider's website that they're actually seeing sexuality as an important part of a holistic lifestyle.

And so yeah, I wanted to ask you about that. Absolutely. So it's, this is gonna be a two part answer. The first answer is when you look at Maslow's hierarchy of needs, I'm not sure if you're familiar with that. Mm-hmm, the very bottom foundation that the whole pyramid is built on. Is food, water, shelter, sex. Yeah. It's a basic physiological function and need so important. So that's one, the second is the world health organization actually recognizes sex as part of health, really.

And so that is where my inspiration came from. So in fact, I actually wanted to read directly from their website, their current working definition of sexual health. And here it is, cuz it's a beautiful one. Sexual health is a state of physical, emotional, mental, and social wellbeing. In relation to sexuality, it is not merely the absence of disease, dysfunction or infirmity, which is physical or mental weakness.

Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence for sexual health to be attained and maintained the sexual rights of all persons must be respected, protected, and fulfilled. Hmm . That's good. I get goosebumps when I read that. Yeah .

Every time that's beautiful and I, I've never heard that before and it makes me think, wow, if that's the world health organization, if it that's their definition of sex, like what's happening. Where do we go wrong? Is that yeah . Where Do we go ? Where do we go wrong? What's the deal with most of the other medical providers, at least in my personal experience, you know, like that's a big philosophical question, but my curiosity goes there, You know ? Right , right . Because yeah.

Yeah. And it really, it , you know, for me, it's like, it's, it's the evolution of a culture of a society where , um, these are constructs, you know, construct negative sexual scripts and messaging, which are all constructs made of constructs yeah. That then we as a society and culture indoctrinate and think that that's quote unquote normal and that things should be shamed or embarrassed in some way. And that's when we get into trouble. so Yeah, man. All right . thanks for that intro.

That's awesome. And that's yeah. I , I think maybe we'll include that quote on the show notes page , cuz it's good. Maybe a link to the world health organization. Maybe not so next question for you , um, in your

practice, what are some of the most common reasons men come to you? Like what are some of the most common things you see? Yeah. So the most common things that I see in my practice are pelvic pain also can be sexual pain. So when I, when I say pelvic pain, the, the , the definition, according to some literature that you might read in research is having pain in the abdomen. The , the genitor region that lasts greater than three to six months, that is not of known pathology.

So there's no infection or other red flags that all that has been ruled out, but it's persisting. Um, it can lead to urinary dysfunction or complaints like urinary frequency, urgency, bladder pain. Um, you also might have , um, bowel dysfunction. So difficulty going to the bathroom, painful bowel movements, constipation, diarrhea, et cetera , abdominal pain , uh , groin , pain, testicular pain, penis pain , uh , anywhere in between the butt bones basically. Yeah .

If , if anything hurts because it shouldn't hurt. Yeah . That area is usually a, an area of pleasure and joy and connection and identity in , in a positive way. I would hope. But when pain starts to creep in , it's certainly alarming for a lot of us. Because again, it's, if you hit your thumb or you hurt your elbow or your foot, in some way, you can go around showing people, asking people for their opinion. But what happens when your , your , your penis hurts?

You're not , you know, maybe , maybe you might feel comfortable, maybe you might don't get me wrong. Maybe you might feel really comfortable to ask your friends or, you know, go and be like, Hey, look, take a look at this. What's going on. Yeah. But it's so important for reassurance. Like again, if something hurts, you wanna be able to touch it, to see it, to rub it, to share, to ask questions. Totally . And that's just not happening.

So what that does is increases the anxiety increases, the worry, increases the stakes of what's going on and that in itself can amplify the pain response. So, you know, when, when you ask me what people coming in to see me with sure. They have the physical pain, but there's also the emotional pain that they're experiencing and the anxiety and the worry and the distress and the suffering. Yeah . That comes as a result of this change in their life, in a body part that used to function and operate.

And they used to connect with in a way that was, you know, wholesome and , uh , embracing. And now it's like, there's a comp there's a disconnect. Yeah. And in hearing you say pelvic pain is a , is a three to six month thing with an unclear cause mm-hmm , my mind is thinking that's really a long time to have pain in that region without, you know, doing anything about it. And when I heard you speak earlier, I heard you say like some guys go for a really long time.

Mm-hmm and yeah, that makes sense. Cuz we've, as guys have received the programming, like, oh, you've gotta be self-sufficient you have to do everything yourself. You have to be fine. You know, be fine. Mm-hmm especially in this region where there's so much baggage and shame, mm-hmm , reaching out for help. Whew . And it seems really important to do so. It does.

And I believe now I don't have any research to back this up, but I believe that if we, as a community medical community were to offer, you know what happens usually with men who have pelvic pain or chronic pelvic pain syndrome, it's another name or chronic Prostitis they'd label .

There's so many labels, but no one can conclude on one definition because there's many different factors that might contribute mm-hmm anyway, they go in with these symptoms, usually see their primary care provider or UR , a urologist and urologist will say, okay, let's do a urine analysis. They might test the prostate fluid. They they'll do a digital rectal exam to, you know, palpate the prostate or touch the prostate. They rule out the red flags.

Nothing is showing up mm-hmm so at that point where You're fine, something You're fine. Yeah . It's all in your head. That's the message. Yep . Go home, go Home. Like you'll just deal with it. You're gonna be fine. It'll go away. And there's no actual, like let's sit down and talk about contemporary, contemporary pain, neuroscience and perspectives as like why you're hurting. Sure. Maybe, maybe it did start with an injury.

I mean, are , are doctors asking you about like , so masturbation styles, let's talk about that. Like when did this pain talk ? You know, like not that masturbation don't get me wrong. I don't want your, the audience to think that like masturbation is bad or that it causes pelvic pain. No, it doesn't. We can get into that, but it's like asking about, well, what are some of the triggers? What has changed in your life?

You know, is there an , perhaps there's some tissues that are injured or irritated or you tried something new, but we're not, you are not asking those questions and it could be such an easy, you know, a thing to address of like, how about you try some lube decrease the friction or lighten up your grip or, you know, like just like things like that. Yeah . So like , you know , again, we're not asking the questions, we're not getting the whole picture.

And in fact, we're not treating the whole person. We , we need to re you're just looking at it from a very myopic lens where you actually need to take your lens and increase the increase the panoramic view to see the entire person and treat the entire person. So that's a person centric approach. Yeah . Not a disease approach, which , which this isn't a disease. You know, this can be easily workable. It's just that we're not approaching. We're not treating pain.

