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Sexual Health - The Week of July 20th · Doing Marriage Well

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  Doing Marriage Well for the week of July 20th, 2026. Studies about sex that
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  could make sex better for you and your spouse.
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  July 20th, Sexual Health Issues? Why, You Must Advocate for Yourself.
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  My virtual pile of articles about sexual health has reached a tipping point,
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  so I will do some of them this week.
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  I want to start by helping you understand how doctors deal with sexuality, or don't deal with it.
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  As I have mentioned in the past, most doctors receive virtually no training
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  about sex. Beyond that, few will bring up the issue.
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  If you need medical help for sexual issues, you will have to advocate for yourself,
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  push a bit, and ask for referrals if you don't get what you need from your GP.
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  There's a growing interest in treating sexual issues. Unfortunately,
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  much of that is done by individuals who don't have as much training as they should.
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  You have the full-on charlatans who sell supplements for every conceivable sexual malady.
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  These folks just want your money.
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  A real concern is that so-called supplements can contain dangerous things.
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  Many over-the-counter sexual enhancement supplements contain sildenafil,
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  which is the drug in Viagra.
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  So it might help you with ED, but it might also interact with heart and blood
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  pressure medications, possibly causing dangerously low blood pressure.
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  Exact numbers are impossible, but thousands have ended up in the hospital from
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  taking sexual supplements, and as guests, hundreds have died.
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  Then there is off-label prescribing. This is a valid thing that doctors do.
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  Often it is based on good research that the FDA has not acted on yet.
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  But it means there is less testing than with FDA-approved drug prescribing And
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  no approved dosages, which makes it riskier For example, there is a growing
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  trend of prescribing testosterone for women There is good science showing this
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  can help menopausal women have increased sex drive,
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  But it can also result in side effects that are permanent Including facial hair or an enlarged clitoris,
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  Other countries, such as Australia, have tested and approved testosterone formulations
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  for women But these are not available in the U.S.
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  At this time There are places that specialize in providing off-label drugs for sexual health.
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  Most of them are telehealth groups who never see patients in person.
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  There is little or no screening for pre-existing conditions that could make
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  a drug dangerous for an individual.
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  Because of the way our medical system is set up in the U.S.,
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  your options are sometimes limited.
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  Bypassing your primary care doctor may be the only way to get a drug,
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  but it also puts you at a greater risk.
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  If you do this, I suggest you let your doctor know what you are doing so they
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  will know and can give you testing or monitoring you won't get from the places
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  that are providing you the drug.
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  This is Paul, and better sex is not worth dying for.
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  July 21st, Needles and Your Sex Life, The Ultimate Guy's Guide to ED and PE.
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  So guys, let's talk about needles
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  and your penis. I'll wait a second for you to get over the thought.
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  There are several FDA-approved drugs that a man injects into his penis at home, give him an erection.
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  They produce a very hard erection in 5 to 10 minutes, and the erection lasts
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  for half an hour to an hour.
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  Men who have used it say, it just works. Side effects are rare and mild,
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  and there are reports of the return of spontaneous erections because of the drug.
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  There are treatments for ED that are less invasive, but if those don't work
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  for you or result in unacceptable side effects, injections are an option,
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  and the needle is very narrow.
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  An off-label injection for ED is Botox, injected by a doctor.
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  This increases blood flow to the penis, which improves erections.
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  In one study, 86% of men with mild ED were helped.
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  For moderate and severe ED, the rates were 79% and 64%, respectively.
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  It takes a couple of weeks to kick in, and then it works for 6-9 months.
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  Botox has been shown to be safe, with only mild side effects.
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  This treatment results in getting erections normally. As a side effect,
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  the treatment can result in a larger flaccid hang size, an outcome men did not complain about.
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  Botox is also used to treat premature ejaculation. This is new,
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  and studies have been small, but good results have been shown and safety established.
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  Positive results last 3-6 months, with increased time tapering off gradually.
