The Austin Love Doctor™, Dr. Emily Porter, hosts a regular podcast about sexual wellness, relationship advice, and more. On this week’s episode, she discusses relationship issues, communication strategies, intimacy, and offers treatments and advice for repairing your relationship. Common treatments that can help patients take steps toward repairing relationships that we perform at our sexual wellness clinic in Austin include bioidentical hormone therapy, the Priapus Shot®, the O-Shot®, and more.
Check out the episode transcript below to learn how we can help you with treatments and advice for repairing your relationship!
Dr. Runels: This is Dr. Charles Runels, inventor of the O-Shot® and thank you for joining Dr. Emily Porter, the Austin Love Doctor™, as she openly discusses your most intimate questions regarding relationships, sex and personal wellness through the eyes of a medical doctor who treats men and women for a variety of sexual issues using the latest medical advancements available. Get comfortable, relax and welcome your host, Dr. Emily Porter.
Dr. Porter: Hello. It’s Dr. Emily Porter, the Austin Love Doctor. Thanks for joining me. Today I wanted to just discuss a case that I had–a patient that was a man in his mid-30s. He reached out to me via the website and lived about three hours away in Dallas. Came in, no real medical problems, was fairly overweight. But his issue was he has a girlfriend who I think was in her late 20s. So there was about a six or so year difference between them. He said that he was having some problems with erectile dysfunction in his relationship. So he told me that he really liked this girlfriend and they would kiss and he would get erect and be all excited and that he would perform oral sex on her and always make sure that she was taken care of. Sometimes during that time, and he would lose his erection a few times now and then. He reached out to her, no pun intended, and wanted her to help him get erect again so they could have intercourse.
Dr. Porter: He told me that she never would touch his penis and she didn’t give him any oral sex at all. But that she would have sex with him and especially liked to be on top. But then, even after they had sex, she would never basically touch his penis or do any oral. She just said she didn’t like it or that she didn’t want any of her stuff near her face or near her mouth or near her hands. But she wouldn’t do it even before they had sex.
Dr. Porter: So anyway, he didn’t really have any medical cause for his problems. But it was starting to affect him. It happened a few times, but it was starting to mess with his confidence, which is pretty common. So he had come down looking for treatments & advice for repairing his relationship. He was going to get a shockwave treatment (or a GAINSWave® treatment). Those are a series of treatments, so it’s a long way for him to drive to have that done. So we kind of discussed his options.
Dr. Porter: I recommended that he walk 21 to 25 miles a week. That’s good for your erections and just in general. It helps with blood flow, cardiovascular health. There’s lots of studies showing that even just a brisk walk, again, 21 to 25 miles a week, which is about an hour a day or you might do a few longer walks a week, will long-term help you with penis health and with erections because it keeps you in shape and it increases blood flow, just makes you happier. We talked about that, I think how walking 21 to 25 miles a week, doing nothing else with no other changes actually will decrease your mortality or your death from all causes. So suicide, murder, a heart attack, diabetes, anything, any cause of death by 50% in the first year, which there’s no pill out there that does that. So walking is really important. Plus he was a little overweight. So I think that would probably help with that too.’
Dr. Porter: And walking, being able to go up one flight of stairs is important. We talked about that after heart attacks. That’s how you know that you’re ready to have sex again with the same partner at the same intensity that you were having before a heart attack, is if you can walk up one flight of stairs. But the energy expended and the METs that you use to walk up stairs, a flight of stairs, is really a good predictor of your endurance in the bedroom, at least from a heart perspective and from not getting out of breath or being out of shape.
Dr. Porter: So I recommended he walk and then I recommended that we check his testosterone. He hadn’t had it checked. That alone can be a cause. Testosterone can start to drop as soon as 25. Then if you’re overweight, sometimes you can have more estrogen. Then your testosterone to estrogen balance can be off, which can throw things off as well. So, I recommended that we check his testosterone, his total and then his free and his sex hormone binding globulin, which is a marker of how much he binds up testosterone. So it sort of correlates with how much of his usable testosterone he has, and then also his estrogen, so that we could see what the ratio was there as estradiol, to be more precise.
Dr. Porter: The range is really high, is really broad for testosterone. It can be anywhere from through mid 300 to a thousand up to 1200. it kind of depends on age, but for a man in his 30s, it should be at least be 350 up to 1000. But when people are having difficulty, they tend to do better with a higher testosterone, more like 900 to 1000 kind of. My range is really 900 to 1100.
Dr. Porter: When you optimize someone’s testosterone, they’re going to have lots of good benefits. They’re going to be able to lose weight easier. They’re going to build muscle easier. You’re going to have benefits to the heart. You’re going to have benefits with cholesterol. All of those things tie into penis health as well. Better mood, less irritability. There’s lots and lots of good benefits from testosterone, in addition to having less erectile dysfunction. I have seen that where I’ve had men that at 40 years old and had out of the blue, had started to have erectile dysfunction. We checked their testosterone and it was maybe in the 200s or low 300s. Just adding testosterone alone completely fixed their problem. And I’ve had that with older men too, just to get them to a higher level. All their problems went away.
Dr. Porter: We use bioidentical pellets, the BioTE® method. For men, they’ll last anywhere from four to six months. They’re tiny little pellets, pills, sort of, about a little bit bigger than the size of a grain of rice. They go underneath the fat, kind of up on the hip where you don’t really feel them much afterward and they last about four to six months. They provide a steady stream of testosterone, so you don’t have the peaks and valleys that you get with shots or that you can get with gels and they’re bioidentical. So, fewer side effects and having to give yourself a shot twice a week or every other week.
Dr. Porter: So I recommended that as a good treatment for repairing his relationship. Then we actually did a Priapus Shot® on him. So we took his blood, we spun it down. We got growth factors. Then we injected it back into his numbed penis in a few spaces. Then he’s going to use a pump afterward for six weeks. That should help with nerves and help with blood flow and all of those great things and help.
Dr. Porter: But the most important thing I think that I recommended to him actually with not medical. It was that he needs to talk to this girl that he has. Because I saw this gentleman as a really sweet guy. He seemed very giving. He told me that he really liked to please this woman. He was of the, “She comes first,” mentality, which when you find that, ladies, it’s like a gold mine, right? And he was always focusing on her being pleased first. Then this woman wasn’t even willing to give back really at all.
Dr. Porter: So I decided to offer him some advice for repairing his relationship said, “You need to have a talk with her and find out what her hesitation is.”
Dr. Porter: He said, “Well, she just doesn’t think she’s very good at it or she doesn’t like it.”
Dr. Porter: But they hadn’t really had that conversation as to why and delved deeper into it. He just sort of let her kind of off the hook. I mean, and now his sex is suffering as a result of it. I just don’t think that’s fair. So find out from her what’s her deal, what’s her hesitation? Did she have a bad experience? Is it hygiene? Is it that she’s not confident? Can you guys go to a class together? Can you read some books together? Can you watch porn together? What can you do to kind of make her be more sure of herself or less grossed out? I think if that’s what her issue is and why? Because I think he would benefit from it and I think it’s fair. Reciprocity is really, really important in a relationship and so is communication.
Dr. Porter: The last thing I said was, “Look, if you guys have this conversation and you tell her how you feel and you say, ‘Look, I do this for you because I enjoy doing it, but also I enjoy seeing you be happy and having you have pleasure.'”
Dr. Porter: He said he would ejaculate during sex, but he was having this problem where he was going soft and she was just acting like it wasn’t a big deal and she wasn’t going to help him out at all. And I said, “Look, if she’s not willing to meet you where you are, then if it were me, I’d get a new girlfriend.” I just told him that straight up. Because is that really somebody that you want to be with long-term? It seemed to me like it’s all about her. It’s all about her and selfish doesn’t have a place in my bedroom. It doesn’t work like that. He was too nice of a guy to be in that situation. So I said, “Look, there’s lots of women out there that will love to give oral sex.”
Dr. Porter: I’ve seen lots of men that have told me that even they’ve gotten divorced because their wives don’t give oral sex. But they’ll do it to their woman. So my thing is that if you want somebody to do something to you, you have to be willing to do it back to them. That’s reciprocity 101. If you want somebody to go between your legs then you’ve got to give it right back. If you want them to taste you, then you got to be willing to taste them and vice versa. If you’re not, then I wouldn’t want to be your partner or your lover because the word partner implies that there’s two of us here and that we’re working together to have better sex. If you’re just going to put a foot down and say, “I won’t do that,” or, “I don’t like that, and not be willing to meet somebody where they are, then I don’t think you’re a partner. I think you’re just a user and you’re a tool. And I wouldn’t be with you.”
Dr. Porter: So I told him that. So we’ll see what happens. Hopefully they’ll have the conversation and he’ll be able to get to the root of what’s going on and she’ll see where she’s been. But call her out on her bullshit. I mean, that’s what I said. Don’t spare her feelings. I suggested that they have the conversation when they’re clothed. Because I think when you’re naked and post-coital and you’ve got hormones running through your body, people can get a little bit emotional. I didn’t really want her to be him to be shitty to her, but I wanted him to be honest with her. And he wasn’t. He wasn’t really being honest with himself, either, which is that this was sort of a one-way relationship.
Dr. Porter: So we’ll see what happens, but that’s my advice for what it’s worth. If you’re in that situation, you’ve got to have the conversation. It doesn’t matter if you’ve been together for a week or a month or you’ve been married to somebody for 30 years. If they’re not meeting you where you need to be and being realistic, I think he was being realistic. He wasn’t saying, “I want you to have anal threesomes with me,” or something that maybe is way out in left field from where they were. I don’t think it’s unrealistic. If I’m going down on you, if I’m fingering you, for you to put your hands and your mouth on me and meet him where he is or where she was.
Dr. Porter: So, if you’re being realistic and your partner’s not willing to give back, then my advice for repairing the relationship is either A, go to sex therapy together, if you’re in a long-term relationship or you cut your losses and find yourself a new partner.
Dr. Porter: I hope that helps. If you guys have questions, please send us an email: Info@AustinLoveDoctor.Com.
Dr. Runels: Thank you for joining Dr. Emily Porter, the Austin Love Doctor. If you have a question about your relationship or sexuality, please feel free to contact her directly at AustinLoveDoctor.Com.
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