I, in , in a , in a , in an efficient way, we're not treating, we're not helping these guys in an efficient way. Um, and then that's where that perpetuates to chronicity because they're off again, like I said, they're often dismissed, not validated and are often for themselves to look in the weeds for help. Yeah. It reminds me about four or five years ago. I actually went to a urologist in Asheville because I had something going on and I was concerned about it.

Turns out, at least turns out according to this person, it was fine. I just think it's fine now, too. But the visit was ultimately just really unpleasant and disconnected and nothing. There was no helpful conversation at all. They just said, oh, are you too experiencing this? No check, check, check. No, no, no. Okay. You're fine. And that was basically it exactly what you're saying.

And while the person was walking out the door at the end of our visit, they said, oh, by the way, you should probably get a circumcision because most women will like you more. And then the door shut . And I was like, you kidding me? Can't make that up. You just Can't happen . No, it's real. And it's happened in Asheville like four years . So sorry you Had that experience. That's thanks . That's inappropriate. Yeah. But this is like, this is the thing .

This is what a lot of people experience in this world, you know? And it was shocking to me at the time. And luckily I've done enough research around this, that it wasn't, it didn't stab me or it didn't, you know , take away from me for a long time, but it definitely, the impact was more the realization of, wow, this is the paradigm you're operating under and you have no personal connection at all here. Yeah. So I think we could talk about that for a long time.

philosophically, what's going on in this world. I'd like to get into some specific

topics. Uh , and you kind of mentioned one earlier, so I'm has shifted the order up here and ask a kind of, I don't know , abrupt question. Can you break your penis? Is that possible? No, there are no bones in the penis so you can't break your penis. However, you do have ligaments and other tissues that may get injured. So no, you can't fracture your penis, but you can certainly injure your penis, just like you can injure any other part of your body.

There's soft tissue structures, there's nerves. There there's ligaments that help suspend your penis and help with rigidity. Like it's called the suspensory ligament of the penis. Mm-hmm essentially, that is a very tough ligament and it helps for rigidity with erection and, and so forth. So when, when folks choose to have penile , uh , I guess cosmetic surgery or enhancement surgeries, this is usually the ligament that , uh , the doctors will cut for the illusion of length. Hmm .

Yeah. Interesting. So , so if, if I'm having penetrated sex with somebody and I there's, sometimes you can like stub your penis, you know , or get caught at a wrong angle and it hurts and it maybe hurts for a couple days. Mm-hmm it might actually, I guess, the medically accurate term, would that be a sprain? Yeah . Would just be injury sprain. Yeah. Okay . That's right . So you can sprain your penis. Yeah. A , a tissue injury, right. And, and the nerve .

So the penis can get irritated and you might have swelling and so forth. Just again, just like any other part of your body. And the more that you know about the part of your body and familiarize yourself with your own anatomy and how it works, the less scary situations are because you have a deeper understanding of your own biology, which is so empowering for all of us to know about our parts and how they function and one to seek help. And when you can kind of take a backseat and wait it out.

So I think empowering people with knowledge like you and I are doing here on your podcast is such a beautiful thing for people. Yeah. Thanks for saying that. And I think so. And that's why I'm here and that's why you're here. And so I guess, yeah, if I think if I sprain my ankle or my arm or something, I'm not gonna jump right back into doing the exact same thing I was doing.

So maybe similar might not jump right back into full on penetrative sex, you know , maybe wait a little bit, maybe do some self massage , Exactly self massage , breathing, you know, relaxation techniques, movement, you know, keep your body moving because all tissues, crave, blood flow movement and space, and that's how tissues heal.

You know, you might, you know , rest maybe for a couple days, but start getting back into self touch and, you know, enlargement of those tissues, cuz that you know that your penis has a function just like your hand has a function. And if you stop using it in a certain way, because there's some fear around getting back to activity, right. Athletes do this all the time.

Like, excuse me, if you have a hamstring strain, a couple days of resp you're right back training and stretching and loading that part of your body in order for it to heal. So we do that all the time for other parts of our body for rehab. Again, just, it's not. So , uh , it's not easily talked about when it has , when it comes to our genitals. right. That's the, I think that's a big gap that we're, that we're up against.

Yeah. And even in the, in the sports world, when people get a massage, we're getting massaged on our entire body and even in therapeutic massage, it's everywhere except for the genitals. I know. And that's a whole other rabbit hole we could go down and it's a big bummer in my opinion too, because wow. What would it be like to actually receive therapeutic touch there? That's nurturing that doesn't have goals or sex attached to it. Thank you.

Yeah. And so, you know, maybe this is part of some of the things you help guys with and if you're a guy listening to this, I encourage you to try just massaging yourself therapeutically, not in a masturbation context, but just see what it feels like to touch yourself there with the intention of self-healing and therapy and, and nurturing yourself. It's pretty amazing. It is pretty amazing. It's not performative , performative based sex. Yeah .

What you're talking about is pleasure oriented sex and touch. I mean, doesn't, the sex sex in itself is a term that I think is

divine defined individually. Like, what is your definition of sex? What are the values around sex? Like what does sex mean for you? Mm-hmm and then expanding that box. You know, oftentimes my work is to help men like view sex other than hard rigid erection ready for penetration. Yeah . At any time instantly, Instantly, which is a huge myth. Yeah . It is a huge myth and, you know, foreplay, isn't just for your partner, you know , uh, toys aren't just for your partner.

It , it , I really challenge men's comfort zone, penis have's comfort zone around exploring their sensory landscape. You have so much to explore. Anything can be erogenous erotic if you associate it in that way and like allow yourself permission to just bring your mind inward and notice and feel without all the baggage

or the pressure to perform or to show up in a certain way. Cuz that is a major killer. Totally. yeah. So let's talk about that. Erectile dysfunction. Yep . Um, pelvic pain, I'm sure contributes to this anxiety contributes to this, but is this something you help people with in your practice? I do. Yeah. Yeah , I do. And yes, pain can be a contributing factor, performance worry . Anxiety can be ATRI , uh , an attributing factor. I like to tell.