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  Many men were able to last 3 times as long as normal, which beats most other PE treatments.
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  I'd call this one interesting, but needing more study. Fine-tuning doses and
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  the injection site could make it better or more reliable.
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  Another off-label PE treatment is injecting hyaluronic acid into the glands,
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  that's the head, of the penis.
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  This has been shown to significantly increase how long a man can engage in intercourse before it climaxes.
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  In one study, the average time per man went from 38 seconds to 5.5 minutes.
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  This time gradually lessened, but was still 4 minutes after 12 months.
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  Hyaluronic acid has been used in cosmetic surgery for decades and has well-established safety.
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  The only issues were minor pain or irritation at the injection site, which cleared in time.
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  Finding someone to do these procedures may take some real effort,
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  and those that are off-label will not recover by insurance.
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  But if you struggle a good deal, it may be worth the effort.
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  Do your own research and know what you are getting. And of course,
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  I'm not a doctor, and I'm not giving medical advice.
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  This is Paul, and who knew an ELO could help you do sex well?
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  July 22nd, The Best Natural Supplement, Regular Sex Keeps You Healthy.
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  There's a large body of evidence that says regular sex is good for us in many
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  ways, and this seems especially true as we get older.
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  Before we look at the findings, with links to the studies in the show notes,
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  let's address how research like this actually works.
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  The classic rule that correlation does not mean causation is always a consideration.
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  Some of the studies dealt with that, some did not.
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  Another issue is determining which is cause and which is effect.
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  Healthier people are generally going to have more sex than those with health issues.
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  Some of the studies controlled for that, some did not.
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  But the findings of these studies are important even when we say healthier people
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  have more sex. It means having less sex may well signal a problem that we should deal with.
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  Some of the causes of ED are things that can kill a man. Going to get help with
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  ED could save a man's life.
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  Depression limits sex and increases deaths. Dealing with depression will lead
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  to both more sex and a longer life.
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  And an unhappy marriage hurts our sex life and our mental and physical health,
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  Working for a better marriage will improve all of those,
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  Some of the benefits found in these studies were seen no matter how one had
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  an orgasm But some were only found when couples had sex And for some,
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  the quality of the sex mattered Here's a quick look at some of the health benefits ascribed to sex.
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  Sex can make menopause easier. Women who engage in routine sexual activity experience
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  less volvular pain, dryness, and irritation during everyday life.
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  Sex can ward off depression. Sex can delay heart problems. Sex was positively
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  related to later risk of cardiovascular events for men.
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  For women, this was only true if the sex was good sex, meaning they felt satisfied by it.
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  Men who had sex at least twice a week were 50% less likely to die of heart disease
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  during a study compared with men who only engage in it once a month.
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  Sex can keep you from getting sick.
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  Having sex once or twice a week significantly increases imuglavin A,
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  an antibody in the mucosal membranes that is considered a first-line defense against infection.
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  Sex improves bladder control. Sexually active women were significantly more
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  likely to have a strong pelvic floor compared with those who were not sexually
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  active. This helps prevent incontinence.
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  Sex at bedtime results in better sleep. Sex improves brain health.
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  Studies have shown sex provides various cognitive benefits for older adults,
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  And last but not least, regular sex can result in a longer life Multiple studies
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  have found a correlation between an active sex life and a longer life If you
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  could buy all those benefits in a supplement, everyone would want a bottle,
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  All it costs you to have those benefits is making time and energy for regular
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  sex And having a marriage that makes regular sex possible,
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  This is Paul, and doing sex well is doing life well.
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  July 23rd, 2026. Want better sex? Start putting your fantasies on paper.
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  What if you could improve your sex life from the privacy of your home,
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  spending less than an hour a week?
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  A recent study suggests you can. There's a link in the show notes.
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  A group of 30 heterosexual individuals were asked to write out a sexual fantasy
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  at least twice a week for four weeks.
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  A controlled group wrote about having a meal with friends.
