
In this episode, Dr. Rena Malik, MD and Dr. Jim Pfaus explore the myths and science behind semen retention, compulsive sexual behaviors, and the neurobiology of orgasm. They offer expert insights into how anticipation, mental health, and guilt can shape sexual experiences and satisfaction, providing listeners with a clearer understanding of sexual well-being.
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Interviewer
Style, every home, there is a movement, right, of people who sort of believe that semen retention allows you to sort of maintain that arousal and you can orgasm without ejaculation, which we know is true. You can orgasm without ejaculation. But I want to know, is there a physiologic basis from an expert, obviously, is there a physiologic basis for that?
Dr. Jim Faust
Not for semen retention, all that, what that's really doing, you know, they call it semen retention, building up my testosterone. Your testosterone levels are actually going to go down over not having sex, whereas having a lot of sexual testosterone. You don't lose your testosterone when you ejaculate. Your, your semen doesn't contain this huge amount of reservoir of your body's testosterone that you're now like leeching into this other partner. It's, I mean, that doesn't happen at all. In fact, it's just the opposite. But what's even retention, what the act of that does is it makes you wait, which makes you want it more. So when you finally have it, it feels better being put off, being teased, being, you know, edged not in the orgasmic way, but edged in the sort of more anticipatory way. It's like, oh, I know you'd like it now, but I don't think so. I don't know, maybe tomorrow, maybe if you're good, maybe tomorrow. You know, so there's like a little bit of that game playing that can happen between people. And of course, when tomorrow comes, even though you had sex 48 hours ago tomorrow, you are, you are ready to go because it's supposed to be today. Yeah. And so I think what happens with this idea of semen retention is that they're just delaying it and delayed gratification. There's a curve, an inverted. You say curve to that, but, you know, as long as you're delaying it up to optimality. Yeah. Then it's going to feel good. If you delay it any further, it's going to feel not so good. Right. In. In the sense that you've now delayed it. You don't even care about it anymore. Right. And that can happen too. And that does happen, unfortunately, with some individuals who believe in this so much that they then sublimate it to go with their daily workout routine. So their workout routine kind of becomes a sublimated sexuality, if you will. Because now it's like, I'm working out, I'm working out, I'm working out. And they get into that almost as a, you know, as a compulsive behavior. Right. Which I think some of that really is. Unfortunately, again, it's a different habit that now inhibits what you're really trying to do with it. Right. Which is kind of not what you would think is going to happen. So I don't think semen retention does that. Well, we know this from hypnosis, okay. You can hypnotize people to have orgasms, and when they do, men don't ejaculate, but they have kind of a motor memory of orgasm in their brain. Their brain knows what an orgasm is. And despite not ejaculating and not even necessarily having, you know, the. The little creep out of fluid, but they have an orgasm and their prolactin goes up. Okay. So. And that happens in women as well. And there's not really good evidence that they even get vaginally lubricated under hypnosis. You can make them get vaginally lubricated if you say, oh, and you're going to feel this vaginal lubrication and blah, blah, blah, because you're activating motor memory. Kind of like riding a bike. Right. You know, if you've never had an orgasm, when you hypnotize people to have an orgasm, they can't because they don't know what it is. Their brain has no idea what it is. If you've never ridden a bike, and I try to hypnotize you to make believe you're riding a bike, you don't have the sensations of it, you know, Whereas if you have ridden a bike, then you do have the sensations because you're activating essentially the. The motor cortex. You're activating the memory of that, right? So that you can experience the memory of doing it, which you know is a whole body experience. And orgasm is that way too. What's interesting is that prolactin goes up and it goes up as if you were masturbating, right? It's at the levels of masturbation. Prolactin are always lower than partnered sex, but it goes up to masturbation like levels. So I find that, I find that interesting in the sense that yes, the orgasm is real, but it's a motor memory of it that doesn't involve necessarily the climax and the seminal emission and the activation of general lubrication, unless that's part of it.