Uh , so all the men out there that erectile failure in your life throughout your life is common and normal to experience that it can be one time. It can be two times maybe in three times, you know, or maybe more mm-hmm the difference here is that when those issues or when that erectile failure becomes persistent and consistent and is also, and is also distressing mm-hmm for you and or your partner partners, then that becomes, you know, a sexual dysfunction. It's not a disease though.

Mm-hmm , it can be influenced by certain diseases like cardiovascular disease or diabetes, you know, also , um, uh , being on certain medications, for example, like blood pressure medications or benign prosthetic hypertrophy, which is enlarged prostate medications, you know, there are lots of medications that have sexual side effects that many people are not aware of. And most my job is really like looking up, you know, I'm like a pharmacist too.

I'm like busting out my pharmacological reference book and, and really just reading like, Hey, did you know that this particular medication can , can cause all the symptoms that you're coming in to see me with? You know, so again, empowering people with knowledge and resources , um, you know, other factors like smoking again, which leads probably to cardiovascular disease and diabetes, sedentary, lifestyle exercise, mm-hmm , you know, things like that.

So there are many , uh , hormones, another one, but there are many factors that could contribute to someone sexual dysfunction , uh , and no one size fits all. And it really does take an individualized approach to, you know, tease out what factors of their sexuality are being influenced, not just from the biological perspective of which we're talking about right. In the hormones, the heart, you know, heart health and diabetes and so forth.

But also it , from the perspective of the psychosocial factors, mm-hmm , the psychological factors, the social cultural factors and the interpersonal relational dynamics, which are huge when it comes to erectile functioning , uh , or difficulty is what's going on up in this head up here yeah .

While you are engaging in a sexual encounter because the older that men are, and , and this is in , in literature, but also just from my anecdotally, from my experience of working with men over the past , uh , several years is it's often the psychogenic factors that are, are weighing much more heavily in that sexual encounter than the biological.

And you know, that makes sense to some degree because the biology , when you're younger, like when you're in your, you know, teens, twenties, thirties, it's on, it's on, you got, you're riding the rails of your hormones and you know, everything else. And it's, it's a novelty too, you know, it's like everything is new and exciting. It's very different when you're older or in partnership for a very long time, often couples will find themselves doing the same old thing and , and in a rut.

And I , I have to tell them like, think about having the same meal for 30 years, chicken, rice, tofu, rice, salt, and pepper. And you've had that for 30 years.

I think I lost a little bit of my appetite there , you know , so it sounds like a huge percentage of these cases are psychological and It's, it's, it's, I , I can't necessarily speak to like what percentage of like for what person, but it's, it always has an emotional, psychological component because that is part of our biology, you know , our thoughts and beliefs shape what our body does. It's like microsurgery for your molecules.

And the best example that I have for this is have you ever thought of something that was sexually stimulating or erotic and like all of a sudden you started to have genital arousal, like a thought or yeah , maybe a scent or even subconsciously just have an erection just pop up outta nowhere. Okay. Right. There was no genital stimulation or touching. Right, right. But you still had these reflexes kick into gear. Well, that example right there shows you that the flip side is also possible.

So what you think, what you believe what's going on in the sexual encounter mm-hmm or solo or partner as far as play, like those thoughts and beliefs and the pressure we talked about the pressure to perform. If that's in the forefront in your mind, or you're trying to rush through, you know, your sexual, you know , your sexual session, you're trying to rush through because, oh my gosh, if I don't hurry up and penetrate, I'm gonna lose my erection. Right? Yeah .

You're actually adding fuel to the fire. Mm-hmm it's you can't force an erection to happen. And stress is a , it's like the killer of arousal a hundred percent. Right. And actually the ability physiologically speaking to maintain an erection A hundred percent. Yeah. So I I'm interpreting is what you're saying.

You didn't say these words, but instead of a guy possibly going online and trying to get a prescription for Viagra and loading up on Viagra when they've been in a long term relationship and the erection isn't happening as often, maybe instead, take a step back and look at your life and your relationship and the quality of interaction there and whether or not you've been eating chicken and rice for 20 years straight, something like That.

If there's anything wrong with chicken and rice or with your partner, it's more about the spicing it up, adding, adding different flavors, expanding your sexual repertoire. And what I've noticed is that it's normal for, for couples to kind of fall into this very traditional style of life gets in the way and sex is on the back burner. But research shows us that 10 to 15% like sex ads enhances a relationship by 10 to 15% just by having , uh , a healthy sexual relationship.

Mm-hmm if you're in partnership, of course. Right. And, and I get that there's, you know, our bodies change circumstances, right? We might have surgery or we might have , um, you know, cancer, for example, prostate cancer or something like that that would require , uh , surgical, inter uh , surgical intervention radiation. And that impacts biologically what happens to the structures that supply your penis. And that might actually create a , an issue, right?

Mm-hmm the nerves of the penis are compromised. So you definitely need to have an intact, nervous system, intact blood flow , um , for those parts to function. But that still doesn't mean even if the penis, if you're not get , if you're not able to have an erection, you can still have an orgasm. Yeah. You don't have to have an erection. And there are many other ways to artificially help support that doesn't have to be sterile and medical.

I often tell people like, let's bring in some sexual aids toys or what have you, like, how can we involve your partner partners yourself? How can we reconnect with your body in such a way that's going to allow you to embrace embody, reconnect with your sexual identity? Because so, so, so many men like penis identity is part of their Def you know, their masculinity or their , um, I guess their, how they would view their own masculinity, I guess.

And, and again , I'm speaking from , uh , more of a, a male-centric , uh , hetero , uh , I guess, normative language mm-hmm . So I apologize for that. And I totally get there's , um, there's much more to this conversation as far as that goes, but yeah, from the people that I work with, there's really this, this, you know, heteronormative , um, or , um, I guess way of thinking your attitude around sexuality, These are the clients that often come to see you.

Yeah. It's really interesting having this conversation right now. I am recognizing, yes, you are a pelvic floor, physical therapist, and you do hands on therapies for people. And there's so much more than that. It sounds like you're also doing some form of counseling or conversation with people, and that's actually a huge component of it. People don't say, oh, I have this problem come in and you do some manual adjustments with your toolkit or whatever. And then they're fine.

You also need to talk about this with people and have these kinds of open conversations. And that becomes part of the therapeutic process also. Exactly, Exactly. And not every physical therapist has . So I went to the university of Michigan to get , uh , a year long program with them, for their sexual health certificate program. So I actually do have sexual counseling and ed education as part of my toolbox. Right .

