← Rena Malik, MD Podcast
Rena Malik, MD Podcast
The Biggest Mistake People Make About Being Ready for Sex
00:26:20
In this episode, Dr. Rena Malik, MD explains what’s actually normal in sex by exploring the sexual response cycle, timing, anatomy, and common myths. She debunks misconceptions, offers science-based advice, and emphasizes communication to help listeners feel confident and informed about their sexual health.
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Sex should be easy, right? The reality is that sex is something you can get better at with practice, but it starts with knowing how your body actually works in the bedroom. I'm Dr. Rena Malik, urologist and pelvic surgeon. Welcome back to The Rena Malik, M.D. podcast, your trusted guide for leveling up your health, sex life, and relationships with evidence based tools. I get questions about this topic literally every single day in my practice. Patients come in worried that they're broken. Maybe they're taking too long to orgasm or they're ejecting too soon. They're concerned about their anatomy or confused about why their experience doesn't match what they're seeing in the movies or neurotic films. And you know what I tell them every single time is that you're probably completely normal. So today we're diving deep into what I call Sexual Health 101, everything you should have learned but probably didn't. We're going to talk about the sexual sexual response cycle, essentially how arousal works, how long things typically take, including arousal and sex. We're going to even talk about anatomy and penile and vaginal size, because I know you're wondering. And by the end of this episode, my goal is for you to feel educated, empowered, and honestly, probably a little relieved because here's what I've learned in my years of practice. My most sexual concerns aren't really medical problems. They're gaps in education. And if you want to fill that gap, I have a free resource for you. Check out my free top 10 tips for more pleasure that are based in science@www.renamalicmd.com morepleasure. All right, let's start with the foundation understanding what actually happens in your body during sexual activity. And I want to be clear from the get go, there is no single right way to experience sex. But there is sort of a general boilerplate. So the sexual response cycle was first mapped out by Masters and Johnson back in the 1960s. And while our understanding has evolved, this basic framework is still very helpful. So they identified four phases. Desire, arousal, orgasm, and resolution. But here's the thing. Sometimes what happens is desire and arousal don't necessarily, necessarily happen in order. And this can lead to a lot of frustration. And I'm going to talk more about that later in the podcast. Now let's start breaking it down by what do each of these phases mean? Phase one is desire. You see something, feel something, smell something that gives you desire the urge to have sex. Desire can be spontaneous, like when you were younger. I know, it's like a light switch you turned on and you were ready to go. Or it can be responsive, meaning that as you start engaging and being intimate with someone else, then you start feeling desire and neither is better or worse. They're just different. And I'll tell you guys, recently I had a patient who came in and she was convinced that something was wrong with her because she never felt that urge anymore. And she's like, something's wrong with me. I never want to have sex. But once I started asking her more questions, she realized that when she was with her partner, like they would be intimate and she would try to have sex with her partner, her desire would come in, she'd remember how much she liked sex, and that was responsive desire. And I told her this is completely normal and very common as people are in long term relationships and as they age. So the next phase is arousal. And this is where you start seeing the changes in your body. So for women who have vulvas, blood flow increases dramatically to the genital area, specifically the clitoris, which is much larger than what you actually see on the outside of the vagina. It is actually going deep into the pelvis and around the vagina. So just like the penis, it gets wider and longer. The vaginal walls start producing lubrication. And this can take anywhere from a few seconds to 20 minutes or more. And I want you to remember that it can take up to 20 minutes. The inner lips of the vulva will actually swell and they might become a little bit deeper pink or reddish in color. For men who have penises, blood rushes into the erectile tissue, which creates the erection. The testicles draw up closer to the body and the head of the penis becomes more sensitive and can also change in color. And with both men and women, you will see that your heart rate increases, your breathing deepens, and even your nipples become erect for both men and women. Now here's another thing, guys. Arousal can vary between partners. So sometimes your partner might get turned on a lot faster or slower than you do. And that's completely normal. There's Huge variation in how quickly people become aroused. Remember I said it can take up