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  At the end of four weeks, those who had done the fantasies had some big improvements in their sexuality.
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  They had a significant increase in sexual desire, an increase in sexual pleasure,
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  and fewer cognitive distractions during sex, especially less worrying about performance.
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  They had an increase in positive feelings about sex and a decrease in negative
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  feelings. The fantasy group also experienced an increase in partner connectedness.
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  None of this is surprising. Sex is mostly in our heads, and writing out a fantasy
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  changes how we think about sex.
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  If you want to give this a try, keep it private at first. If you want to share
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  what you wrote later, that's fine.
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  But worrying about what your spouse might think will interfere with the process.
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  Do write, be it longhand or typed into a device. Other studies have shown what
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  we commit to paper or screen is more powerful than what we think about.
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  Obviously, you write about sex between you and your spouse. Exploring something
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  you have never done but think about is fine, but writing only about things your
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  spouse doesn't want to do is a bad plan.
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  Eventually, sharing some of your fantasies could be a good thing for your sex
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  life, if doing so feels comfortable and safe.
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  It will teach your spouse how you see sex and what you long for sexually It
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  could be a way to start a discussion about something new you want to try Ensuring
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  a fantasy could be good foreplay This is Paul, and fantasies can help you do sex well.
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  July 24th, 5 Proven Habits of Couples Who Stay Sexually Satisfied It's common
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  for both passion and sexual satisfaction to decline as a couple spends more
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  and more years together But there are couples who don't follow this trend What
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  makes those couples different?
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  A study of almost 40,000 people looked at that. The authors pointed out that
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  sexual satisfaction is important for the health of a relationship and gave this
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  as a motivation for the study.
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  The couples in the study had been together at least three years.
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  The majority, 83%, said they were sexually satisfied for the first six months they were together.
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  But many did not feel that way years later. 55% of the women and 43% of the
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  men were generally satisfied, while 27% of the women and 41% of the men were dissatisfied.
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  Roughly a third of both the men and the women said their sex life was as passionate
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  as it had been at the start.
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  Sexual satisfaction and ongoing passion were highest for people who had sex
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  most frequently, those who received more oral sex, had more consistent orgasms,
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  experienced more variety of sexual acts, and had better sexual communication.
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  Let's talk about these things that correlated with greater passion and sexual satisfaction.
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  Frequency. There is an obvious chicken and egg issue here, but it's still a valid issue.
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  A drop in frequency either signals an existing drop in satisfaction or warns that one is coming.
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  Making yourself have sex usually isn't going to improve things.
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  But don't ignore the change.
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  Oral sex. This could be about the pleasure oral sex can give or how effective it can be as foreplay.
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  It might also be an indication of how sexually free a couple feels.
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  You can have a good sex life without oral sex, but if either of you is less
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  satisfied with sex than you used to be, adding or increasing oral sex could
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  result in an improvement.
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  Consistent orgasms. This is mostly an issue for women, but a lack of orgasm
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  would certainly make a man unsatisfied with sex.
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  Some women honestly don't want to climax every time. Some women want to most
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  or every time, but say, it's okay, or fake orgasms out of fear or shyness or
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  because they think it's their fault.
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  If you need to orgasm more often, please speak up. Most men value their wife's
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  orgasm as much or even more than their own orgasms, and I bet he would be happy
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  to make sure it happens when you want it.
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  Variety. It's not just the spice of life. It makes your sex life more satisfying.
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  You don't have to get crazy or keep finding new things. Using more than one position will do.
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  Unscheduled morning sex or making out on the couch also qualify.
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  Communication. Being able to talk is the lifeblood of a marriage and of your sex life.
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  Good sex requires being able to communicate what you enjoyed,
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  what you want, and what you might like to try.
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  You also need to feel safe talking about what is not working.
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  You can make sex more satisfying and bring back passion. Which of the things
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  I've mentioned would be a good starting place for you?
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  This is Paul, and a satisfying, passionate sex life makes doing marriage well easier.