So it's just why it's, you know, I have the training mm-hmm , but I will say this, that not every pelvic floor, pelvic therapist has the, the , that knowledge set, you know? Yeah . Or the comfort or what have you. So, Man, it seems like it should almost be a requirement. I agree, you know, to be able to go in there, cuz I think back to times, and I'd like to go into some of the biology

here, but I think back to times , um, at one point I was in this very different from what we're talking about now, a non-medical but a retreat type setting where there was somebody who, for the sake of this workshop exercise, they had their finger inside me and it was , uh , the not, yeah, therapeutic sexual, I guess you could say. And what happened for me is while they were, they had their finger inside of me, there was this spot inside of me that felt extra tight and kind of Bernie .

And they just kept their finger there and they weren't touching my penis or stimulating me in that way. When I was, I was breathing deeply and I had all this emotion come up outta nowhere and just like started crying and bawling and then realized, holy, this thing happened when I was five that I had been carrying this whole time.

And it somehow was like, inside me, mm-hmm you know, and I'm just imagining if you're gonna be doing this kind of work with people, like you've gotta be, I would hope at least understanding that that kind of stuff could happen, but that brings up so many other questions for me. And what I'd like to go into with you is this, this internal realm, literally biologically internal , um , you do work with people internally and there's so much that can be held there.

Not just physically, not just, oh, you have pain here. Let's touch this massage. This you're fine. Mm-hmm . And so I'm curious to start, how does that, how does that happen? Why, you know, I don't know. Does anything feel inspiring to talk about from what I just said? No. And I , I just wanna say and acknowledge, thank you for sharing your experience because it's important to acknowledge those parts of ourselves that might show up in such a very intimate therapeutic setting.

It I'd like to say that we are so, you know, sometimes medical providers are so quick to sexualize things. Mm-hmm , where in fact you have a human being who has human experiences throughout their entire life that they may or may not remember. And we should be informed individuals to, to help support or just hold space. No, one's saying that we have to fix their issue in any way.

Mm-hmm , , that's not our role, but it is our responsibility to hold space, to empathize and to have compassion in those moments. And that is with our touch . It can also be with our touch as you're alluding to mm-hmm , touch not to poke and prod and fix and oh, here's a muscle let's stretch the hell out of it. No, no, it doesn't work like pain and you know , sexual dysfunction doesn't work that way.

What we're trying to do with our hands is not to fix them, but to support them, to support people and to communicate with their nervous system, their biology, their brains, and of course, on , on so many other levels energetically that I just don't know about. Yeah .

You know , mm-hmm so I'd like to think that when we do do , uh, anal rectal work or that we are, whenever we put my, whenever I put my hands on someone it's always with consent and it's also with , um , gentleness mm-hmm because I know how I would like to be touched. And even though this is a , a medical therapeutic setting, that, that doesn't mean you leave all those factors at the door. Yeah .

In fact, all of those elements really matter more, so much than what you're doing or the technique you're using. It's about, can you, have you created a safe container for that, for , for this in , in interaction to happen.

And so safety cues are important and holding space and communicating, looking at that person in their eyes and regulating with them, you know, mm-hmm , , I think that's just such a powerful, that's a powerful tool when we're talking about manual therapy and touch mm-hmm that that's really powerful. Yeah. It's really powerful. So question, have you had men that you've been working with that have had these emotional releases in your practice? Have, yeah. Yeah. Many, many, many times, many times.

And they're , they themselves are surprised they , you know, they're tears. Um, sometimes their body will shake. There'll be like , um , it might be a trauma response honestly, for some , um, and, and there might be some fear there might be relief, you know? Yeah . And I just stay curious, I acknowledge that this person is processing in some way. And I say, you know, how can I support you here? You know , do , would you like me to give you some space physically?

And mm-hmm , certainly in the room, you know, can do we , do we wanna just sit here and be with this for a moment? And I I'll help, you know, guide you through some, some just breathing and self soothing and so forth. So I really fi I really think it's so important to allow our, our patients or the people that we're working with to guide our sessions, to be the ones that tell us what they need instead of us having the agenda.

Cuz often, you know , as you said, medical providers, your experience was a perfect example of that checklist. You know, did I get this, this and this? Okay, good. You're done out five minutes later, you know , their , their hands on the doorknob and thinking about the next patient. Yeah . And that is what is lacking. Yeah. And so in these men, well a just to like drive the point and you've had lots of people, lots of guys that you've worked with have this experience.

I think that's important to note, this is a common thing. And B have you found that in this sort of psychosomatic release of that experience like that in itself has been a big healing opportunity for people or you've noticed shifts in these guys afterwards? Absolutely. Absolutely. Like physi just from a physiological standpoint, their nervous system is reorganizing in some way. And when it comes to, to pain in particular, that's super important. You know, that really are important.

Mm-hmm , you know, that release the, the discharging of negative energy, the relax, physiological relaxation that their body then then goes through. Obviously there's new patterns being created neurologically. Mm . And you know, often we'll find ourselves and habitual ways of, you know, moving and, you know, tensing our body. It's like a guarding reflex.

And if we can work to dismantle that a little bit and create some ease, ease mm-hmm , that is healing that helps to decrease immune responses, inflammation , uh , uh , neural upregulation in sensitivity, muscular guarding, et cetera , et cetera . Yeah. Muscular guarding being tightness. Yes. Pelvic floor tightness, correct. Yeah . Yeah. Tightness, scrotal lifting, you know, the scrotal Mo feel tense and lifted almost like, you know, their , their balls are going up into their abdomen.

Mm-hmm , you know , the penis feeling like withdrawn in, you know, like just tight and tense . Yeah. Buttock, gripping anus , squeezing, you know, just, yeah. There's this part of me, that's feeling the call to say something like all men go out and explore your. Yes . You know ? Yes . Yeah . There's some blank . There's some blanket statement in there that I'd wanna make. But I think a really important point here is to notice that this is a really common experience for guys coming to see you.

And for a lot of us guys in society, like I mentioned earlier, we're holding a lot and we don't, we stuff down our emotions a lot. We don't often let ourselves cry. We don't often even ask for support mm-hmm . And a lot of times that end does end up stuck in our body. And for whatever reason, it really seems like this region houses a lot of that stuff. And again, for whatever reason, when it starts to be explored, it could be pleasurable, but also it could be painful.

