Libido

[00:00:02] Speaker A: Hello, everyone, and welcome back to another episode of Gay Men Going Deeper. This is a podcast by the Gay Men's Brotherhood where we talk about personal development, mental health, and sexuality. Today, I'm your host. My name is Michael Diorio. I am a life and wellness coach, and I specialize in sexuality, self confidence, and relationships. Today we are talking about libido, one of the big topics of our community. But today, what we want to do is demystify a lot of the concepts around libido and answer your burning questions. So some of the things we'll be covering today are what role does aging play in your sex drive? How can you even tell if your sex drive is high or low? What causes a loss of libido, and what can you do to increase it? So to help me with this, I brought on my special guest today. He is Dr. Hector Rodriguez, who is. Has actually been on the show before. For those of you who are avid watchers and listeners, Dr. Hector has done a show with us called Shiny Object Syndrome, which is episode 92, and intergenerational relationships, which is episode 119. So thanks for coming back to the show, Hector. Why don't you go ahead and introduce yourself to our audience, Maybe those who have not had a chance to listen to those episodes yet. [00:01:18] Speaker B: Well, first of all, thank you for having me again. I love always coming back. And I'm Dr. Hector. I'm a psychiatrist and I work with the Amen clinics, especially in the office in South Florida. But I see patients throughout the world, which is kind of interesting what I get to do. And I do specialize a lot with just different kind of sexuality or sex related topics, whether it be past sexual traumas and libido. [00:01:48] Speaker A: Perfect. Yeah. I have actually loved our episodes that we've done together, Hector. And I know that if you. If you go to the YouTube comments of the show, there's so many great questions and comments there. So I'm sure this will be just another one of the same. [00:02:01] Speaker B: Yeah, I'm pretty sure. [00:02:03] Speaker A: All right, so what I want to do before we jump into the questions is I want to just do a little intro and start off by defining what libido is and why. Specifically, I really wanted to do this topic and then we can jump into everyone's juicy questions. Okay, so I googled it because Google knows. And so it came up was libido is defined as the instinctual desire for sexual activity, and it varies widely from person to person. Does that make sense, Hector? Just want to get the expert approval. Okay, good. So here's why I wanted to do this topic. So I coach mainly gay men in my, in my coaching practice. And there is a stereotype out there, I'll call it, that men, specifically gay men, are sex obsessed, that we have a lot of partners and that we're always on the hunt for sex and so on. And while that may be true for some, it certainly is not true for all. But what happens is, especially in the gay community I see, is that we put a lot of value on our sex drive, especially if it's a high sex drive, on our virility, if you want to call it that. So the, our sense of identity is very much tied up in our libido. You know, it's tied up in our masculinity, the way we, the way we see ourselves, our self confidence, our self worth, worth around being men, and specifically gay men. So there's a lot at stake, if you think about it, when it comes to the male sex drive, especially if you're using it to identify your sense of confidence and self worth and masculinity. So it's not uncommon. I would say this is me speaking personally, at least in my social circles. It's not uncommon to feel a little bit of pressure sometimes in certain environments to boast about one's sexual prowess and sex drive and talk about all the notches in your bedpost and so on. So I think it is an unset expectation, I'll go as far as saying that, that men should have a high libido and that's what contributes to our sense of masculinity. And actually this is even true for not even gay men. I probably say that straight might probably feel a little bit of the same. Their sense of masculinity is probably tied up as well in their libido. So if you have a low libido or if it decreases over time, it's a cause for concern for a lot of guys out there. And, and what makes this worse, I would say, is that we tend to not have honest discussions about this. Right. Like, listen to the words that I'm saying here. High libido, low libido, what does that even mean? What is high? What is low? But is there, is there a measurement out there? And I think a lot of guys don't really talk about it. So I run a workshop, workshop for World Sexual Empowerment 101. And one of the things we talk about is libido. And in that particular session what happens is they'll say, I've never actually talked about this with other guys in this way. Right. Like, what are we actually talking about? So if it's something that people are concerned about, I wanted to have this podcast because here we have Dr. Hector, who's, like, the perfect person to ask our questions to. And a lot of guys are also. They will. They will say that they're hesitant to speak to their doctor or hesitant to speak to anyone about this because there's maybe, you know, a little bit of shame involved or they don't know how to say it. But the problem, of course, is having these unanswered questions results in a lot of misinformation. So that's why I wanted to do this podcast. I want this to be maybe like the first step you go to for answering some of your questions, and hopefully Dr. Hector can answer those. And then, of course, we want to advocate for talking to your own doctor, if that's something that's required. So we all experience. I should say we all, a lot of us experience sexual pleasure or have the desire for sexual pleasure that happens in our body. Right. We think of sex as very much of the body, but the sex drive lives in the brain. So I'm not a doctor, but Dr. Hector is. And so today we're going to answer a lot of these questions on libido. I'll chime in with my own two cents, with my own personal stories, but Really, I chose Dr. Hector because he's gay, he's male, he's a doctor, and he deals with these issues all the time. Right? [00:06:03] Speaker B: Correct. And I think a lot of the things that you just said were. Are very true. [00:06:07] Speaker A: Yeah, yeah. [00:06:09] Speaker B: Gay men. [00:06:10] Speaker A: Yeah. We don't like talking about this stuff, but I think it's necessary. So let's jump in. The first question that I have here, which is probably the number one, and I think you had said the same Dr. Hector, when we were preparing for this, is what role does aging play in your sex drive, and is it normal for it to decrease over time? [00:06:32] Speaker B: So, I mean, as we just finished talking about, I think since we value or we put so much weight on our sex drive, especially within males, and they don't have to be gay, by the way. I think males in general just boast about their sexuality and their sex drive and. And, you know, to think about it, just all humans in general, we have a sex drive. And I. I actually consider it like, sexual appetite. Just like we have food appetite, we have sexual appetite, and sometimes that's increased, sometimes that's lowered. But honestly, as we age, there's actually a Lot of factors that come into play. The biggest one is hormonal changes. I know we've heard of menopause, but there's actual something called an andropause, which is something that happens in males. Our testosterone levels start dropping after around our late 30s, early 40s is when it starts going down. But we've also seen, like, across the board, everyone has been having low T. T levels. So I check my T levels on all my patients. There's a lot of theories out there that it could be just hormones in our food nowadays compared to like 50, 60 years ago. But in general, the population has been decreasing in these sex hormones. So it's a big area of concern. Um, so when we have a lot of people with, you know, they show up with low energy, like, they look like they have depression, and in reality, they just have very low T levels. T levels in my head, I associated with dopamine. And dopamine is our go, go, go, exciting neurotransmitter in our brain, but it also increases pleasure. So I think across the board, there's this also this drive for. For people looking for boosting their dopamine. And I think one of the big factors underlying that is low T levels in everyone in the population. So it's kind of interesting because it. This topic we're talking about libido, but it does open up a lot of other behaviors and other things that people are doing to kind of boost that low lethargic kind of feeling, which is pretty much low T, low dopamine levels. Other things that happen as we age is just our physical health starts deteriorating. Like, we don't take care of ourselves as much. We gain a little bit of weight. And what happens when we're overweight? Well, testosterone turns into estrogen and fat. So the more fat percentage we have in our body, again, the lower T levels we could potentially have. And then there's also the psychological factors. I mean, we look at. At everything, right? The physical, psychological, the spiritual and the social components. There's also medications that can lower your T levels. And as we age, we start having conditions that require us to take medications. So then some of those can. Can lower T levels, but also just libido in general. So those are some of the main ones that I would say, as we age are huge factors in lowering our libido and our sex drive. [00:09:50] Speaker A: Okay, what is, what is the T level exactly? [00:09:54] Speaker B: So in men and women, they're different levels that we would expect as normal. I treat a lot of men, so I always look For a number greater than 500. I like the, the total T between 500 to 700. Those are healthy numbers. But there's also a huge rise within the gay community of using anabolic steroids. So that's an app, an exogenous way of getting your T levels. So what happens to a lot of those people? They rise their T levels in the thousands and then your natural T level production starts going down. So what happens when they stop using the testosterone? Well, there's a huge drop, like in the 200, 100 range, which is very, very low. They focus obviously a lot on the physical because you do make more muscle. Right. But they forget that you can get very depressed. You can gain weight easily with those low T levels. So then, then you have to go back to try to normalize them to that 500 range. I mean, I have one of my patients who I'm always boasting about, he's 78 and his T levels are in the 7 hundreds. So sometimes, you know, we think as age as like the big, like, oh no, you know, that's going to drop my, my libido. And he is very healthy in his libido, but we do all those things to make sure that they're in, in the high range. Even though he's 78. [00:11:24] Speaker A: Nice. So there is a way to, to measure libido. Yeah. And it's this, these T levels. [00:11:28] Speaker B: Yeah, yeah. [00:11:30] Speaker A: And what role does testosterone play in all this? You said testosterone, and that's sort of what, in my, in my limited knowledge, that's what I imagine libido kind of comes from, is this hormone of testosterone. [00:11:41] Speaker B: And, and I call it like, he's like best friends with dopamine, but the one that really does it is dopamine. And at the end of the day I'm always looking for those values to be in, in the higher range. Not for everyone. Right. It also depends on someone's sexual activities. Sometimes people don't require to have sex every day. Some people are just happy in their relationship having it once or twice a week. But then other people, you know, natural sexual activity is they want to have it every day. So I always try to think about that too. It's like, okay, what is your, your social and your psychological and your relationship factors play a role and how busy you, you want to have your, your sex, your sex, you know, life to be. So at the end of the day, I want to try to match that as much as possible. There are some, my patients that their libido is too high and Their dopamine is very high and that can cause problems in their relationship. It can lead to infidelity, it can lead to just a lot of other stressors within the relationship where one partner wants to have sex all the time and the other one just doesn't. Right. It doesn't mean that one is