to 20 minutes for women to get full, fully aroused. Phase three is the orgasm. And most of you hopefully have experienced this. And this is essentially the peak of sexual tension which is getting released and you get rhythmic muscle contractions. And for women, these happen in the pelvic floor muscles, the uterus and the vagina at typically a rate of every 0.8 seconds. And some people will have a single orgasm, some people might have multiple, and some unfortunately don't experience orgasms at all. Up to 12% of women have never had an orgasm. For men, orgasms usually coincide with ejaculation. So they also have tension and rhythmic contractions in their pelvic floor muscles as well as their urethra. But the reality is that orgasm and ejaculation are two separate processes. And like I said, they usually happen together, but they don't have to. So sometimes people will ejaculate, but they won't actually feel the pleasure of the orgasm. And phase four is resolution. Your body goes back to its baseline state, and this is where we could start talking about multiple orgasms. When you reach this resolution period, your body is releasing different hormones. That basically puts you into a refractory period or a time at which it's very difficult or impossible for you to get aroused again. And so usually there's an absolute refractory period, meaning that no matter what is going on, there is no way in hell that you're going to be able to get an actual arousal, an erection, or be turned on again. For guys, this refractory period can vary dramatically in time. Sometimes when you're younger, it can be minutes, like 10 minutes. And as you get older, that can be hours to even a full day. For women, many don't actually have a clear refractory period, which is why multiple orgasms tend to be more common. But I don't think we fully understand this yet. Next up, I want to talk about timing, timing to arousal, like I mentioned, sort of hinted at earlier, as well as time of sex. And this is where there's probably so many misconceptions, because honestly, we are bombarded with unrealistic expectations from the media and from frankly, most of us never learned what's actually normal and what to expect. And so let's talk about arousal first. Here's what the research tells us. For men, visible arousal, which is essentially an erection, often happens within 30 seconds to a few minutes of stimulation. However, and this is really important, that doesn't mean That a man is ready for intercourse. Full arousal is not just physical, but it's also also mental. And that takes time for everyone. I think it's so important that men, like, they're not robots. You're not just ready to go at the drop of a hat. And I think we need to really take time to accept that and understand that. For women, however, physical arousal typically takes a lot longer. Studies show it can take anywhere from four to 20 minutes, as I mentioned before, for full lubrication and engorgement. And the other thing that happens during arousal is the vagina widens and lengthens to allow for the accommodation combination of whatever's going in the vagina. So in this case, likely a penis. And obviously, you need to have full time for that to happen so that sex is not painful. And of course, again, the mental arousal is so, so important. So they have to be in the right headspace to be aroused. And so really quickly, I want to share a story about a couple that came in. So the couple came in because they were having issues with their sex life. And really the. The female partner was having trouble because she felt like she just was never turned on. It took a really long time, and, like, she rarely got there. But when she did get there, it was because they had like, a really sort of. Had spent a long time with a lot of foreplay. And she was sort of feeling guilty like something was wrong, like, why does she need this much attention? And I explained to her and her partner that this is completely normal and actually enjoy it, embrace it, and make it part of your sex life that you're incorporating foreplay and that it's really sort of allowing you. You to get aroused. And it's actually making sex more fun. And just like, knowing that made them feel so much better. And they went in and actually spent time figuring out, like, what sort of things helped her get aroused quicker and helped her feel more in the mood. And at the end of the day, they had better sex because of it. Now, let's talk about how long sex should last, because this is where, again, there are so many myths around this. So the studies are actually done in a very interesting way. They have the female partners use a stopwatch so that when penetration starts, they hit the button, and when the ejaculation happens, they turn it off. And so in this study, they had over 500 couples. And this is from around the world. And they found that the average time for penetrative intercourse, from penetration to ejaculation was 5.4 minutes. Now, the Range was pretty wide. It went from less than a minute to over 30 minutes. But most couples were somewhere between three and 13 minutes. So, guys, people are not having penetrative intercourse for hours at a time. Now, this