And also it could provide a really incredible transformative experience for you where you release something that maybe you've been holding for 20 years. Mm-hmm oh yeah. Yeah. And there's so much fear and repression, you know, there's a book called, I don't know if you've heard of it. The body keeps the score mm-hmm by besel .

VanDerKolk exactly what you're alluding to is the body does keep the score and our emotions do shape and shift our biology and, and you know, emotional regulation or , um , discharge, or just trying to help someone move through experiences. Right. Pain in itself in a region that, again, you're not talking about, no one knows what's going on. There's so much uncertainty. You don't know if you're gonna be one of the guys that are gonna be living this with this, for the rest of your life.

Mm-hmm I mean, it is like detrimental. In fact, men have reported that having pelvic pain or chronic pelvic pain syndrome is right up there with experiencing a heart attack and having Crohn's disease. Mm Oh . I mean , it's a big deal. That's huge. Yeah. So just telling people just live with it. I dunno . What's wrong with you is not acceptable. No so, yeah,

it's not acceptable. So if there's a guy who's feeling like they want to explore this prob not all the guys listening are gonna be able to fly to Asheville to have sessions with you. Like what would you suggest a , a man do to explore this on his own, either in the context of self pleasure or self therapy ?

Mm-hmm Mm-hmm so a couple of resources, I'll say the first being, you know, sex therapists, sex counselors and educators mm-hmm they do have to go through extensive, further education to be able to, to use those designations mm-hmm . So they do have just depending on the curriculum, but most curricula have the, the biology, the science, the education to help support someone through self touch and self-pleasure and et cetera .

So having someone like that to help guide and coach you, it would be phenomenal. So you, you can use , um, a website called asec.org , it's AA, S E ct.org , and find a professional there in your area. You could also look for a pelvic therapist like myself , um, and , and that could be through pelvic gu.com . The American physical therapy association academy for pelvic health also has a directory to, to find someone in their area.

I, I, I strongly encourage folks when they're looking to connect with someone to have a conversation and consult with them first to see if they're a good fit mm-hmm , you know, the conversation that we're having would be a really good, I guess , uh , framework to have as far as like, oh, the person that I'm going to see, are they comfortable talking about these things? Mm-hmm do they understand where I'm coming from? And can I trust them?

Mm-hmm , that's the most important thing I think is trust . Yeah . Can you trust that person to, with your story with your body? Um, or are you just going to be another number mm-hmm , you know, and that, that you , that does take courage to pick up the phone to , to , to make that consult call or to call them and ask to speak to someone that, you know, you would like to talk to to address your concern.

So I think, you know, being your own advocate and empowering yourself to just, you know, initiate that phone call and have a conversation. The other thing is certainly if someone's interested in , in working with me directly, many different options to do that, cuz I realize that there's such a need for this I outreach and not everyone thinks and approaches things like I, you know, like I do. So , um , there's ways to connect with me.

I do remote consultations and coaching, sexual coaching, you know, pelvic health and a combination of all of that. Yeah. Uh , certainly in person, as you alluded to, and I also have an online program, so it's specifically for men who are experiencing pelvic pain, you know , uh , but uh , that program also is a community.

Uh , it's a community where men can have a safe space to, to speak with each other, to connect with each other, to celebrate their victories and accomplishments and social support and connection is very important as far as prognostic factors for recovery. Yeah. Positive social support is important. So, you know, my, my, my goal here, the idea here is to help empower people through, through connection, through resource, to knowledge and, and really build resiliency , uh , in this community.

Awesome. And do you encourage men to explore anal pleasure on their own? Do you actually encourage toys, self touch All the time? Yeah . What would you , what would you , how would you encourage them All the time? So, you know, first you , when you're , when you're doing a sexual history or intake, right. It's it's, you're not making assumptions.

Certainly mm-hmm so you're starting off with the most generic questions and you kind of go into the deeper questions of, you know, I'm going to be asking some sensitive questions around your sexuality, please feel free to answer as , as little or as much as you'd like, certainly. Um, and also normalizing that conversation and saying, it's okay for you to , to talk about this.

Mm-hmm , you know , um , asking about their sexual preferences, you know, sometimes I'll walk people through like what's a turn on and what's a turnoff for you. Mm-hmm , you know, what accelerates your engine and what kind of puts the brakes on. And that's, that's an , a therapeutic exercise just in itself because that'll kind of show you as the provider of like, well, what have they been trying and what are they thinking about and what are they willing to explore with?

So, you know, I ask how do you feel about anal play? What's your experience with anal play or, or penetrative play, if that was, or prostate play, for example, you know, what's your experience with sex stories or sexual aids? You know, you , I kind of use language differently just depending on who is in front of me and you gauge , you know, how comfortable they are. And a lot of people, you know, rightfully so are very nervous to be in the hot seat.

So , you know, my, my role is to really help to land the plane with them and know that it's okay to talk about these things and then they'll kind of warm up and open up. But yeah, it just really depends on that individual what's on their sexual menu.

And if they're willing to explore out , you know, to explore beyond their current sexual menu to add to their repertoire as solo or in partnership, and often I will involve the partner in the , you know, and have couple sessions to see like where's red, where's yellow, where's green as far as where do you wanna explore?

Mm-hmm um , and for pain, it's really important for guys to explore their own bodies because they need to be able to guide their partner to say, you know, I really would like, like, I would love for us to use this position. Can you go slower, maybe firmer, can we, you know, use this toy? Can I, can I stretch my legs this way? Can you massage, like around my anus, like, it doesn't have to be like medical mm-hmm how can we incorporate pleasure to basically inhibit pain?

Yeah. And that's so powerful. So yeah. I am such a proponent of toys and vibrators or vibrators, you know, I, I have a , a whole drawer full of toys of demos. that I use. Awesome. Lube is a toy. Yeah. How many men, like, I can't tell you how many men I , I talk to and say like, no, I don't need lubricant . And I'm like, hold on a second. It's it's A set . Have you tried it? Have you tried it? Like , it's pretty great. Yeah. It's pretty great. Yeah. Yeah .

Maybe we'll put a link to, I'll ask you later some of your favorite toys, or we can put a link in show notes as well. Baba . Boom . Nashville is a great, They are, they are a Great boutique. Mm-hmm uh , here in town. I'm from Chicago and I've been through, so to some, some sex boutiques myself there.