normal or abnormal. It's just a matter of matching it. I'm a big believer of balance. [00:13:02] Speaker A: So, yeah, great segue because this is one of the areas that I think a lot of guys have a hard time with because I think, you know, they have this image or this construct maybe from comparing to their peers or just what they see on social media or porn or whatnot, that their sex drive needs to be like up here, whatever that even means. Right. There's no number attached to that. And so they'll feel like this compare, like, oh, I need to, I need to do more, I need to be higher, like it's not happening. And, and that can in and of itself cause a lot of mental stress, which I would imagine would impact your sex drive. [00:13:34] Speaker B: Yeah, no, that can definitely happen. And I think for gay men in general, since, you know, they're always boosting about our sexual activities with each other, right. We're like, oh, you know, how many, you know, this week or whatever, when that starts to drop, even though it was just always very high, we, we go into this like freak out moment, right, where, oh, you know, what's going on? Is there something wrong with me? I think that's the, that's the biggest issue, right? And, and, and you're right. When you start comparing yourself to social media to, you know, pornography, like, there's a lot of other things are going on there to keep them working at that performance. But if you're not at that level and you feel that you're dropped just a little bit in the last couple of years. Yeah, it's definitely going to cause a lot of mental turmoil. And it's a matter of just kind of guidance, I think, you know, educating as much as possible and then trying to meet the expectations of, of that person. [00:14:33] Speaker A: Yeah, it's so, it's so good what you had said about kind of figuring out for yourself what your own normal, quote, unquote, normal is Your, like, what that baseline is? Maybe that's a better way to say it. So is that something that you would measure? Like if someone's listening to this and like, okay, I want to know what my, what my T levels are. How do you do that exactly? What's the test? [00:14:51] Speaker B: Well, It's a blood. It's a blood work. [00:14:53] Speaker A: Okay. [00:14:54] Speaker B: I pretty much checked that on all my patients. In my first assessment, especially when they're coming with, like, depression and just low energy, I always check T levels or honestly, all hormones in general, but T levels is a little bit more in connection with libido. And chances are their libido is very, very low. So I'm always going to be checking those. But it's a blood test. [00:15:20] Speaker A: Okay. And that's the number, that 500 number that you're saying. [00:15:22] Speaker B: Yeah. [00:15:23] Speaker A: Is sort of what you look at as a normal from a. An actual objective perspective. [00:15:27] Speaker B: Yeah. And I'm not an endocrinologist, but I see a lot of neuropsychiatric symptoms, and libido, whether it's high or low, is one of them. So immediately I have to make that connection with hormones. When those do come back, if they do come back abnormal, I'm not one to go ahead and treat because again, I'm a psychiatrist, so I always do recommend them to go see their endocrinologist or even their primary care doctor. [00:15:53] Speaker A: Yeah. Good. Okay, let's talk about what might cause a loss of libido. And there's probably a lot of different factors here, so I'll let you go ahead and maybe say what the top ones are and we can kind of talk about them from there. [00:16:07] Speaker B: You know, the top one is obviously we just talked about hormone changes. Right. So you just gotta check. And what you don't check, you can't treat. Right. So you gotta check it and then you can go and get treatment. There's certain medical conditions that can definitely do that. We talked about just having a bigger. Just weight. Right. So obesity can do. A cardiovascular disease can also do it. I always think about the heart and the brain being these two organs that need really good blood flow. But that also includes the genitals. Right. They have to have good blood flow. So usually when there's cardiovascular disease, like cholesterol, diabetes, these other factors that can affect your heart, most likely your other two heads are going to get affected because they're not going to get good blood flow. You know, so those are things that I always make sure that are not present, and if they are, the person is getting treatment for it. Stress and anxiety, those are huge, right along with substance abuse. But stress and anxiety are one of our biggest reasons why we use substances, especially things like alcohol and pot. A lot of people that I have that come with low libido, high anxiety, chances are like 99% of the time they're smoking pot and drinking alcohol, we forget that those two substances, not only do they reduce blood flow to all organ systems, but they do drop your libido. So in the moment you get this feeling of disinhibited. So then, you know, they call it, what is it? Liquid courage. [00:17:41] Speaker A: Yes, exactly right. [00:17:43] Speaker B: But that liquid courage can only last a short amount of time. Time. Once you take that person home or you go with your partner to have sex, it's going to be a really hard time for both of you to, to get into it because the libido is going to be affected. So there it goes into like a, just a physical side effect from alcohol and pot. So yes, you do get relaxed, but that, that can only help you so far. [00:18:07] Speaker A: Yeah, I like to think of it as that it helps you reduce the inhibition to maybe go talk or dance with the person and do that. But then the physical aspect of it, you know what we call it? Whiskey dick. Right? Yeah. It's like, oh, doesn't work. Right. I've seen that happen a lot too. [00:18:23] Speaker B: So when you have people that, that are engaging in that kind of substances, I call those downers. Right? They're downers. It's not going to get up. They're downers. So I think I try to teach people that, that information and a lot of us don't think about it because they get so encouraged into what everyone else is doing. Right. At a bar everyone is either smoking or drinking and, and using