study, of course, only looked at penetration, not total sexual activity. So that could include, obviously, foreplay and other types of sex, which are very much part of a sexual encounter. So when you look at a real encounter, it typically lasts longer, like 15 to 30 minutes. But bottom line, if your penetrative sex lasts two minutes or 20 minutes, you're both within the normal range. And what matters is honestly, that your partner and you are satisfied with your experience. There's. You need to compare yourself to. And I've had patients who literally come in convinced that they had premature ejaculation because they lasted only seven minutes. And I was like, that's above average. And on the flip side, I've seen people who are worried because they feel like they're lasting too long and there's too much friction. It's too uncomfortable. Again, what matters is how you feel, not what society tells you. Now, here's the interesting thing, and where the. The gap comes in is how long it takes for people to orgasm. For women, the average time to orgasm requires 12 to 14 minutes of stimulation. Now, I just mentioned how long it takes for men, Right? Ejaculation takes about 5.4 minutes. So if you just focus on male pleasure, there's a very high likelihood that your female partner will not orgasm. Now, of course, not reaching orgasm doesn't mean that the experience wasn't great or that something's wrong. What matters is that you're enjoying the journey. Journey and the destination. I think oftentimes we are just running to get to the orgasm as if that is the be all, end all. Yeah, it is great. Don't get me wrong, everyone loves an orgasm, but there's so much more to enjoy about sex. And honestly, sex itself should be an intimate and loving and fun and playful experience. Okay, I could talk about how we need to look at sex differently for hours, but let's focus on where we're going with this. And we talked about normal in terms of sex. Now let's talk about normal in terms of genitals. Specifically, let's start off with penile size. Now, how long is the average penis? 5.1 to 5.6 inches. And this is looking at multiple studies for men around the world. And the range of normal can be anywhere from 3 inches to 8 inches. But it follows a bell curve. So the majority of the people are going to be at the top 5.4 inches. It's going to be very unlikely to find somebody with an 8 inch inch penis and very unlucky to find somebody with a 3 inch penis. But here's another interesting point. When researchers ask people to estimate the average penis size, they usually guess much higher than average. And that's because, right, you're seeing a very small selection of penises in real life from the media, from adult films, and you're typically not seeing genitals in non aroused or flaccid states. So I've had guys come in all the time who are well above average, but they're so anxious about their size and, and feeling like it is actually affecting their entire relationship and how they look at themselves. And this is why knowing what's normal matters so much. And let's talk about girth too, because that's actually probably more relevant because as the penis is a little bit more girthy, it can stimulate the legs of the clitoris more easily. So the average erect Circumference is about 4.5 to 5 inches, with normal ranging from 3.5 to 6.5 inches. Okay, now this penis that you have has to go somewhere, and that's into the vaginal canal, which also has an average size. So the unaroused vaginal canal is about 3 to 4 inches deep, but as I mentioned before, it changes. So during arousal, the vagina lengthens and widens. It's something called vaginal tenting. And it's amazing, right? The vagina can prepare for sexual activity. And so when you do that, you can imagine that the average vagina probably fits the average penis. Now the vulva, which is everything on the outside, can vary tremendously from person to person. The labia or the lips can be long or short, symmetric or asymmetric, light or dark. Now this is really important because again, just like we only see certain penises in erotic films, we also see certain labia in erotic films. And the reason this is important is because those labia are chosen so that you can see more of what you need to see during the erotic film. Because they want the right camera angles, they don't want to hide anything. And so you're not necessarily seeing the wide variety, but it is all normal. And so many women, just like men, feel worried about penile size. A lot of women feel sort of insecure about what their labia look like. Now, the clitoris itself is again, that the little bud you see on the outside. But it's also mostly Internal. And that can vary in size and sensitivity from person to person as well. Another myth I often hear is that vaginas are too loose or that they've been having too much sex with too many different partners. Now, guys, let's think about this critically for a second, right? If you are a person who's been married or in a solo relationship and you've had sex with that person thousands of times, no one's calling you too loose. But if you've had multiple partners and you've had a thousand partners and had sex with each of them