#ifeelyoubro: Sexual dysfunction and other insecurities with Sean Low - Podcast Shownotes

All of us deal with self-esteem issues every now and then, and sometimes our gender may play a role in the way we experience and deal with them. 

For men, sexual performance is a common insecurity, but the shame associated with not being able to perform in the bedroom, alongside the pressures of what society defines as masculine behaviour, make it difficult for men to voice out their struggles and seek help. As a result, for many men, sex can be a source of stress rather than pleasure which can then contribute to worsening the problem

Podcast Excerpt 

The following interview has been edited for brevity and clarity 

Egan: Is erectile dysfunction (ED) something all men should be aware of? What are the telltale signs? 

Sean: ED presents itself in two ways. On a simplistic level, it is the inability to get an erection. The other level is the inability to maintain an erection. 

Sabrina: How often is ED a result of something mental and/or physical issues? 

Sean: So there are about 3 different categories. You’ve got the medical, physiological and psychological reasons. For example, oftentimes people who are obese or diabetic would have ED. It’s essentially a symptom of the condition. Physiological issues would show themselves as signs of ageing, whereas as we age, our bodies just don’t function as well as before. When we serve our patients, we sometimes refer them to psychologists. They might be suffering from trauma and it could be something about their relationship.

There’s also something quite interesting called the sex paradox. It’s a psychological thing whereby you don’t suffer from ED but the more you think of it, the higher chance you end up getting it. It’s sort of like being stuck in a loop. That shows how much your mental health plays with your whole body as well. Ultimately, if you’re having bad erections, it is a sign that something is wrong so your body sort of acts as an engine check. 

Egan: Let’s approach another topic of premature ejaculation (PE). Are you able to share any stories? 

Sean: Porn has created this unrealistic expectation of what it is to perform in bed. We have patients coming to us claiming that they have premature ejaculation. These are not 20-year-olds, freshly watching porn. These are 50-60-year-olds. When our doctors asked if they know what premature ejaculation is, they will say that they want to last 30-40 minutes in bed because that’s how long they last in porn and that they can only last 10 minutes. But that’s normal. We cannot compare reality with porn. So there is this difference in expectations and people think that they are underperforming even though they are normal. PE is actually when a man ejaculates within one to two minutes. 

Sabrina: How do you know if it’s something mental versus an actual condition that a man needs to pay attention to? 

Sean: PE is very much tied to your psychology. The first line of treatment for men with PE isn’t medication but therapy - talking to a sex coach or sex therapist and sometimes learning the different exercises and techniques to control things. Medication can help but over time, doctors will also recommend that you use every opportunity to practice trying to last longer in bed. 

Egan: How do we talk about and start addressing such issues? 

Sean: We have to understand that these conditions are health conditions. Sex and genitalia are often tied to manhood. We saw this many times when a young man gets ED or PE, his ego gets hit and he starts feeling embarrassed and less of a man. That’s where the shame comes in. We have to reframe and see it as a health condition. 

For example, erectile dysfunction is often an early warning sign of heart disease. This is because the blood in your arteries is not pumped well enough. So if we can reframe this and look at it as part of a health condition, we can remove the shame. When there’s nothing to be shameful of, people tend to start talking about it and seeking treatment for it. 

Egan: What can partners do? 

Sean: That’s a great question. I would say the first would be to not shame your men. Every man, at least once in their life would not be able to get an erection as hard as they normally would. This could be due to stress and many other factors. What’s great is if the partners do not take it personally or take it the wrong way. The common feedback that we have is that women tend to take it personally 

Sabrina: You’re quite right. I haven’t experienced that personally but one of my female friends shared with me that her partner wasn’t able to get an erection. He said that he had a lot on his mind but she took it personally. She was concerned about not being “sexy enough” and if anything was wrong with her. Furthermore, the bedroom is a place where a lot of personal insecurities come up because we’re so bare and naked right? When we are so physically vulnerable and naked with someone else, other insecurities may come up too. 

Sean: Step two to this is to be there for your partner and being open about it. It’s not something taboo or shameful. Let’s try not to make it all about sex because then he might go down that spiral. It’s a health thing. If it’s a one-time occurrence, that generally happens to guys. It’s only ED if it’s recurring and consistent. That’s when you should seek some treatment or medical help. 

Just like if you have a fever, you have no shame in seeing a doctor. So in the same way, if you have ED, it’s a health thing. We had a patient who came to us for ED. After our doctors diagnosed him and sent him to check it out, he realised he had a heart condition as well. 

Sabrina: I think it’s also important to reassure your partner that you’re with them not just for the sex. There are many other reasons that you’re with that person. 

Sabrina: Can you explain to us, medically speaking, how different medications such a viagra work and help with the conditions? 

Sean: Just to preface, I’m not a doctor. Prescription drugs like Viagra and Cialis are often called PDE5 inhibitors. PDE5 is essentially an enzyme in your body that causes blood to flow out of your penis. What these drugs do is inhibit the enzyme from flowing out, retaining blood in your penis to maintain an erection. You’ll need a doctor to prescribe the medication as there are side effects and could contradict other medical conditions. 

Egan: Is Tongkat Ali just as effective? 

Sean: According to one of our medical advisors, Professor Peter Lim, it increases blood flow to your whole body and thereby increases blood flow in the penis. For this to take effect, you will need to take it daily for at least three months. 

Egan: Hair loss also contributes to a huge amount of affecting a man’s ego. How do we deal with that? 

Sean: A lot of people don’t know this, but hair loss is a young man’s problem. A lot of people’s hair loss problems start young because it’s genetics. The good news is that there are medications that can help with hair loss, so start early. 

In our experience, a lot of hair loss patients who come to us suffer from lower self-esteem, especially those who are younger and suffer from more severe hair loss. When their ego and self-esteem takes a hit, we also recommend they talk to someone as we have therapists available. 

Ultimately, I think the thing about mental health is providing easy and convenient access where there’s a low barrier of entry. What we want to do is to be able to connect you with a professional when you need to talk to someone. 
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Calm Conversations is a podcast series launched and facilitated by Calm Collective Asia. As a means of sharing personal experiences, lessons, and advice, we speak to people from all walks of life about topics that are universally relevant yet often still taboo in the hope of normalising conversations about mental health. 

Available on Spotify, Google, and Apple, you can tune in whenever and wherever. We hope that by listening in, you feel less alone, learn something new, and find the courage to continue these conversations with the people around you. Stay calm!