Interviewer
And I think you brought up an interesting point before you started talking about hypnosis, was that if you go too long with semen retention, you then sort of don't want it anymore. And is it, do you think, in, in cases where there's like compulsive behavior around sex, those are the people who really feel that, like mental clarity that o, oh, I'm finally not thinking about it. Is that the people who tend to benefit the most, you would guess?
Dr. Jim Faust
Yeah, I think they benefit from it. But one of the problems with the semen retention thing, it's almost like the problems of a 12 step program where you're always thinking about it but not doing it. And so relapse is really high. 12 step programs for alcoholism, for example, relapse is way high. Taking heroin, it's, it's even higher because you're always thinking about it like, don't do it, don't do it, don't do it. You want to do it, but you're not going to do it because. And if you think you're going to do it, call somebody who's going to come on over and help you not do it. And people who are into that, into semen retention and into like the no fat movement, for example, they've got like hundreds of people that they can call and say, I need an intervention. I feel like I'm going to touch myself. You know, it's almost like watching, I don't know, Dr. Strange Love, when he's trying not to do a Nazi salute and he's grabbing his arm and forcing his arm not do it. They're like forcing their hands not to touch their penis. Don't touch my penis as I need porn. And if I look at porn, then I have to touch my penis and somebody come over and stop me from doing this. And, yeah, I think because they're always thinking about it, then you always have this greater propensity for relapse. And I don't want to talk about it, like, as an addiction, because I don't really believe that you can become addicted to your own neurotransmitters. But I think that with them, it's so compulsive and their impulse control is so low, you know, and again, even that wafts and wanes. Right. So when it's wafting, it's much more difficult for them to gain control. Yeah. And then when they have this mental clarity, it's like, okay, I know that I'm not going to touch myself. But they always sublimate it into something else.
Interviewer
So they transfer it to something else. Yeah.
Dr. Jim Faust
Does that help? Maybe. But maybe getting them to have a, you know, a more realistic view of their own sexual needs. Right. And not to kind of be married to this notion that, oh, my God, every time I ejaculate, like I'm losing all my testosterone, it's like, no, you're not. You know, and maybe understanding that is important to get them not to be in this. Oh, my God. I. I can't. Oh, my God. I have to stop myself. Oh, my God. I have to think about it. Oh, my God. Don't think about it. No, no, don't think about it. No, don't go to. Don't go, oh, my God. Porn, porn, porn. I. Yeah, and then they're. And then they're lost, and then they got to start over, you know, Whereas if they had a better idea of their sexuality, it would be, you know, something they wouldn't have to be like, you know, getting the monkey off their back.
Interviewer
Yeah. So you mentioned one of the. I think the big myths is that, like, when you masturbate or watch pornography, let's say, because that's actually what people say is when you watch pornography, your brain's response is so different from that of when you orgasm with a partner. So let's talk about the science behind. Behind that. What happens in the brain?