stuff. Right. But that can affect your, your libido. Not in the moment, but also just in the long term. They damage the capillaries. So what do you think is going to happen? You're going to have problems over time. So here I have a 30 something year old that can get an erection because they've been smoking pot since they were 12. So now we have to work on trying to reverse that damage. And that goes a lot further than just the, the having an addiction. Right. It's physical damage to the blood, capillaries and the arteries. So I always tell my patients, hey, if you're smoking, try to, you know, quit and let's come up with a plan to get rid of that stressor first. Because these are things that we can actually fix and remove aging. We can't. Right. We can't reverse that. That's going to happen, you know. So I always look for what are the things that I could reverse. Right. And that includes substances is a big one. Stress and anxiety. We live in such a high stressful times and I Think after Covid, that definitely just kind of jacked it up across the board. People that before never had anxiety now have panic attacks all the time. A little bit of social anxiety, and those things can definitely directly affect your libido. So I always look for ways to, like, self soothe, teach my patients breathing exercises, make sure they're doing mindfulness meditation, all these kind of things to help them increase or decrease their stress. That's. Those are the big ones. [00:20:28] Speaker A: Okay, I want to go. There's. There's two things I want to go back to. Let's start with the reversal aspect. So is it possible to actually reverse any kind of physical damage from years of substance use or alcohol use? [00:20:41] Speaker B: Yes, it is. The first thing you got to do is remove the toxin. Right. And then there's other different therapies that we do. One of the ones that I recommend a lot is hyperbaric oxygen therapy that you go into a hyperbaric chamber for 30 to 90 minutes a session. And what that does is basically bring back good oxygen to the tissues. So that can get your good cells healthier and your bad cells just get a little better or they. They decide to. To die by natural process. But at the end of the day, what do we want to do is improve blood flow and oxygenation. That's how cells stay young and. And stay alive and kicking. [00:21:23] Speaker A: Yeah. How about any. Are there any particular foods that would. If take, like, if you eat a lot of that food, it would kind of lead to a loss of libido over time. [00:21:34] Speaker B: Loss of libido, definitely. Like, simple carbohydrates can do that. You got to think of, you know, testosterone, for example. It's a. It's a steroid. It's a. It's a fat. Right. So I always tell my patients to make sure that they have good, healthy fats in their diet. You know, things that come from avocado, salmon, nuts. And then really do a proper evaluation of what your. Your nutritional intake consists of. And a lot of the times the simple, simple sugars. Sugar in general, can. Can really screw that up. [00:22:10] Speaker A: Yeah. Okay, good. Good to know. And then the second piece was the stress and anxiety. And I completely agree. I think that I. I've even seen that in my own life, right? When I'm under high amounts of stress or anxiety, it just isn't happening. It's like. It's like my brain is like, nope, this is not important right now. We have other. We got other more important, pressing things to deal with. And your. Your dick and libido is not one of them. So I think it's really important that. And this is why I think men and mental health, that's why something I'm so passionate about. I think historically women have done a really good job being more intuitive with their own mental health, getting themselves what they need and even coaching, if you look at my industry, coaching is predominantly very female dominated, which is great. But I think it's time for men to start taking up some of that as well and really think about those questions that you asked. How do I self. Self soothe? How do I, you know, get in touch with how I'm feeling? Because I think a lot of the times we just either don't ask the question to ourselves and just suppress it, ignore it. And that stress and anxiety doesn't go away by ignoring it. It just gets worse over time. And that can have a lot of physical impacts, including to your libido, but other impacts as well. Would you agree? [00:23:21] Speaker B: Yeah, big time. I think when it comes to that, I mean, those are one of the first things that I tackle with my patients on, honestly, the first visit. You know, it's like, let's lay out what are your current stressors. [00:23:36] Speaker A: Yeah. [00:23:37] Speaker B: And see how you, what are you doing to. If we could remove them. Remove them. But if most of the time we can't just remove work, for example. Right. It's what we're doing. It's what we're doing. But what are some things that you can do to self soothe? And I agree with you. I think women have always been more inclined to, you know, have girlfriends, have. Create a network of people to emotionally support them. Guys, we, we don't really do that, you know, and that's a big mystery. But I think, I think we're slowly coming around. But the numbers of suicide and mental health conditions among men is still on the rise. So it's still a big factor and something that I'm always trying to talk about, make sure that we are. Even if it's just talking to your friend, you know, learning to build relationships. We're hunters and gatherers. We're not building relationships. Right. Those usually tend to be the other. One of the other sexes. [00:24:43] Speaker A: Yeah, yeah. You know, and that's, that's why this work is so important. I think that you do in your way and that I do in my way. Because having these conversations, hopefully this podcast, even just, you know, people listening to you talk about this sector, is going to demystify a lot of the unknowns. Because it's like I had said in the Beginning it might be like, either having a high, like, if you think, oh, my libido's too high, something's wrong with me, or my libido is too low, quote, unquote, something's wrong with me. Like, these are all just thoughts that you're having. And what we're advocating for here is, you know, find out what the truth is, right? Go get, go get that, that T test and get those. Get that figured out so that you can actually start looking at, is it actually too high or too low? And if so, what can you start doing to. To address that? Right? What happens is, and this is so true for so many people, is we just don't know. And that unknowingness, that not knowing creates even further anxiety and further stress. And it's just a cycle that perpetuates itself. [00:25:43] Speaker B: Yeah. And that's why I always tell my. My patients, you know, or anybody that. That asks me these kinds of questions, you know, is you have to make sure that you're first finding out what is your baseline, Right? We gotta kind of figure that out first. And, and since we don't go around our day thinking about that, what ends up happening is we start. We think more about sex than. Than we probably like to think that we don't, but we do. We talk. We think about sex pretty much every seven seconds. I think the, the. The last thing I read about. So when you are able to establish your baseline and from there say, okay, what has changed? Right? Then you gotta start looking for causes. That's what I like to do. It's like, okay, well, if you notice that it has changed, you notice that it has increased or it has decreased dramatically. What has changed in the last. In the last year, in the last six months that you can identify? A lot of people don't think of a move being a stressful situation. And I'm like, well, that's a change. You lost something, right? You lost your circle of friends in that city, for example, or you lost a routine. And those moments, we kind of belittle them, or we don't think that they don't impact us, but they really do. You're now in a new environment. Have you thought about that? You know, so I'm always asking patients, I think, and look for the causes and what are some of the changes that you've had? They don't always have to be just the. The lab value. You know, there's those kinds of stressors that. That can definitely come into play. And so, like I told you, like, for me, sexual appetite is just like food appetite. So guess what? Your food appetite is going to be very similar to your sexual appetite. You're not going to want to eat. Right. These are all the opposite of fight or flight responses. And when we're in a stressful situation, we're in a fight or flight response, we're in a sympathetic drive. We're not in a parasympathetic. We're not in a calming, relaxing state where usually food can be healthy and enjoy it. And that kind of appetite increased. The same thing happens with your sexual appetite. It gets better. It gets increased when we're calm and relaxed. [00:27:58] Speaker A: Yeah, makes perfect sense. So let's talk about that. Let's talk about the flip side of it, which is, you know, the other big question is, how can I increase it? What can I do to increase it? And we can answer this in a few ways. We can answer this from a medical perspective, a psychological perspective, and even if there's any natural things you can do. So I'll let you start with the, the medical perspective. What can we do to increase libido? [00:28:19] Speaker B: Well, number one, you have to have healthy lifestyle habits. Right? So you got to look for a balanced diet that are going to help improve your T levels, for example. Right. They're going to help you lose weight if we're overweight. Right. The other one is manage stress. You know, you have to figure out ways and tactics to re to self soothe and decrease your stress. Breathing exercises are huge. I try to teach my patients how to do that. A lot of the times people just pull them out kind of like in an emergency setting. It's like, no, no, you got to do this daily. This is like exercise, right? You got to exercise your mind. You got to exercise your thoughts. That goes into these automatic negative thoughts that we call them at amen clinics, which happens to all of us. But we have to make sure that these ants don't, don't, don't get us. Right? And I try to teach them different exercises and how do we call them? Kill the ants. You got to question these ants, you got to challenge them. Since we're always thinking about them, well, you got to start creating positive thoughts. And at that, I try to teach my patients to turn those ants into affirmations. So then you have your own list of affirmations that came from these automatic negative thoughts. One simple automatic negative thought that can come from this is, you know, my, my sex drive is ruined. Right? We have that kind of like all or nothing thinking. A lot of the Times. So then think about, well, is it really ruined? Well, no, it's not, right? I feel that it's decreased, but I can't say that it's ruined, right? So right there I just kill the ant. But then I tell them like, okay, think of the opposite. My sex drive is thriving. That's an affirmation. That's it. You wrote your own unique affirmation that is related to what you're going through right now. So then you have to kind of tell yourself those things every single day, just the same way that our brain tells us automatic negative thoughts. So that's one simple thing that I try to teach my patients to do. Try to lower stress, lower these automatic negative thoughts. Another one is you have to manage the medical conditions. You know, we talked about cardiovascular health, obesity, diabetes, right? So if those are there, we have to really be active at improving and managing those conditions. And then hormone levels, right? There's different ways of naturally improve T levels, lower estrogen if it's necessary. I mean, I have a lot of my patients, female patients, that put testosterone pelvis, and that's a big trend, especially down here. It helps sometimes, but I've seen in, in general, it really has increased anxiety and panic attacks in a lot of my female patients. So I always do tell them like, hey, there is some benefits into testosterone therapy. But try to go with a little bit more subtle, like using supplements, for example, to boost the numbers. Not necessarily just jack them up too high. There's things like dhea, there's things like dim. These are natural supplements that once you are under the treatment of I, I like to work a lot with functional medicine doctors or naturopathic doctors. They'll look for these other ways of kind of helping and boosting these, these numbers without necessarily going to the other extreme right of have them being way too high and then now you're going to have other source of, of symptoms. And then when it comes to relationships, I mean, I think having open communication, sharing that you're feeling this way can reduce a lot of the tension, right? Because we haven't talked about that. That other flip side of the coin is the other person, right? Because we're in a relationship and our, and our just libido goes down. The immediate thing that the other person think, oh, they don't not into me anymore, right? Oh, they don't want me sexually anymore. No, it could be that they started a medication and that's a side effect of that medication. A lot of antidepressants can kill libido. So I, I personally try to stay away from those because who wants low libido? Nobody. So, but maybe that's what happened. Maybe they haven't shared that with you that they start antidepressant, right? So having an open communication can really just help tremendously. So you can start sharing, hey, I'm feeling this way, but it has really nothing to do with you, right? This is how what I'm feeling in my body and I'm doing something about it. I just want you to know that it's happening. A lot of people don't share those things and I think it's harmful instead of helpful by keeping that information from your partner because then the partner doesn't read mind, right? So they're going to start doubting themselves and start having their own automatic negative thoughts. So those kinds of things are important for. I also see a lot of patients who have really high sex drive and that can cause a lot of problems in their relationship. So I always am very open and, and encouraging them to share with their partner their sexual fantasies. Right. A lot of the times that can happen too. So I tell them like, hey, instead of keeping that again, open communication, right? Keeping that again for you sharing with your partner, hey, I'm noticing an increased sex drive. I don't know, something that I started eating Brussels sprouts. Anything that is like a cabbage kind of thing can increase dopamine. So I always look for, for those kinds of things, right? So if that's happening, share it with your partner. Hey, I'm noticing an increased sex drive, right? Maybe they started taking an antidepressant that boosts sex drives. And those are the ones that I try to stay with. They basically boost dopamine too. So when I, when I look for those medications and that's an issue, so they have low libido, I'll go for those kind of medications. But then share it again with your partner. Yeah, hey, my sex drive is now super increased and I want to have sex with, you know, so and so want to have a threesome. That's a fantasy, right? Share it with your partner. You know, you got to, I think, prepare that kind of kind of talk. Not everyone is open and quickly have that kind of conversation. But, um, if you set up your steps, like have a good relationship, good communication, share your downs, but then also share your ups. If you're having increased, you're having fantasies, you're imagining things, share it with them too. And, and I think that can not only strengthen the relationship, but it can also create another level of Intimacy that I think some people don't think about. You know, they're. They're more afraid of being rejected, of their partner getting mad or becoming an argument. You know, I think when I have those. Those patients are a little bit skeptical to share with. With their partner. I say, well, have someone else present. Do it with your therapist. Do it with their therapist present. So that third party can really be a. A good, you know, shield. [00:35:34] Speaker A: Yeah. [00:35:34] Speaker B: And kind of relate in that kind of conversation. And then, honestly, the other really big one is just limit substances, limit alcohol, limit pie. Those are the two big ones that. That really just kill libido. The opposite can happen, too, with amphetamines. I also treat a lot of gay males who are on this amphetamine drive, like Hunt. Right. What are they looking for? They're looking for dopamine. They're looking to increase and heighten their sexual experiences. Well, that can also damage your natural dopamine production. So we think about the moment again. Right. So what's very common in our community is, is using amphetamines to increase and heighten their sexual experience. But if your sexual experience now has been heightened to this level, what do you think is going to happen to your brain next time you want to have another sexual experiences? Yeah, it's going to require that same high level of dopamine. And this is, unfortunately, what's, I think, killing a lot of our LGBTQ members. You know, it's a big problem. Those patients, I put them on really strong controlled medication that. That I can kind of help keep those levels high, but then lower them slowly to. Because bringing back the mind and the brain, honestly, just a physical chemistry to a healthy level of dopamine could be really, really challenging. You know, we. We rise it so high that when I'm looking for just simple pleasures and, you know, having a good day at work, that's no longer pleasurable because we're expecting this super high rise of pleasure. So that's another big challenge that I personally am working with a lot of my patients. What do you think happens when they want to have a normal, just sexual experience with their partner? It's not the same. Yeah. Right. So that creates another kind of problem where now there I need to really boost their dopamine as natural as possible. But it's really hard because the bar has already been set really high because we're using just crystal meth is the most common one. So for me, substances, I'm like, just stay away from them. I think it's very common to. For for people with, not to go too much into the brain part, but usually that's a decreased activity in their frontal lobe. And that's something that we see in our brain scans. Those patients are always looking for excitement drive, thrill seeking behaviors. Those patients have frontal lobe decreased activity. So how do you turn that on? With dopamine? So a lot of them, they are self medicating with amphetamines. So we, we do our scans, right. And I think we talked a little bit about the scans in the past, but you can just see a complete decrease activity in their frontal lobe. And that's the part of my brain that allows me to have drive, motivation, pleasure. So it's, it's very interesting. Now I think across the board everyone is having this dopamine hunt, so it, it can create a lot of problems both ways. So those are things that I probably [00:39:06] Speaker A: say to, to control here in Toronto. You know, that is a big issue. Crystal meth. And there's a lot of campaigns to help around that, especially in areas where like I live in the village here. But yeah, I mean, I think when you're used to. It doesn't have to be. But anything that really skews your dopamine. Yeah, it does. To your point, it makes it a lot harder to kind of just go back to a regular quote unquote level like of just getting your dopamine from, you know, your partner touching you or any other random guy touching you when you're not under the influence of substances. Yeah. I want to go back to something you had talked about with relationships. I'm really happy that you brought that up. I think that part of the work I do is helping people have those what they would consider an uncomfortable conversation. I call it a hard conversation because there's a lot of discomfort in that conversation. Right. There's a lot of vulnerability. It's hard for a lot of guys, I think, to, you know, speak about, especially if it's a lower sex drive or even if they have fantasies that maybe they feel shame about. So a lot of my work is healing that shame. Really coming to terms with who you are, owning your sexuality, your libido, everything about it, your fantasies, and then finally being able to speak about that with the people that matter to you. Right. For example, a partner. And so that I agree 100% when it could be a source of. And I'm happy you said this word intimacy. Having a hard conversation, even if it's not a fun topic, could actually create deeper level of intimacy in your relationship. Because the intimacy Equation authenticity plus vulnerability equals intimacy. It hits both of them, right? You get the vulnerability of like saying, okay, here's what's truly going on. And then the authenticity of, okay, you know, this is what's happening in my life for real. And sharing that with somebody, you know, is very much an act of courage. It's not easy. It's definitely not easy, especially if you're not used to it. So that's one of the things that I, I like to help with in that thought work and giving them the tools to have those conversations, because it requires a lot of courage. And a lot of times we don't want to go there for fear of shame, fear of rejection, fear of getting judged, fear of getting whatever that is. So that is such a huge component. And then the other piece is, let's say I have a client who's going through this right now, comes. Comes to mind. Let's say you're on a medication that does decrease your libido, and you, you need to be on that. You want to be on that. You make the choice that that's what you want to do. And so this is a sacrifice you're going to make. So be it. There are so many other ways to get those intimacy needs met that are not necessarily through sex, that don't even require you to get an erection. Right. You can do lots of other things, even physically. Even physically, like cuddling, touching, all these other things that don't even require your. Your addict to get hard necessarily. But even beyond that, there's emotional intimacy, there's experiential intimacy, there's intellectual intimacy. There's lots of different ways to get those intimacy needs met. And I think, again, we don't know those, or we kind of just kind of gloss over them like, oh, yeah, yeah, whatever. That doesn't count. We put so much emphasis on the sex piece and that, that is a disservice to all of the other areas that we can achieve that, that need for connection and bonding and belonging, that we want that intimacy. [00:42:29] Speaker B: No, I, I totally agree with you. Just, you know, for, for people in general, I think even using the word intimacy, the first thing that comes to mind is sex. [00:42:40] Speaker A: Of course. Yeah. [00:42:41] Speaker B: And I think it's. It's something that is slowly, like, very slowly changing. I think people are becoming a little more aware of these other levels of intimacy that you can, that you can bring to a relationship. But I always teach my patients words, you know, so when I say, you know, don't go up to them like, hey, I have Something that we have to talk about, you see, it just changes the way that you might be perceiving my topic. But if I say things like, this is something that I feel that we need to talk about so we can move forward, or this is something, a topic that is very important to me so we can reach a new level of intimacy, that just changes the tone and at the same time, the expectations that the other person's like, oh, okay, so I. I want to know, right? And. And creating those kind of scenarios is what allows the conversation to, in my opinion, flow a little bit better. I try to tell them things like use the word sexual appetite instead of libido. Right. Instead of having that kind of emphasis and focus on just the sex. And. And because sometimes I can just get someone else a little bit scared to have the conversation. But those are things that I always try to get my patients to. To get there to have that conversation with their partner. So I agree 100%. Looking for other ways to. To have intimacy. The. The problem is that when people bring up those conversations, they only stick to the sex, right? So you can start off by having that conversation of other levels of intimacy, and then maybe three conversations from today, then you have the sexual intimacy conversation. So you kind of lay out the framework. So I try to teach those things to my patients so then they can kind of ease them their way into. I don't know, they want to have a threesome with their partner, and they're afraid that their partner might reject them or my make or judge them honestly. So these are things that I think setting the stage is important so it becomes a good experience for both parties. I think you want to be comfortable sharing yourself with them. But then I feel that. I would like to think that you want to make your partner feel comfortable too, so they're not pushed into doing something that maybe they don't want to do. [00:45:13] Speaker A: At the end of the day, what I've learned is that we all people that I've. That I've coached and myself want to be seen for who we truly are without the masks and feel safe doing so and hurt, and it's the same thing. So I think taking any steps towards that creates that sense of connection and belonging that I think is sometimes better than any dopamine from a high on any drug. Because that. That sense, when you actually get it and you feel seen and heard and you feel like you truly are connected with someone, that is the most wonderful feeling, I think. I don't know if it's dopamine. Exactly. But it's. It's a. Well, like, maybe it's oxytocin, but it's like that. That wonderful feeling that kind of beats anything else for me. [00:45:55] Speaker B: Yeah, I agree. [00:45:57] Speaker A: Okay, let's go back and talk about the original question here, which was increasing it. So one of the things that I've learned for myself, and tell me if this is. If this is pretty standard, is for me, exercise or working out. If I do any kind of biking workout, walking, even any kind of physical activity, I am super. My sex drive is very high afterwards. Is that standard? Yeah, yeah, yeah. [00:46:24] Speaker B: That's. That's the runner's high. Right. That's serotonin. So the interesting thing about serotonin is that it regulates all circadian rhythms, or I call them animalistic things. Right. So what does every animal do? They sleep, they have sex, they eat, and they bond. So those are all cycles or natural, you know, animalistic behaviors that are controlled and regulated by serotonin. And that happens in the thalamus. One of the little things in my. In our brain. So when I recommend these lifestyle changes, number one is exercise. Right. And if you do things like hit, for example, that can give you a little bump of dopamine when you do it, too. So there's certain things that you can do, especially with exercise. But, yeah, definitely, that's a very natural, great way to boost your. Your libido. [00:47:19] Speaker A: Okay. Yeah. So, I mean, really, it's all the things that. These aren't too big of a surprise of what we're saying, like, you know, reduce your stress, manage your stress, watch your diet, stay away from alcohol and pot or substances like. These aren't. These aren't secrets necessarily. [00:47:37] Speaker B: Yeah, I know. [00:47:37] Speaker A: Yeah. [00:47:38] Speaker B: But isn't it crazy? And people don't do them, right? [00:47:40] Speaker A: And we still don't do. We're still looking for the magic bullet. [00:47:43] Speaker B: Yeah. Most of my patients, when they come, you know, they. They want to have this whole lifestyle plan, but then they end up sticking to, what do I have to say about supplements? What do I have to say about medications? And I'm like, hey, that's just a part of the equation. So I have to always kind of redirect and reteach and say, hey, we gotta do these other things too. You know, that's how you get all the ducks in a row. [00:48:08] Speaker A: Speaking of medications or supplements, does. Is there any impact on taking things like Viagra or any ED medication, does that have an impact on libido over time? [00:48:18] Speaker B: What that really does is just increase blood flow Right. So. So that's the thing. Sometimes I have patients that, hey, I'm on Viagra. And I still can't. I'm like. Because that's a whole other thing. Right. That's just to increase blood flow. It's not necessarily going to increase your libido. So if there's factors that are permitting the. The genitals to have good blood flow, then then, yeah, that you need to remove them. And then you can use Viagra if that is the cause. But if it's just pure libido, we got to work on other things, too. There's definitely different medications that both drop it. And some, like I told you earlier, increase libido. So I always try to match it with that. There's supplements. Things like maca, I use a lot. Jinxin are really good naturalceuticals to increase libido zinc levels when they're low, I supplement with zinc because it would also increase testosterone. Same thing with DHEA is another supplement that I use a lot to increase it. But it all goes into how your lab values. Right. How. How are your numbers? And I always do recommend people to have those checked before you do any of these supplements. [00:49:35] Speaker A: Absolutely. And that's a great, great book. And so this has been super useful, super helpful, I think, for a lot of guys, myself included. So, Dr. Hector, before I wrap up, is there anything that you wanted to add? [00:49:46] Speaker B: No. You know, just, you know, at the end of the day, make sure that your healthy lifestyle is in place. Make sure that you're taking care of yourself and others. And enjoy sex. [00:49:59] Speaker A: Yes. Amen to that. Okay. And where can people find you if they wanted to connect with you? [00:50:05] Speaker B: My website is Dr. Hector.com or on Instagram, just Dr. Hector. [00:50:09] Speaker A: All right, awesome. I will link all that in the show notes for any viewers and listeners out there who want to have another chat with Dr. Hector, we will definitely be having him back on the show. [00:50:17] Speaker B: Who's. [00:50:17] Speaker A: This is not your third time, right? [00:50:19] Speaker B: I know. [00:50:20] Speaker A: Yeah. So more to come on this. So I want to thank all of our viewers and listeners for sticking through this episode with us. Hopefully it's been very helpful for you. Please, if you enjoyed the show, give us a five star rating on whatever podcast platform you are listening to us on. And if you're watching us on YouTube, go ahead and subscribe to the show. We have new episodes every Thursday. All right, Dr. Hector, thank you so much for joining us today and to our viewers and listeners, have a great rest of the week. We'll see you next time. Bye. [00:50:46] Speaker B: Bye.