once, now people are automatically thinking you are too loose. The reality is that looseness has nothing to do with how much sex you have, because your body is meant to be adaptable. We literally give birth to children through the vaginal canal. The vaginal canal snaps back. It's a very adaptable structure. And so really, what causes looseness is not sex, is not how many partners you have or how large those partners are. It's about your pelvic floor muscles. So when those muscles weaken, and that can be due to having a lot of children, it can also be due to neurologic issues. It can do genetic issues. In fact, I just saw a patient in my clinic recently who had, like, really small babies. But she has a family history of weakness in the pelvic floor. Her grandmother struggled with it. Her mom struggled with it. Meaning that there's likely some alteration in the makeup of the tissues that make them more likely to become weak over time. That's what causes looseness. Now, in terms of tightness, again, I think people think that tightness is a good thing. Now, if your pelvic floor is always tight, that means that it's not functioning normally, and it will likely hurt during sexual intercourse. Does not mean that's a good thing. You want your vagina to be normally functioning. It should be able to tighten. It should be able to relax, and it should never be painful to have sex. Bottom line, having sex with someone isn't about matching, like, some ideal measurements. It's about actually talking to each other, making sure there's enough time for desire and arousal and allowing lubrication and just enjoying the experience. And the reality is, guys, it is not about how large your penis is or how large your vagina is. It is about actually talking to each other, understanding what feels good and allowing for time for arousal and lubrication and your body to the normal things it does to prepare for sex. And I've seen couples with every possible combination of anatomy find ways to have very satisfying sexual experiences. In fact, we had the man with the largest medically verified penis. And on the podcast, you can listen to that episode because it's so interesting. You would think that he has amazing sex all the time. And that's not actually the case. Now, I want to talk about a few of the other myths I hear about all the time. And the reason is that these cause so much unnecessary anxiety. And so knowing the facts can help a lot of people. Number one, real orgasms only happen from penetration. Now, this is completely false, as you guys know, if you've been on my channel before or you've been here on the podcast before, the clitoris is the most reliable root for orgasm. It does not require stimulation from penetration necessarily to have an orgasm. And the Clitoris has about 10,000 nerve endings. That's more than the head of the penis. It's the only organ in the entire human body that's there just for pleasure. What you need to focus on in terms of allowing for female orgasm is stimulating the clitoris in a way that your partner enjoys. So you have to ask them and talk to them and figure it out. I promise they will be happy that you care about their pleasure. All right, Myth number two. That sex should just automatically be amazing, and if it doesn't happen naturally, you shouldn't have to work at it. This one drives me nuts, because good sex, just like anything else, is a skill, and it requires practice, communication, and education. And there's nothing wrong with learning techniques or using things like lubricant or other things in the bedroom and taking time to figure out what works, because sex can be amazing with any partner. You just have to work at it. And working at sex is great because at the end of the day, that means that you will have sex worth having, that you both desire, that you both want, and that you both enjoy, rather than going through life trying to find the one person where you magically connect sexually. And that's very unlikely to happen. Next myth is that you and your partner should want to have sex the same amount all the time. Guys, this is impossible. Sexual desire varies enormously between people and even within the same person. So depending on hormones, stress, how long you've been in a relationship, how satisfied you are with that relationship, your other health conditions, maybe medications you're on, all of these things can affect how much you feel the urge to have sex. And there's no normal for how often you should have sex. But I obviously encourage people to have sex regularly because I think it's such an important part of being intimate, of feeling connected with another human being. And there's actually data to show that it improves longevity. And you can check out my video where I talk about how having sex more often is linked with living longer. And if you guys are struggling with different amounts of sex drive, it is important to talk about it, to figure out ways where you can sort of include intimacy and work on building that into your lives as a regular thing, whether that includes sex or not. But it really is important because a lot of times men will see sex as the only time that they're intimate. But there's value in being intimate without actually having sex. And I think incorporating that in your relationship will only let you understand and feel desire and enjoy each other in a way that you didn't before. And myth number four is that you should always just feel desire, like on demand, or it should be spontaneous. Guys, I've talked about this throughout this podcast multiple times, but it's so important that I want to bring it up again. Responsive desire, meaning where you feel aroused first and then you feel desire, like, sort of like going to the gym. Oftentimes you don't feel like actually going to the gym, but once there, you're so glad you did because you actually feel great. And it's the same thing. It's allowing yourself to feel aroused, be intimate, and then feeling desire afterwards. And this is completely normal. And a lot of people, women and men, include experience desire in this way. So you have to be open to arousal, but also cultivate an environment where desire can flourish so that you can actually sort of feel aroused and feel desire throughout the day, not just during sex. And lastly, the myth is that pain with sex is normal. Guys, pain with sex is never normal. Now, sometimes the very first time you have sex, it might hurt because you're just not giving yourself time to allow for lubrication. But if you're having persistent pain every single time you have sex, please talk to a doctor. Don't just drink a glass of wine and relax. That's not going to work. You need to figure out what's going on. On. Okay. Lastly, I want to wrap up with some practical steps that you can take starting today to help improve not only your sexual health, but your confidence in the bedroom. Step number one is reframe your relationship with normal. Instead of asking, am I normal? Start asking, am I healthy? And am I satisfied and happy with my sex life? Normal is just arrange and likely. You are normal, but what matters is how you feel. Are you enjoying your life? Do you Feel like you're having a very good and pleasurable sexual experience. Great. Who cares what's normal? Step number two is talk, guys. This is the most boring advice, but is the most important advice. You have to talk to your partner about what feels good, what doesn't, what you want to try, what you're curious about. And realize that this is going to take time. You're going to have to actually sort of take small steps towards opening up lines of communication about something that most people feel very awkward about. And you could even try things like, hey, I learned something really interesting today about sexual health on Dr. Malik's podcast. I'd love for you to listen of this. Maybe we can talk about this later. Start with really positive things and just get used to talking about sex. And I promise you it will enhance your sexual experience and your bonding as a couple significantly. And step number three is I want you to focus on the whole experience, not just the destination, is enjoy being connected, touching, intimacy, and of course, enjoy the orgasm. But what I want you to enjoy is the time it takes to get there because that's when you really start noticing, you know, being mindful, being present, and then ultimately having more intense and enjoyable orgasms. And step four, if you're having issues like you're having pain or you're really upset or distressed about your sexual function and it's affecting your relationship, don't suffer in silence. Talk to a doctor who's an expert in sexual health or a sex therapist or somebody who is can help walk you through these issues. Because very often, once you've been diagnosed, we can help you get better. Better. And lastly, step five is keep learning. And one way you can do that is by subscribing to this podcast. Subscribe, follow wherever you're listening to this. Because sexual education shouldn't stop after just this one episode or after one conversation. Keep reading, listening. However you learn best, just find education on sexual health and don't be afraid to ask questions. Now, your homework for this week is have one conversation about sexual health. It can be with your partner, which I prefer. It can be with a friend, or if you don't feel comfortable, just write something down with yourself in a journal and think about what you learned today that challenged your baseline assumptions and what you want to learn more about. And as we close today, I just want to leave you with one thing to remember. Your sexual experience is yours. It doesn't have to match anyone else's to be valid, healthy, and and satisfying. And remember, the range of normal is huge and again, what matters is how you feel, not what's normal. Communication and education will probably help alleviate a lot of your sexual issues, and your body and your experience are yours. So if you guys felt like this episode made you feel more confident, taught you something new, make sure to share it with somebody who might benefit because because sexual health education is a human right that everyone deserves, but the large majority of people never received. And as always, you want to take care of yourself because you're worth it.
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