And I cannot tell you this little town in Nashville , BA boom , you rock because they have the best quality and the most sex positive as far as their mission, their values, their education, their community outreach, like phenomenal place. So anyway, that's my, It's A good plug plug for , I've bought a lot of stuff in Baba . Boom . I think it's great. If you have a local sex shop , definitely try to support that. Mm-hmm for sure.

All right . A couple more topics. I want to go into here with you. Um , Kegels tight pelvic floor and this concept of semen retention and blue balls. And it's , I think we have enough time to do it all. uh , I'd like to No pressure remembers is a no pressure Situation. so let's talk about Kegels. Mm-hmm Keels are everywhere on the internet right now. It's kind of the cure all to everything.

It seems , uh , I see for lows of you listening, she just like did a gesture of like, oh , disappointment, put our head down but I see 'em everywhere. Like keels for this keels, for that keels will improve everything about your sex life. So I'm gonna ask you, is , is it possible to do too many keels? So keels , uh , I have a love, hate relationship with them and keels are pelvic floor contractions, right? Mm-hmm they may be appropriate for some situations.

Like , um, if there's true re if there's true weakness, right? And then they may be appropriate, but if you're dealing with pain or premature, not helpful in the beginning, do we do want to get to intentional and purposeful coordination and con like motor control and exercises? Certainly mm-hmm we don't just not do those things cuz it's not functional. Like the muscles around the base of the penis, their job is to squeeze and relax, squeeze and relax, to help with, you know.

Yeah. They also help with maintaining an erection and rigidity. So, you know, we need to get back to function. So, but initially Kaggle's night might not be the thing for you, right? There is no number as far as how many or too many there isn't. It really depends on how quickly this activity and how much is being introduced and is your body,

can your body handle the tissue demands being placed on it and adapt over time? What happens is people do too much, too soon, too fast. And that's like with any exercise, right? Yeah. And then they get tight And then you get yeah.

And so yeah, so you get tight or they're just focusing on the squeeze mm-hmm and not being conscientious about the letting go because in order for you to turn open a lid or open the door, you have to open your hand and then you use your hand to squeeze and turn mm-hmm , but you can't do that with your fist closed. So you have to let go to have an efficient contraction. So it's about the squeeze and also about the letting go. So coordination.

Yeah. So you might not want to start off with a ton of keels if you're already tight in that region. Sounds like, Yeah. Yeah . Right. That's a huge thing. And, and I've heard from a lot of guys who they'll email me, they've never done any of my programs and they just have read about keels or learned about them and they've said, oh Taylor , but I've been doing keels for two months, like all the time. And I'm still struggling with recharge . Why like what's happening.

And then I'll ask a couple other questions about the tightness in their pelvic floor and they realize, oh wow. I am like just totally constricted in that region. Yeah . And yeah, I like how you spoke to it. The relaxation is really important too. So important, so important. And I like to also plug this, if I may please about like tone or, you know, hyper toity of pelvic floor is an old term. So it's still circulating, but we've since moved away from saying hypertonic pelvic floor.

Cause there's no neurological issue, like having a stroke or mm-hmm , a brain injury that would actually change tone from that perspective. We we're starting to move towards overactive or non relaxing pelvic muscles mm . Which are draw driven by reflexes of the nervous system. So people will often come to me and say, my pelvic floor is really tight. My pelvic floor is really tight and it's like, okay, I gotta like stretch the muscle. I gotta do this through the muscle.

I gotta do this through muscle. And it's like, well, what about everything else? That's like co you know , that's contributing to , it's like descending facilitation of this reflex of mm-hmm of guarding. Yeah. That's right. Like, and, and again, it's, it's like recognizing that it's not just the a , it's not a muscle pathology that we're dealing with. Mm it's. It's a protective response in some way. , that's huge. That's huge. And I think there's there , we live in such an active world.

There's so much going on. So many of us work so much and we're constantly stimulated by all these things and we don't ha take time to just relax. And so that ends up, you know, we have a massive, I think tight syndrome. Yes . in the world, you know, and, and this is something that happens. Yeah. It does. And you know, when, when someone does an assessment, for example, of the , of the pelvic floor, we don't have gold standards of well, how what's too tight.

Yeah. Because we don't have what's normal. Mm-hmm . So I'd like to demystify this on your show here for once and for while . Yeah. Let's do it as far as, you know, when somebody says, oh my gosh, I'm too tight. And again, trying to pathologize muscle it's it's it's we don't have like, we as clinicians. And I say, we, we don't have a gold standard of measuring tightness. Mm-hmm like, there's no normal there, there isn't. And what we feel on your body is subjective. Mm .

So we're, we can't really equate like muscle tightness equals pathology or dysfunction because I have tight hamstrings and I can do yoga. In fact, I did it for a whole month of every day , studying, doing my yoga teacher training. Mm-hmm , I didn't grow five inches and my legs didn't get longer. And in fact, everything's still the same. everything's still the same. So there's neural adapt .

There's neurophysiological adaptation processes that happen that like contribute to changes of how we feel in our body. And again, that ease mm-hmm , but that's really like, that's definitely a conversation for another time, but like, your brain has a lot to do. And the context has a lot to do with how you, how comfortable you feel in your body.

And the more we resist something, or the more that something is scary or unknown or exciting, you know, then that's going to change obviously the motor output or the output response. Yeah . On many different levels. So Sounds like we all need to be breathing more deeply. taking pause . So maybe let's all take a deep breath. Right now And relax your pelvic floor. That's right. Let it go. Let it float . Yeah. But don't pee your pants. Right. So thank goodness for pelvic floor so

yeah. Have you heard of this thing called semen retention? And do you encounter men who come to your practice ever that say they're doing this? So I would like to ask you to help me understand what you mean by Siemens retention. Cuz I have heard a couple of different things. Like for example , uh , some men will define Siemens retention as, as their client , like the ready to EJA climax.

They'll actually physically stop the semen from coming out of their penis by squeezing their penis in some way. Um, others call this edging, you know, mm-hmm so I would like to know what you mean by when you ask me what Siemens retention. Great. Well, this is a cool first test, I guess you could say, cuz there's a ton of guys out there on the internet watching videos about Siemens retention all the time.

And I think a lot of different ideas about it mm-hmm and that you don't have a clear idea it's it's indicative of the nature of the thing mm-hmm um , so in this context it could mean any number of those things, right? But specifically I'm talking about a guy who chooses to intentionally not for a number of days, an extended period of time, for the sake of whatever mm-hmm mental, psychological physiological benefits that they would get from that even if they're having sex during this time.

