In this Ask Me Anything (AMA) episode, Dr. Malik tackles a range of pressing questions about sexual anatomy, the crucial role of ...

finding-the-g-spot-curing-porn-addiction-orgasm-with-penetration-post-void-dribble-ama

Finding the G-Spot, Curing Porn Addiction, Orgasm with Penetration, Post-Void Dribble | AMA

welcome back to the Reena Malik MD podcast I'm your host Dr Reena Malik urologist and pelvic surgeon today we are doing an episode of ask me anything we've pulled these questions from our special members who signed up for the premium membership at supercast which is renam malik. supercast dcom you can also feel free to leave me your questions on social media we do see these so follow me on your favorite social media platform Instagram YouTube Tik Tok Facebook wherever you are you will find me and you can leave me com Ms there so let's get right to it all right first question I'm only 20 years old so don't judge me but where exactly is the G-Spot I can see the [ __ ] but to my reading that's not the G-Spot it's apparently inside but I don't know if I should be feeling for something with my hands or penis all right well thank you so much for this question it is so important so first of all when you think about Anatomy let's take it from what you're seeing on the outside so the the entire space from the top of the pubic bone to the anus is called the vulva okay and so when you look at it from the outside you're seeing the outer lips or the labium Majora and then the inner lips the labium manora if you follows all the way up you're going to see the clitoris which also has a hood which is a clitoral hood just like a man's penis has four skin female's clitoris has a hood so you got the clitoris that's great you go right below the clitoris you see the urethra that's the P2 then below that you get get into the vaginal Canal now the vaginal Canal is where you'll find the G-Spot now why do people want to find the G-Spot because they think it's this magical button that when you press a woman's going to have an immediate orgasm now that's not always true because the most important organ arguably for pleasure in women is the clitoris and it is the homologue of the penis so when you think about how it feels to get your penis stimulated it's the same as what it feels like for a female to get her clitoris stimulated and so that's going to be the most reliable route to orgasm and pleasure for a female now the gspot is actually not a spot or a button or a specific place that you're going to exactly feel it's called a Zone it's a a g erogenous Zone and it's an area where several sorts of nerve endings are coming together and it's right underneath the urethra so underneath that P tube about 2 to 3 cm in and it's also where when the clitoris expands and and enlarges just like the penis gets bigger when it's erect the clitoris gets bigger when it's erect and when a woman is aroused that area also gets pushed on and so you take these very pleasurable sort of nerve endings you have this other special gland called the skin gland that also has some nice nerve endings and that's similar to the male prostate and so put all these nerve endings together the enlarged clitoris the skin gland the nerve endings that are more prevalent in that area and you stimulate it and for some women and this leads to orgasm so you can stimulate it by essentially feeling that area palpating that area sort of like if you were putting your finger in and doing like a come hither motion you're going to hit the gzone and so I think yes it is very pleasurable for many women to experience the sensation or pleasure or stimulation of that area but it's not necessarily always a reliable route for orgasm but there you have it that's where it is very good all right let's get to the next one I want to cut back my porn addiction I think I watch it way too much how should I do this okay this is a very good question because what is porn addiction really right so pornography is a visual construct that people use for Fantasy to help them achieve pleasure and it is very commonplace a lot of people are watching pornography and a lot of people are using it in a healthy manner meaning they use it for pleasure and it's enjoyable when they're using it and they're able to return to normal life have great relationships have great sex they're not preoccupied with the use of porn they're not using pornography in a way where they're using it over spending time with their friends or family or other things and that's completely normal so in those circumstances it's very reasonable to continue using pornography as long as it's not sort of interfering with your day-to-day life now if you find that it is interfering with your day-to-day life I think the real question is why are you seeking pornography very often it's not that people who use pornography compulsively do it because they really enjoy pornography it can be because you're using it as a way to dull some other emotions other people can develop a pornography addiction just like any other addiction where essentially you watch something you develop these sort of you develop pleasure from it and your brain then develops of these patterns that it wants to go back to this thing because of the pleasure and then you continue feeling this feeding this Loop and ultimately you start needing more and more of it to receive the same amount of pleasure it needs to be more enticing or novel or interesting to develop the same amount of pleasure and so you get in this sort of vicious cycle now if you find yourself in that cycle it's really important to then seek help and sort of identify