About this episode
Is your sex life bad? Dr Rena Malik walks you through every single sex question you're too nervous to ask - from testosterone, porn, and erectile dysfunction, to libido and stress! The Better-Sex Doctor Rena Malik is a urologist, pelvic surgeon, and sexual health expert who helps millions better understand sexual health and taboo topics through science-based education and honesty. She is also the author of her upcoming book 'The Hard Truth'. She explains: ◼️Why bad sex is often a sign your overall health is breaking down ◼️Why erectile dysfunction can be an early warning sign of heart disease ◼️The 4 pillars that control your sex life: fuel, strength, environment, and confidence ◼️How porn, masturbation habits, and performance anxiety can rewire arousal ◼️What low testosterone actually feels like, and when TRT is a mistake Independent Research: https://stevenbartlett.com/wp-content/uploads/2026/04/DOAC-Rena-Malik-Independent-Research-Further-Reading.pdf Follow Dr Rena: Instagram - https://link.thediaryofaceo.com/9eD5dDG X - https://link.thediaryofaceo.com/BDcDWi8 YouTube - https://link.thediaryofaceo.com/CTzkeOx Website -https://link.thediaryofaceo.com/TyaRNr You can pre-order Dr Rena’s book ‘The Hard Truth: Everything Men Need to Know for Good Health, Great Sex, and Long Life’, here: https://link.thediaryofaceo.com/FQSv9xe Enjoyed the episode? Share this link and earn points for every referral - redeem them for exclusive prizes: https://doac-perks.com The Diary Of A CEO: ◼️Join DOAC circle here - https://doaccircle.com/ ◼️Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼️The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb ◼️Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼️Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsor links: Wispr - Get 14 days of Wispr Flow for free at https://wisprflow.ai/steven Ketone - https://ketone.com/STEVEN for 30% off your subscription order Fiverr - https://fiverr.com/diary and get 10% off your first order when you use code DIARY Cometeer - https://cometeer.com/steven for $30 off your first order *Steven is an investor in this business
Episode summary
Welcome in with a bang: yes, traction devices can add around two centimeters with steady use, pistachios showed benefits for erectile issues, and regular sex maps to longer life for men and women; the clitoris and penis share the same spongy tissue, so blood flow and use really matter.
Quick ask up top: follow the show so our best episodes land right in your feed; now, I want to get into morning erections, squirting, clitoral stimulation, and positions that help my partner climax.
If a fan stops you, what do they ask most?
People want to know what they can do today to upgrade their sex life, because media makes great sex look effortless and many feel they’re missing it.
Yet the numbers show young adults are having less sex; what’s going on?
We’ve crowded out intimacy with endless screens, shallow app dating, and porn-as-education, so first encounters are often awkward, communication is poor, and trends like choking feel “standard” even when many don’t love it.
Could dopamine-heavy scrolling and porn be blunting arousal and performance?
Constant novelty trains the brain to drift, so in bed you’re chasing an orgasm on autopilot instead of being present, which kills desire and connection.
I need real mental space after a hectic day to get in the mood.
That’s normal; arousal needs a calmer, parasympathetic state, and many men also need a story, cues, and time—not an instant on-switch.
Expectation can become pressure, which then tanks performance.
That vicious loop is classic performance anxiety; take penetration off the table for a bit, use sensate focus, explore each other slowly, then reintroduce genital touch and later penetration once the body responds without you overthinking it.
Some couples avoid the topic entirely, which is sad.
Sex is a vital health signal and a bonding tool; people who have sex weekly live much longer than those who do it yearly, and more orgasms in men track with longer life, though sex also reflects overall fitness and connection.
Foundations for great sex—what should we focus on?
Think four pillars—fuel, strength, environment, and confidence—because without that base, quick fixes don’t last.
Fuel: a Mediterranean-style pattern rich in plants, healthy fats, and fiber is linked to fewer erectile issues; colorful fruits like blueberries and nuts help, fiber supports vessel health, and managing weight reduces sexual dysfunction risk.
So pistachios are my secret weapon?
They can be part of the solution, but it’s the whole eating pattern—omega-3s, antioxidants, and fiber—that supports hormones and blood flow.
Strength: approximately one hundred fifty minutes a week of moderate cardio can improve erectile scores on par with a pill, lighter walking plans still help those with heart disease, and heavy resistance training preserves muscle, supports testosterone, and slashes erectile problems as you age.
Muscle really is medicine.