Okay. You know, and may maybe that includes them, not during sex and squeezing and stopping that mm-hmm mm-hmm you know , but ideally it doesn't involve having like squeezing to the point where you actually have a retrograde, which goes up into the bladder and is not actually seem retention anyway. Right. Exactly. Exactly.

So it's usually not a common thing that someone will come to see me for unless something starts hurting mm-hmm so I will share with you from my perspective of this practice with congestion or , um, because what happens is you still have all the physiological happenings, like the contraction of the tubes, like again, your prostate fullness And speaking to when you're being sexually active. Yeah. When you're aroused mm-hmm I guess I should say yeah.

When there's psychogenic or genital simulation or arousal, there's all those reflexes are kicked into gear. Right. And so there's a natural process and flow to that. So there I'm here , not , there's not like a right or wrong with this it's it's really, again goes back to how gradually did you introduce this practice in your life? Yeah . And did you approach it from a start, slow and then build up and that's where people get in trouble.

In my, in my experience clinically is that it's a practice of too much, too soon, too quickly. Mm-hmm where their body just isn't able to adapt to the tissue demands that are being placed on it. And that again, whether that's muscu, you know, it's all mu you know, it's muscular it's , um, erectile tissues, the testicle itself, the VAs Derin , you know, the prostate gland, the ejaculatory duct, all those structures are, are regulated by the autonomic and nervous system.

Mm-hmm and some are not under your control and others are. And so again, I , I don't think there's this as a black and white answer, so to speak. Yeah. But it , and there's a lot of gray it's did we just gradually start to introduce this practice slowly? And if you give yourself time to adapt, there shouldn't be any issues.

And in fact, people find it very, very erotic and , um , helps, you know, like with their sexual energy and mm-hmm , you know, is , and also helps with ejaculatory volume and force cuz you know, that could be very pleasurable for, for penis haves of like, you know, building that. So anyway. Yeah . So yeah , it does. I think it's a really helpful, important piece at least to hear this from you who is somebody who's studied the medical model of things in depth as well.

That if you're U if you're a guy who's used to maybe every day , maybe not the best, probably not the best idea to just stop cold Turkey and try to go for 30 days without that, because all your tissues are used to the things that happen when you get aroused and and aroused and. And if you do that, you might experience tension or pressure or going into this concept of blue balls. I have a blue testicle right here for you, Taylor it's from my heart guts. It's a little plush toy.

If you have anybody who can see this but I use this for educational purposes anyway, it's actually blue. So I thought it was very fitting for this conversation. Nice. Al hypertension I've heard. Yes . Is this and exactly . And so one thing , um, let's see how to phrase this question Is Do people ever come to you who have this regularly?

Yes. And then what, what do you do or say mm-hmm so we actually have the conversation of, you know, when can you start , when can you, I there's an important it's it comes down to the conversation of, are you willing to experience discomfort for all the other benefits that you're trying to do? Uh , whether that's semen retention or some other sexual practice, like , because you're not essentially hurting or harming yourself, it's uncomfortable.

And for some individuals, cuz if you're Themus houses mature, sperm mm-hmm . And so the body naturally reabsorbs that and like breaks down that DNA, but there is the immune part of it, your immune system actually macrophages and other molecules come up and like, you know, break that down and clean things out, you know, so to , so to speak .

So it , it there's to some degree it might increase maybe some of the immune response or the inflammatory response, which again, might sensitize visceral structures or visceral tissues mm-hmm cause you have nerves around these too. So yeah, it could be congestion for , for sure. Um, people who have a vasectomy, some people have, you know , chronic testicular pain or epi epidemial pain because for whatever reason, genetics or , uh , yeah, we really don't know what the causes are.

Why , why men, some men experience chronic , um , testicular pain after a vasectomy versus not. Um , but in some cases it is like inflammatory autoimmune where the body is just not able to, you know, work with the influx of, you know, genetic material that's coming into this, this, you know, storage tank up on the testicles. So yeah , Yeah, yeah .

So it sounds like there's literal physical physiological stagnation that's happening because these fluids, whatever build up, get engorged, and then you don't have the release that usually comes within an ejaculatory orgasm. So this is one really interesting area that I'm I like how some of these esoteric traditions actually line up with the medical model because in the TK and the dos traditions, mm-hmm they speak to, they just, they use the same word stagnation.

They say, oh, you're stagnate, you're stagnated in that area of your body. You didn't actually allow the energy to move mm-hmm and energy, physical stagnation, whatever. It's basically the same, same thing there mm-hmm .

And so I guess hypothetically, it could be true that if you are somebody who is practicing se retention mm-hmm and you're not doing whatever you need to do to move that physical or energetic stagnation that possibly it could add to more tightness, more epi epidemial hypertension, possibly inflammation of the prostate. Right. It could be. Yeah. Yeah .

Because yeah, because you have fluid the prostate, actually the seminal vesicles, which are two organs that are located on the back of the bladder, mm-hmm ha they house 70% of most of the , of semen it's actually proteins enzymes, protective fluid that protects sperm sperm in itself is just what, eight to 10% of your actual volume mm-hmm not much. And then the rest comes from your prostate gland.

So you know, all these structures again, because there's , uh , a rise in energy, a rise in constriction and pressure just to help with that , you know, ejaculatory process to, to get that declaratory duct to open. Yeah . There's a lot of contraction, relaxation, contraction, relaxation to build up.

And so all these structures are involved and when that doesn't happen, it, it , it can, it can be for some people painful or irritating, but it really does depend on how you're introducing something new, like an activity to your body. If you're starting slow and you're working your way up, your Bo your body will have an , uh , an easier time adapting to, to that particular process. Yeah. So can I see this, this diagram?

Yeah. This is , um, you know, it's interesting to see this out of context of the rest of the diagram, but the urinary doctor also, this is also, That's a urethra. This is the urethra . Great. So I've heard from an , uh , more than a handful of guys actually, who are practicing semen retention, who say that they've actually had a difficulty or ex experienced challenges around urinary flow mm-hmm . And so I'm wondering, is that possibly because of an in inflamed prostate?