where you're struggling because usually there's an underlying issue that's caused you to sort of develop this addiction now yourself there are several ways to try to essentially change your your addiction in terms of if you're finding that it's a habit that you are constantly going towards it's looking at what's the cue for that habit so identifying okay I always want pornography at this you know I'm stressed I'm tired I'm angry I'm upset and so figuring out what those triggers are and then identifying those triggers and finding something else to take its place right and sort of slowly changing your body's response to that same cue that's telling you to go go watch pornography so that's one way that you can sort of try to limit your pornography use if you so desire but again I think there's a lot of people who use pornography and use it in a positive way to achieve pleasure even to watch with their partner or to just try something new and I think it's very fine and safe to do so as long as it's not interfering in your day-to-day life all right let's go right into number three my husband has stopped giving me oral sex I really cannot orgasm without him going down on me we don't always have time for sex because he works so much so even I don't always give him oral sex but he always orgasms with regular sex and I can't I usually have to go to the bathroom or other room to finish myself is there a way for me to orgasm with penetration only this is from Mona yeah so this is a great question and I think that this is not uncommon most women I would say over 80% need some form of clitoral stimulation to Climax and this is because of something we talked about earlier right the clitoris is the homologue of the penis and so what that means is that when you stimulate the clitoris it's going to respond like a penis responds it's going to get enlarged it's going to engorge it's going to fill with blood it's going to feel good until you climax now that doesn't mean that's the only way to climax there are some subset of women who do climax through penetrative sex alone and it really depends sort of on each individual person now if this is your desire to climax with penetration you may need to identify certain positions that allow better stimulation of areas that are ayous so some women find the gzone we talked about earlier erogenous some people find the cervix erogenous and so you may need to identify ways to stimulate those better certain positions or you may need to find certain positions that allow to stimulation of the clitoris while p penetration so that could include things like angling rocking um I've made a video about different positions that you can try as well as the coal alignment technique so check those videos out where I go into more detail in the research about these different positions that might be helpful but ultimately if you enjoy cliteral stimulation there's no reason not to incorporate it in some way so if you can't figure it out with the position it can be manual stimulation either you do it your partner does it or bringing some sort of vibration into the bedroom where you can actually utilize that to help you climax and ultimately this is sort of a thing about communicating with your partner letting them know what you like and how you need to be stimulated and bringing that discussion in not in the bedroom but before the bedroom so that you guys can have that discussion and no one is surprised at the last minute that you're changing things up or feeling maybe insecure because you're just saying look I I really enjoy our time together and I just want to enjoy it even more and this would help me enjoy it even more and ultimately I think that you can absolutely have a wonderful and productive and pleasurable sex life as long as you guys communicate and talk about what you want very good as as a reminder a lot of these questions uh they're great questions once again and we do have a lot of these covered on past videos so please do take a look at the library of past videos you may find some of these questions answered in more detail there let's move on I'm taking Calis I do get hard but I don't think it lasts as long as it should seems to wear off even while I'm having sex should I switch medications to something else great question so talify or Calis is a medication that's used for erectile dysfunction it falls into a category of medications called pde5 Inhibitors now all of these medications work to essentially get rid of the signal to stop the erection and so they help you maintain erections longer helps it makes it easier for you to get erections increases blood flow to the penis right right so these medications are very very helpful they work in about 60 to 70% of men so they are very effective now what happens if one is not working in this case tadalfil there's also selenop venail aahil there's a whole bunch of them but the most commonly used ones that I use in my practice and most urologists will use because they're affordable are tadalfil and seleny and they all work relatively similarly but selenop works in a pd5 inhibitor and tadalfil has has some pde6 inhibitor Pathways now what does that mean right who cares if they have different Pathways because of that sometimes one is more effective than the other in people now the other thing to note is that tadalfil lasts about 36 hours so you can actually have multiple sexual encounters after you've taken to dofil over the course of maybe a weekend whereas selenop lasts about 4 to 8 hours so you're only going to really be able to have maybe one or two in that short period of time if you're having