Modern life keeps us seated, so lifting and moving protect against sarcopenia, which otherwise drags sexual function down.
Where do pelvic floor muscles fit in?
They sit like a sling under the pelvis, drive the rhythmic contractions you feel at orgasm, support continence, and—when tight from stress or injury—can cause pain, urgency, erectile issues, reduced clitoral arousal, or premature ejaculation; kegels help only if the floor isn’t already tense, so learn to relax it or see a pelvic floor physical therapist.
How common is erectile dysfunction, and what ages does it hit?
It rises steeply with age—about half of men over fifty—and often flags vascular disease years before a cardiac event, so treat it as an early warning.
Define erectile dysfunction for us.
It’s the ongoing inability to keep an erection firm enough for intercourse, which is different from climaxing too quickly.
A friend can stay hard with porn but loses it with a partner; does that count?
If solo sessions remove pressure or involve a very specific grip or routine, you may be habituated to a kind of stimulation a partner can’t match; morning erections suggest the plumbing and hormones work, so address anxiety, diversify solo habits, and rebuild arousal with your partner.
Do women have a morning analogue, and does lack of arousal shrink tissue?
Women also experience nocturnal swelling of erectile tissue; without regular blood flow—via sleep, arousal, or sex—spongy tissue can scar and shorten over time in both sexes.
Is clitoral stimulation like stimulating the tip of the penis, and where’s the G-zone?
The clitoral glans is as sensitive as the penile tip, but the clitoris extends deep with bulbs and legs, so many enjoy external touch plus gentle pressure on the upper vaginal wall a couple of centimeters in.
Morning climax makes me feel flat; is that chemistry?
After an orgasm, dopamine drops and prolactin rises, which for some brings clarity and for others a short-lived low mood called post-coital dysphoria.
Walk me through pillar three—environment.
Chronic stress elevates cortisol, blunts testosterone, and blocks arousal; break the loop with movement and small connection rituals like a twenty-second hug or a lingering six-second kiss.
Sleep is huge: a week of five-hour nights can drop testosterone by about fifteen percent, and undiagnosed sleep apnea is common—fixing it can raise levels dramatically.
So bad sleep often means low testosterone; what are the signs, and what about plastics?
Low T can look like fatigue, brain fog, low desire, mood dips, more fat and less muscle; endocrine disruptors from heated plastics and nonstick coatings can nudge hormones the wrong way, so store and heat food in glass or metal, avoid hot plastic bottles, reduce dust, and choose more cotton—do what you can without spiraling about it.
Do you live that way at home, and do our peers shape our sex lives too?
We use metal bottles and ceramic pans, and yes, friends who dismiss sex as unimportant can normalize avoidance; surrounding yourself with people who value connection measurably improves healthy sexual behavior.
Is there such a thing as too much porn?
It’s about relationship, not raw hours—compulsive use to escape feelings or deep guilt after viewing are the red flags; many couples who watch together report higher satisfaction, but frequent solo climax can lengthen the refractory period and make same-day sex harder.
What’s pillar four—confidence?
It’s knowledge plus curiosity: learn anatomy, read your partner’s cues, talk openly, and consider toys or small twists for novelty; vibrators don’t permanently numb you, and slight challenges can create a sexual flow state.
Any positions that meaningfully boost a partner’s odds of orgasm?
Woman-on-top often helps because she can angle clitoral pressure, and the coital alignment technique uses a rocking motion to rub the clitoris during penetration, though it takes practice and a sense of humor.
Is squirting just another word for orgasm?
About four in ten women may squirt—a clear, high-volume fluid from the urethra that blends bladder fluid with secretions from Skene’s glands; the composition differs from urine, and what matters most is whether it feels good, not whether it happens.
There are evolutionary theories for squirting—flushing bacteria, a vestige, or mate selection.
UTIs after sex are usually about anatomy and thrusting pushing outside bacteria into a short urethra, and evidence tying orgasms to fertility benefits is intriguing but thin.
Don’t forget the whole body is in play—necks, nipples, lips, inner thighs, and more are commonly erotic, and gentle, slow human touch lights up special nerve fibers far better than fast strokes or a glove.
Human touch beats robots for massage and, clearly, for arousal.
Everyone I know is suddenly talking testosterone; what’s changed?
Average levels have fallen markedly in recent decades, likely from more obesity and insulin resistance, inflammatory ultra-processed diets, and endocrine disruptors; aromatase in fat also converts testosterone to estrogen, which can lead to gynecomastia.
Does higher testosterone mean more fertility?
Not automatically; sensitivity varies by androgen receptor, and pushing levels too high brings risks like thicker blood, heart strain, mood shifts, acne, and no extra benefit once receptors are saturated.
Who should consider therapy, and is it the same as anabolic steroids?
Medically guided replacement is for men with true low levels plus symptoms after lifestyle fixes, aiming for normal—not bodybuilder—ranges, while anabolic regimens chase muscle and carry massive cardiovascular risks.
I’ve delayed therapy to protect fertility.
Smart, because testosterone suppresses sperm production—many become infertile on it—and while levels drop only about one percent a year on average, not everyone needs therapy; if fertility is a goal and you’re low, options like HCG or clomiphene can stimulate your own production under expert care.
So not every man over fifty should jump on testosterone.
Correct; assess symptoms, free testosterone, and SHBG, and rule out lookalikes like thyroid issues or high prolactin before touching hormones, because once you start, it’s often long-term.
Young guys chasing big muscles worry me.
Steroid abuse is surging, driving infertility even within weeks, and poor semen parameters track with worse health and shorter lifespan, so a semen analysis is a surprisingly useful health check.
I saw your huge YouTube video on penis enlargement and was stunned by how many men care; why is that?
More men want extra length than extra height, shaped early by jokes, media, and porn that glorify outliers; the man with the largest documented length even struggles because partners find it uncomfortable. Anxiety comes from skewed comparisons, since average erect length is roughly five and a half inches, and real‑world preferences land near that average.
Does size change with age, and what actually works to increase length?
Keep blood flowing and keep weight down, because the fat pad above the pubic bone can hide length even if the penis itself has not changed. I do not recommend lengthening surgery due to high complication rates; instead, gentle traction devices used about thirty minutes twice daily for a few months can add around two centimeters and may help Peyronie’s curvature, but permanence is unclear, and you should avoid risky hacks like jelqing or bizarre “cures” that can cause lasting injury.
I remember feeling small and anxious in school locker rooms before puberty.
You do not need a big penis to be a great lover; the clitoris is the most reliable path to orgasm, and most women are satisfied with average when they feel cared for.
Do vaginas vary in size, and what matters for pleasure?
Vaginal length averages about three and a half inches and expands with arousal, so average and a bit above fit fine; most women do not climax from penetration alone and need direct clitoral stimulation.
Why do different partners feel so different even at similar sizes?
Pelvic floor strength lets some women squeeze and release in rhythm, which can feel snug without being tense all the time, while girth, motion, and angle on the male side change sensation.
Do hands, feet, height—or anything—predict size?
Hands, feet, and height do not predict length; one small Japanese study linked longer noses to longer penises, but that is not a rule.
How does Ozempic touch desire and performance?
GLP‑1 meds can improve metabolic health and blood flow, lift mood through weight loss, and shrink the fat pad so the penis looks more visible, but because they act on reward circuits, some people notice reduced sexual desire. Track changes with simple desire questionnaires and talk to your clinician about dose adjustments if your libido drops.
What is a good way to start hard conversations about sex with a partner?
There is no perfect script—pick a calm moment outside the bedroom, lead with something positive, be curious, and agree on a time if they need space. See sex as connection, not a chore; many men seek closeness through sex while stressed women may see it as one more task, so build the conditions—affection, praise, and small touches—so desire has room to grow.
Men worry about performance and erectile issues, while many women feel uneasy asking for more foreplay or clitoral focus, and both sides carry taboos around pain, body image, boundaries, and fantasies.
Share a helpful clip or this episode to open the door, and do not hide behind “men do not talk”; everyone can learn this. Kinks and fantasies are common and normal—from submission or voyeurism to romance—so consider privately writing yours, then each share one you would try together and keep it playful; more healthy sex often means less loneliness and better well‑being.
We are getting more sexless as attention gets hijacked and stress spikes, so we need to reclaim sexual health.
I wish sexual education included this; women often steer family healthcare, and understanding male sexual health helps everyone, and sex can even motivate men to improve blood sugar and blood pressure.
Our closing tradition: the last guest left a stamped, human‑certified, Gen AI‑free question—so, when the world feels hopeless, how can someone reclaim their agency?
We are built for connection, so prioritize community, shared spaces, and live experiences; history swings, but it also reunites, and I am optimistic we will find joy and unity again through human connection.
I think we are already seeing the first signs of that—thank you, Dr. Reena.