Dr. Jim Faust
Well, it's exactly the same as when you're with your partner, but not at orgasm yet. But the orgasm is going to be exactly the same too, especially when you feel guilty and when you feel like you shouldn't do it, you're trying very hard not to do it, that creates an even greater dopamine response. Right. It's something that. That a guy in Germany called Wolfram Schultz studied that when you predict that a reward is going to come and it doesn't come. So he calls that reward prediction error. When that happens in your brain, your dopamine's like, okay, wait a minute. Whoa, hold on. Timeout. What the hell's going on here? I thought it was going to come, and now it doesn't come. So rats, if they're bar pressing for a reward and it doesn't, you're. You're looking at their dopamine in their, like, nucleus accumbens or the mesolimbic system. Yeah, it goes up. It stays up. It stays up. The reward doesn't come. And now it goes up even further and it activates the motor system to try to figure out, well, what the hell? Like, I bar pressed. I bar pressed 10 times. I'm supposed to get a pellet. I didn't get a food pellet. What the hell? So they bar press even more. We see this in human behavior, right? You press the button to get the candy bar out of the machine. The candy bar doesn't come. So what's the first thing we do? We press the button like 50 more times to try to get the. To try to get the candy bar out. A perfectly natural response, right? And it's a bar pressing response, just like rats do sexually. It's a similar kind of thing. Don't do it, don't do it, don't do it. So you're thinking about it. If we look at, for example, their ventral striatum, right? Which, you know, voom. Did in a paper, you know, with fmri. Well, the ones that say, oh, well, I've got, you know, compulsive sexual behavior disorder, or I've got porn addiction or whatever, they come with that area already because they know they're going to see porn. They come with that area now already massively activated. Whereas people that don't identify as sex addicts, for example, don't have that, right, because, well, it's no big deal. I'm gonna see porn. Big deal, right? I always see porn. Doesn't mean anything to me except I masturbate. So it's no big deal. But these guys come with, oh, my God, oh, my God, I'm gonna see porn. Oh, you know, And. And now the dopamine response is much greater because they have this reward prediction error that's happening. And guilt is a great driver of that. I shouldn't do this, I shouldn't do this. Oh, now it's much greater because you want to do it. And if you shouldn't do it, then you're not going to do it, but you're going to think about it more. And that's beautiful. Reward prediction error.
Interviewer
So just build this cycle.
Dr. Jim Faust
Yeah, and that's why we think the brain is different. But it's not. And when they ejaculate, when they have an orgasm, you know, if I could be taking their blood, I would see, I'm sure I would see that the prolactin goes up and probably go up just like it does with everybody else who, who masturbates or has partnered sex. So it's. And if I could, you know, put a probe in their rectum, I could see their pelvic floor activation. I'm sure you get this massive pelvic, you know, pelvic floor activation is like an earthquake. So you would see this earthquake, you'd see the prolactin go up. I would venture to guess it probably wouldn't go up any differently than it would in somebody who was kind of a yolked control to them. Okay, I haven't had sex in like three, three weeks. Okay, so you're now yoked to the anti. No FAP guy who's going to come in. And now we're going to do this study and yeah, I, I bet you there's going to be no difference.
Interviewer
Right.
Dr. Jim Faust
And again, you also see this in people who don't identify that way. And they look at porn, you know, more than twice a week, they masturbate, they do everything, but for them it's no big deal. And we bring them into a lab, they have no problem getting an erection. They have no problem. These other guys are worried about it, right? They think they have porn. Porn induced erectile dysfunction. No, what they are, is in a very long refractory period because they cranked off three ejaculations yesterday and today they can't get an erection because they're still refractory, you know, so lay off it for 48 hours and it's going to come right back.
Interviewer
You think they're. That their refractory period, like in. Do you think there's a difference? Because, so, you know, the thing about refractory periods, at least biology wise, some people have really short ones, especially when they're younger. As they age, it gets longer. So do you think that those people who are having, let's say like three ejaculations in one day from pornography are, are different or. Because you would suspect that after you're right, probably 48 hours, it should all be good to go. But like, are they like masturbating so often that Their effective is always on.