Well, It could, it could be in inflamed prostate, or because you have the urinary Fier , which is skeletal also part of your pelvic floor . That's at the apex of the prostate, which is the bottom of the prostate mm-hmm . And then you have the bladder neck , uh , which has the internal urethras Fier . That's not under your control. It's actually autonomic nervous system, which is also the system that is responsible for all these reflexes. We're talking about as far as.

So in order for you to out of your penis and not into your bladder, there's a symphony of things that have to occur very quickly, which means the bladder neck has to get a message to close. The external urethral sphincter has to open and the muscles have to around the prostate have to squeeze. And that emits the fluid mm-hmm right .

But when we're, when we're stopping that process, inadvertently think about like, if you're trying to pee and you stop the flow of urine midstream, and then you go and you keep doing that. Yeah. What happens to the , the coordination and the neurological feedback loops starts to diminish , it starts to diminish at their role. Mm-hmm like, oh, you're telling me to do one thing and then it doesn't happen.

Okay. Okay. So that might actually lead to perhaps a , um, like I said, a neuromotor dysuria of some sort , uh , or just, it could lead to habitual tension, guarding , um, congestion , um , like you said, inflammation, but I don't really know to what degree again, I'm, I'm kind of saying this arbitrarily as far as like inflammation and what that really means for someone hypothetically.

Yeah, Yeah. Yeah. So in the traditions that talk about this, being a good idea for men to do, they all say that you need to be doing practices. If you're gonna be having sex and not practices to integrate that into the rest of your body or to reduce the stagnation. Mm-hmm , maybe that's self massage . Maybe it's stretching, just something like that. And if you don't do that, then you are going to experience pain. Right . And I encourage guys to do this too.

Everything from Chiang to self massage , to self prostate massage, you know, just to keep things literally just physically moving. Even if you don't believe in the concept of energy, just get things physically moving in that part of your body. Mm-hmm any advice, Thank you for this conversation. Been thank You. Awesome . Oh , you're a very wonderful host. Yeah . Great. Yeah. I'm trying work in progress. It's super fun.

It's super fun for me to be here in person with you to have this conversation and yeah. Thank you to everybody listening right now. And please go check out Susie's website. We'll put all those links below, by the way. Remind us again. How can people find you? Yeah, so the website, https://drsusieg.com/. That's Dr. S U S I E g.com . I also have a YouTube channel, check it out, lot of free resources from sexual health and sexual medicine to pelvic pain and everything in between. So, Awesome.

I realize there's one last question here. Sure. Go check out her stuff.

Um , nitric oxide and erections. Yeah. Uhhuh. I've heard that if we breathe through our nose more regularly than our mouth, that actually increases nitric oxide production in certain parts of our body. Have you heard that? Do you counsel men around this? So I don't have, I guess in my wheelhouse of knowledge, the researcher literature, I haven't dove into that. So I don't have a , a clear answer for the, whether or not breathing in , through our nose in particular.

I do know that from like a spiritual meditative, as a meditator, from a spiritual perspective, there it is encouraged to breathe in through, through , in and out of your nose. And I don't know what the science is behind that. Yeah .

However, I will say that when we're breathing in and out through our nose, it does require us to slow down our breathing because the aperture of like the air flow , like our mouth is bigger and you have a , an ability to kind of breathe faster with your mouth open than closing your mouth and like having to breathe in and out of your nose. It like literally causes you to like slow down and, and slow your breath, your respiration rate. The other thing with erections nitric oxide.

So your nerves, when , when stimulated psychically or with genital stimulation, or both will release nitric oxide to help relax the arteries mm-hmm and then the arteries allow blood to go into the penis and then the cavernosal tissue. So your erectile tissue, which is corporate cavernosa and CorpU Bunim , it's like hot dog in a bun that those tissues fill up with blood and en Gorge.

And during that pressure, that that process, the penile pressure increases and then basically presses on the veins and that causes venous occlusion. So that prevents retrograde blood drainage, right? Mm-hmm so that's the process of like nitric oxide and so forth, but physiological relaxation is necessary for erection. Mm . Because at that stimulates the parasympathetic nervous system, which is the rest and digest and the relaxing nervous system that is important.

And I do talk to men about physiological relaxation and putting pressure at the door like performance , uh , performative pressure at the door. That's so important because that is actually going to accelerate your ability to have an erection. The sympathetic nervous system is responsible for. That's a fight flight or freeze adrenaline, no upper Nerine, you know, all of those that kicks in , uh , at , at climax.

So when that sexual energy goes, so it's important to know what processes of this , uh , I guess, of an erect , the sexual response cycle is involved. So in order to get erection parasympathetic, so relaxation have to be in physiologically, have to be physiologically relaxed that allows blood flow circulation to the tissues, et cetera . And then when you're ready to climax to muscles tents , you know, around the pelvic floor, sympathetic nervous system kicks in boom. Lift off . Yeah. Yeah .

So that, so that's, that's what I can say to your question about nitric oxide and blood flow, but your yeah. Parasympathetic stimulation is the driving factor. Awesome. So that light leads or lends even more evidence to the, the practice of breathing deeply throughout sexual intimacy for the sake of lasting longer in bed . Right? Yep . Like if , cuz if we're , , that's stressful and you know, could lead potentially And premature, isn't the One. Yeah. Yeah . That's So important. yeah.

To breathe and slow down. Exactly. Well, I'm glad we got that last question in there. Thanks for asking. Yeah. That's awesome. So in closure, it sounds like you have a really awesome course for men around pelvic pain. Mm-hmm and that's on your website. Mm-hmm , I've got a course that I'm creating right now, coming up around anal pleasure , all things anal. And so if you want some tools and techniques to explore that part of your body, there will be some sexual practices.

And I'm also just self therapeutic practices in that realm. And hopefully I might actually do another interview with you about that at some point long game and yeah. And remind us all where we can find you . So , uh , my website, Dr . suji.com , I'm on YouTube and Instagram. Great. And we'll put all those links in the show notes. Thank you, Susie so much for being here. It's been a treat to share this conversation with you. Thank you, everybody listening, check out Suzi stuff. She's awesome.

And I hope you all have a beautiful, beautiful rest of your day. Thank you friend for listening to this episode. I have one request before you go, if you got something useful, if you got something valuable from this episode, please take a moment right now to go to apple or Spotify and leave a review of this podcast. That'll be really, really helpful. It'll do two things. Number one, it'll let me know that you actually like this podcast. Number two, it'll help more people find this podcast.

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