issues sometimes can be because you're just starting the medication they have actually shown in multiple studies that if you take these medications over time when you start them the first time the success rate is is lower and as you take it four five six times you're going to see that you're more likely to get an erection and this is probably because it's sort of stressful right when you take something new like is it working is it going to work so as you get more comfortable trying the medication using the medication you get better erections so that's number one if you've been on it for a while and it's a consistent issue like you didn't just have a you weren't really stressed or really tired or other things that could also affect your erections then it's time to think about okay should we try something else so at that point you can either increase the dose of the medication you're on you can switch to a different medication so in this case probably if you haven't tried it already seleny or you can start a low dose of tadalfil every single day the benefit of that is that it sort of takes it it brings the spontaneity back into it right you don't have to think about it you can take a low dose everything single day and Take 5 milligrams and over time you know after about a month you should be able to see if it's working well or not and so that's another reasonable option and ultimately if these things are not working and you're still struggling then please see a eurologist talk about the other options available there's a whole host of other options available including vacuum erection devices intracavernosal injections which are injections that you give yourself to get erections or penal implants I've talked about these things on my channel before so make sure you check out those videos if you're interested in learning more all right next one I pee but even after I'm done I shake it off at the toilet I always find some pee leaking out when I put my underwear back on how do I fix this okay so this is called postvoid dribble or after dribble so this is very very common about 2third of men experience some postvoid dribble or after dribble and why does this happen right it's pretty annoying it's definitely really annoying for most men this is one of the most annoying things they deal with and they are just just wanted to stop right and so why does this happen first off this happens because of a few different reasons most commonly it's because you have an enlarged prostate so all men have a prostate and as you age it tends to enlarge and when it gets larger it can actually block the flow of urine because it as it enlarges it sort of pushes on the urethra or the P tube and makes that that your WRA a little bit more narrow so I describe it typically as if you were drinking from a straw if you drank from a boba tea straw it's pretty easy to drink but if you drank from a coffee tea straw it's pretty difficult you got to suck a little harder so similarly if you have a narrow urethra your bladder has to push a little harder to get urine out and what happens also is that some of the urine gets stuck behind the prostate and so when you finish peeing later that urine can come out what can you do about it well you can take medications to relax the prostate to allow urine to flow better and these are a variety of different medications called alpha blockers like tamsulosin or alfuzosin that help relax the smooth muscle of the bladder neck as well as the prostate to help urine flow better you can also take things like finasteride or dutasteride which are medications that shrink the prostate as well as daily tadalfil which we just talked about there's also some natural things you can try to do to prevent vent en llarge prostate the big ones are exercise moderate intensity exercise 150 minutes per week as well as increasing your vegetable intake and um taking in lycopene which is found in cooked in tomato products and watermelon and you can eat more of that and also cooked Tomatoes can be very helpful but I've made a full video on that so make sure you check that one out as well the next reason for this is a narrowing so it can be an actual narrowing in the urethra that's caused by maybe you had trauma to the area like someone kicked you or you fell on a on a bike seat or you fell on your crotch somewhere um or it can be due to having a procedure if you've ever had anyone put anything in the urethra it can develop scarring if there's you know if there's not enough lubricant or if it for a variety of different reasons it can lead to scarring and so that can make it more difficult to let go of all the urine leaving this a little bit behind for postvoid dribble the other thing is sometimes you just have a weak stream and that can happen with age too in addition to having a large prostate but sometimes that's because the muscles around the urethra are a little bit weak with age and so sometimes doing Keele exercises or strengthening those muscles around the urethra can help you empty the bladder a bit better and also prevent this postvoid dribble I've made two videos on this before as well so if you want a more in-depth discussion on this check those ones out thank you guys so much for joining us today if you guys enjoyed this and want to hear the rest of it make sure to sign up for premium membership at renam malik. supercast docomo answer questions from our premium Members First so if you want your question answered make sure to sign up for our membership and as always we going to take care of yourself because you're worth it

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