Dr. Jim Faust
I think for the ones that say they have quote unquote, porn induced erectile dysfunction. Yeah, yeah. It's like, it's, it's on until they start, you know, looking at the dark web and finding porn that they've never seen before of things that they know are naughty and maybe even illegal. Right. And so they find that and they're, oh my God, now I'm aroused. I've never seen a woman have sex with a dog. And oh my God, look at that. Holy toot. And suddenly they have an erection again. Because if you think of the war between dopamine and serotonin, because they're always mutually inhibiting each other. Yeah. So adopt me is high, serotonin is low. When, especially in the frontal lobe. When serotonin is high, dopamine is low. And. And it cycles naturally, right? So if dopamine is low and serotonin is high. But I see something that's now going to like, like raise this above that level. Well, now I'm, I'm here and now I can get my erection again, Right. And if I keep on masturbating to that particular set of images, well, now habit's gonna make this happen and you're gonna be like, oh my God, I am an addict. Because now I need to get, you know, more stimulated in order to achieve that. And again, just if you don't do it when you want to do it or when you think you should do it, because you did, I don't know, three yesterday, so you should do three again today. You know, it kind of reminds me of people that do like, you know, 60k runs every day. They don't do 60k. If they only do 59k, they're going to get fat. So, so the, you know, this obsessive compulsive kind of thing which is driving that behavior is now driving this particular behavior because it works, but it only works for a short period of time. Which is another thing about individuals like this. The comorbidity with anxiety and depression is huge. And I think what's happening for some of these people, if not most of them, is that they're, they're using sex as almost like a way of self medicating against their depression, you know, so it's like, you know, they ride this roller coaster. They're down, down, down, whoa. But now they have this, but they're still down, right? And then they have another whoa. But they give up. And now they're down again, right? It's a momentary Relief of the depression.
Interviewer
Just talk to Dr. Prowse recently, I mean, maybe like a few months ago, and she had done some preliminary research, it's not published yet, that looked at people who were defined as having compulsive sexual disorder. And there was such a huge commingling of depression that maybe we're actually. If we treat the depression, we'll actually treat the compulsion.
Dr. Jim Faust
Interestingly, putting them on antidepressants, especially SSRIs, helps to do that. And it helps to do it because now you're amping the serotonin, so the dopamine is now, you know, and you're. You're kind of. Instead of the dopamine, always going way up, right? Now it's. It's now back in this normal little cycle, right? And you can start then to treat the whole set of behaviors. I mean, some people use sex, some people use eating. That's their way of treating their depression. Some people use skydiving and other obsessed, you know, and some people just get obsessive about what they do. Oh, my room is all tidy now. You know, I gotta tidy my room every day because, you know, I'm putting my life back together. But. No, you're not. You're putting your room back together, but your life is still a shambles. And you're not dealing with that because you're dealing with this other compulsive behavior, right? And so it's. Yeah, and. And neurochemically, you're kind of realigning the system, you know, which is what they need.
Interviewer
So is it a compulsion or is it an addiction? Because one could argue that if you need more novelty or more intensity to get the same result, that's sort of a facet of addiction. But is it that or is it, Is it a compulsion?
Dr. Jim Faust
Well, it's. It's also a facet of compulsivity, right? Because you're always doing something to make sure that it works. And usually it never works. So you got to do it better the next time. And even. And when that doesn't work, you do it better the next time. You're better the next time. People have seen this like in. In serial killers who are showing compulsivity, where if they screw up this time, then they're not going to screw up next time, but they do because it's kind of built in. That's the inherent nature of compulsivity. I think one of the reasons why. It's not two things happen that make it not an addiction. Two very important things. One is that there's no withdrawal effect and there's habituation, but not tolerance because tolerance and withdrawal build up together. So for, for example, if you're a heroin addict, heroin being diacetyl morphine makes it a beautiful analgesic. I mean, you need less heroin to, to have an analgesic effect. What you see happen in withdrawal, in addition to, you know, the hallucinations and everything that happens with them, you also see that they become hyperalgesic. So things that, you know, touch that would be normal. Like, you know, you know, oh, don't, you know, here's a little love tap, you know, don't do that. It's like, ow, what have you done to me? Ow, you broke my hand. Ow. It feels like my hand is broken. Okay, no, your hand is fine. But you now are developing showing the super sensitivity to the opposite effect of the drug. Because your brain and neurons do this just on a neuron by neuron basis. If you tweak them a certain way, they re establish homeostasis under the tweakage. So if my drug is constantly depressing the pain system, the reestablishment of homeostasis, which is tolerance, means that now I'm going to show a normal response under the influence of the drug. Pull the drug away. Boom. Now I've got a much hyper response. Which shows you how the cell itself was reestablishing its homeostasis, right? If you can't hear something, you turn up the volume, right? But now the volume's up and you know, you turn on the radio or the TV in the morning and the volume is really up and you're just like, oh my God, like what? Ow, that hurts my ears. Right? But last night it didn't hurt at all. It was perfect for the movie you were watching. Tolerance and withdrawal co occur. Now what could we say about being in a refractory period? Like let's say they're in a refractory period, but they're going to call that the addiction, okay? They want it, they crave it, they, they need it. They, you know, they need to have it. But now their penis doesn't work, okay, so I'm going to go off porn. What should happen if tolerance of withdrawal had built up is they should be walking around with an erection, like almost priapistic erection the next day and the day after and the day after until that kind of weans down. But that's not what happens because habituation is built up, not tolerance. Addiction just takes it one step further because you're actually putting A foreign substance in there that is now doing what your neurotransmitters can't do. Whereas porn activates your neurotransmitters, but it doesn't activate a foreign substance. Right, That's. That, you know, like, yeah, you know, is now antagonizing a receptor for a really long period of time so that the. The neurotransmitters can't get on at all. So the cell has to, like, say, oh, I'm not hearing the neurotransmitter. I'll make more receptors for it. Right. So now I can turn up the volume. Yeah. So it. Your brain doesn't do that to natural stimuli, but it does it to these, to. To a drug because it's kind of taking over the system, like pharmacologically taking over the system and doing something to that system physically that your own neurotransmitters can't do, but your own neurotransmitters can do a lot like it. Right. And it's not to say that they don't have a problem. I think they. I think they do. And that problem really needs to be taken care of one way or another. But it's. It's just too easy to say, oh, well, I've got porn addiction, so therefore, you know, I don't have to take responsibility for my actions because I'm an addict. Right. It's too easy. It's too easy to do that and then rely on that as. As your reason for why you cheat or your reason for why you, you know, like, I mean, God, we saw this with Tiger Woods. Yeah. I mean, Tiger was having sex all the time. Right. And as long as his wife didn't know about it, things were in balance. But once she did, she attacked him with the golf clubs. And then everything, well, everything went down. His golf game was destroyed because it was riding on his arousal. Right. So his golf game and his. And his sexual behavior were kind of co. Occurring with each other. And once the sex went down, the golf plummeted as well, which I think is really interesting.
Interviewer
Yeah, yeah, because he needed that. He. His brain had sort of habituated to that level of arousal.
Dr. Jim Faust
Yeah. And I mean, you saw him play. I mean, I don't play golf, but I was never excited by golf until I watched him just go and just do it like, you know, a Zen master, you know, with his eyes closed, just. Just like, oh, making shots that were, like, incredible. And you'd see this, and it was just like, oh, my God, like, what is sustaining that and, well, now we know.
Interviewer
If you guys enjoyed that clip, make sure to check out the full video with Dr. Jim Faust right here.
Podcast: Rena Malik, MD Podcast
Episode: “Moment: Neuroscientist Completely Destroys the Semen Retention Myth”
Host: Dr. Rena Malik
Guest: Dr. Jim Faust (Neuroscientist)
Date: October 28, 2025
In this focused episode, Dr. Rena Malik sits down with neuroscientist Dr. Jim Faust to break down the popular but controversial topic of semen retention. Together, they dissect the myths, clarify the science, and explore the psychological and neurochemical realities behind masturbation, orgasm, compulsion, and purported “addiction.” The episode gives evidence-based insight into sexual health, busting myths that flourish online but have little biological basis.
This episode offers a clear, science-informed rebuke of the semen retention myth and the broader panic about masturbation and porn “addiction.” Dr. Faust explains that much of the supposed benefit of retention is delayed gratification or psychological, not biological. There is no testosterone “wasting,” no hidden hormone reservoir, and most so-called porn-induced dysfunction is the result of normal physiology or compulsive behaviors often linked to mood disorders—not true addiction.
Listeners looking for actionable advice: