Dr Anand Patel

Episode 116 – Good Sexual Health for Dads with Dr Anand Patel

Episode Highlights

00:03:44 Common symptoms associated with sexual health issues
00:06:57 Recognizing early symptoms of sexual health issues
00:08:01 Noticing  what is “normal” for you
00:09:18 40% of men aged 40 have erectile problems
00:10:39 Erectile problems can be an early marker of heart disease
00:11:52 Are you too obese to see your own genitals?
00:15:16 The importance of starting health maintenance early
00:16:19 Why do women live longer than men?
00:17:26 Building social connections to  keep your mental and physical health in check
00:18:45 Being aware of your lifestyle and medical/family history
00:20:12 Making good food choices
00:22:38 Carbohydrate rich diets are bad for you
00:25:27 Our brains are not evolved for delayed gratification
00:28:38 Paying attention to your own risk factors and taking responsibility
00:29:35 Making small changes and keeping it simple
00:31:18 The use of Porn can trigger arousal issues in men.
00:37:23 Low body weight can be equallly as bad for mens health
00:43:33 Sexual relationships change at different stages of your life
00:48:51 Premature ejaculation is one of the most common sexual dsyfunctions in the UK
00:54:15 The dangers of anabolic steroids and testosterone supplements
00:56:09 Finding a club to help boost social connections
00:57:42 Its never too late to make a postive change for your health 

Links

Transcript

Welcome to the Fitter Healthier Dad Podcast, where you can learn how to improve your diet, lose fat and get fitter in a sustainable and fun way without spending hours in the gym. Here is your host Darren Kirby.

Darren: Welcome back to the podcast, guys. This is the number one podcast for men in their forties who want to improve their health through nutrition and fitness. This is episode one hundred and sixteen. On today’s episode, we are talking with Dr. Anand Patel about men’s sexual health, a topic which is often overlooked and not spoken about nearly enough until it’s too late. Anand qualified in 2000 at King’s College London. He is a GP partner in a London GP practice, after attending his GP training in Mid Sussex and was one of the first doctors in the UK to gain the Fellowship of the European Committee of Sexual Medicine in 2012. The only accreditation in the field recognized in Europe and sees patients with sexual problems alongside his general practice. Hi Anand, thanks very much for joining me on the podcast today. How are you?

Dr Anand : I’m very well indeed. Thank you very much for having me. Very nice to be here.

Darren: Yeah, absolutely. And like I said, thank you very much for your time. I do appreciate you giving us your time on the show today. So for people that haven’t come across you before and want to find out a little bit more about your background and your practice in sexual health functional specialist, can you give us a bit of background on Anand and your profession?

Dr Anand : Yeah, sure. I mean, I’m a GP by training and I’ve been a GP for about 15 years now. It’s a great job and I work in inner-city London, so it’s a very varied, rather deprived area of London. And then as a specialist interest, I do men’s and women’s health really, but specialize in men’s sexual function. So I work for a clinic on Harley Street, called the Center for Men’s Health. And so we see men for a variety of reasons. Sometimes they’ve lost their focus, their sort of mojo. Sometimes they’ve lost sexual interest, so their libido dropped. Sometimes they’ve got erectile problems. Some people have, you know, they just want to check up. They want to see that they’ve got to their 40s or 50s. They work a busy life like most people do, and certainly most dads do. So it just means that they want to work out, perhaps why they’re just getting a bit more tired when they’re not sleeping so well, why they might be not getting the gains in the gym that they might be expecting, given the work they’re putting in. And that can be for sort of lots of reasons. So we get to spend a lot of time in that clinic trying to work out the reasons behind that.

Darren: Yeah, fantastic. What I will say, though, is before we go any further, is anything that’s shared on this podcast today is not medical advice, it’s just a conversation between us and Dr. Anand, and it’s just for informational purposes only. So I just want to get that disclaimer out the way before we carry on. Thank you. So, yeah, so it’s an interesting topic, I think, because for me personally, I don’t currently suffer with any of these issues. So I’m aware, but I am aware of lots of people that have these, issues. And so you obviously see a lot of people that come through your practice and you mention there about them being dad’s parents who are got a certain milestone in their life, whether that be 40s, whether that be fifties. So what kind of common things do you see for people that come and come to you in terms of their symptoms?

Dr Anand : So I think I mentioned it briefly before, but if we kind of go through, they would often say I’m tired and it’s not just the normal tired of having interrupted night sleep or, you know, having to take kids to school and all that hard work, et cetera. It just they find that they’re even more bone tired than that. They find a difficulty sleeping at night. Sometimes they find that their focus and appetite for work may have decreased so that in that drive that often people have, that would just be less. And sometimes they’ve even reported that their workplace have said, Are you all right? Is something going on because they’re just off the top of their game? But they haven’t? Yeah, they’re trying just as hard or even harder than they normally would. It’s just that hunger seems to have. Just like the flame is just being turned down a little bit. They can’t work out why. They also have sort of symptoms there could be a little more snappy and irritable. I’m not quite sure why that’s going on. Sometimes their partner has sent them in going, Look, you’re a handful to deal with. Can you just go and get checked out in case there’s something else going on that might be causing that beyond, you know, being really busy and having kids, et cetera? If that’s what’s going on, otherwise, people are just quite blunt actually with us, which is great working in our environment because we have to ask very sort of clear questions.

Dr Anand : So they come in saying, Look, my erections don’t work or they’ve started to become a problem, and it’s the start that’s really helpful if we can see someone in the first few months of their erections being problematic. Yeah, right. That’s the best time for us to see them because it’s when you got to the point, because most men don’t talk about their problems with other men and they, their partner may recognize that these problems are happening, but often you develop other ways of dealing with it. So, for example, someone might just do a lot of foreplay and get their partner to orgasm first. And then they might try penetration because actually, if it doesn’t work out for very long, it doesn’t matter. Yeah. So they develop secondary behaviours to their primary problem. Yeah. So erectile problems, we get people who’ve got low libido, so they just don’t have that. You know, vava voom, they used to do that. You know, people walk past. They used to would normally have a think about a glance at nothing happens. They get no sort of stirring in their pants or anything like that.

Dr Anand : And when they try and have sex, it’s more difficult to have sex. They find that they lose their nighttime erections, morning time erections, and that’s just those erections are really super important because lots of men think, Hey, that’s me being turned on all night. I’m a real man. And actually, it’s not. It’s just housekeeping for your penis, because basically, if you don’t flood your penis full of oxygenated blood on a regular basis, your body thinks, Well, what’s this useless organ for? So actually, it tells the cells to commit programmed cell suicide apoptosis. So you haven’t used your penis for a period of time that can be, for example, you know, you’ve had an injury or you’re depressed or you’ve been stressed at work or your partner’s left you. You know, for all of you, you’ve got lots of kids, you’ve got kids, they’re keeping you occupied. There’s been no opportunity if you haven’t had any sort of intercourse or sex or even masturbation for several months, you know it can be that your erections are then more difficult to restart again because they can offer a longer period of time. You can get actually scarring and fibrosis of the penis, and not many men want a sort of scarred, shorter penis.

Darren: No, absolutely not. I think, yeah, that’s a fascinating insight, actually. But the other, but I just wanted to go kind of go back a little bit to what you said in the beginning of that part was about, you know, men coming to you because either it’s been pointed out to them that there’s a problem or they feel like it’s a problem. How many men do you think actually don’t even realize that because a lot of it’s going to be knowing yourself? And I think the challenge with us men is that we are very good at just kind of putting up with stuff and maybe just even accepting that that’s the way life is now because you’ve got to 40 or 50, but so. What would you say? Well, I guess there’s two questions in there, really. What would you say people could do to kind of recognize that in the first place that there potentially might be a problem and do something about it? And what would you say to people about actually kind of reflecting and knowing yourself, I guess.

Dr Anand : I think that’s a really helpful question. I think the listeners would really be aided by that. I think one of the key things is recognizing What’s your version of normal? Yeah, because absolutely those people don’t do a scoring card of how tired they are and all the basis on an average, I’m a three out of 10, but actually today I feel seven. Most people haven’t actually written that down, but actually, if you do a diary of what your symptoms are, you’re saying, Oh, I’m starting to feel a bit tired. Is this normal for me? And you go, Well, actually, it tends to happen after I’ve had a big night out. It tends to happen actually If the kids have been crying at night, it tends to happen. If I don’t know, we’ve had a fight, I don’t know what, whatever. That’s the times. I feel rubbish the next day, but if I go on holiday. Actually all of that goes away, and I probably feel fine that suggests that your life is the thing that’s causing you more of those issues. If, however, you then you go on holiday and actually that isn’t better. Now you’re still bone tired, you still can’t focus. And actually, you’re having far more free time, you’re having far better sleep. Or perhaps that’s not even better, then that would be a way of thinking, Alright, maybe something’s up. Also, something is persistent because, you know, erections go up and down, and they’re a real barometer of men’s health. If you’re knackered, your penis is not necessarily going to be up ferreting around for you.

Dr Anand : And if you’re anxious, if you’re stressed, depressed, all of these things, your brain is not going to want you to get an erection because actually fathering another child is not going to be that helpful for you. If you’re in a stressful situation and your body is quite good at recognizing that, so they don’t . It either. But if, for example, for three to six months you’ve had problems with your erections for three six months, you’ve had a persistent tiredness or a persistent loss of focus or persistent low mood, persistent hot flushes, things like that. Then I would definitely think about getting yourself checked out, and one of the things you can do is the Sexual Advice Association have it’s it’s a web app. So www.SexualAdviceAssociation.Org. If you just Google it, they’ll come up and they have an app which if you which allows you or your partner to put in your symptoms. Okay. And it’s got a whole series of validated questionnaires. So if your problem is erectile problems or you think you might have a low testosterone, you basically just put in your issues into their questionnaire and they will pull up what the most likely help leaflets are for that condition. Right? And I’m not trying to turn everyone into Dr Google, but actually, that could be a really helpful way of getting a start or a feel of what might be the problem. Mm-hmm. And obviously, I appreciate your listeners will not necessarily have problems with erectile problems but 40 percent of men aged 40 have erectile problems.

Dr Anand : Wow. So that’s a reasonable number. And when you get to 70 at 70 percent and obviously when you’re younger, more of those issues will be psychological or stress related as  you get older. More of those will be perhaps due to having a blood vessel problems, because if you’re you, think of your pain, especially as a balloon, it’s a large blood vessel it varies in size. But let’s go with large blood vessel so your heart and your blood vessels have to be working properly for you to get an erection, but so do your nerves. So if there’s any problem with your blood vessels or nerves, both of which are damaged by diabetes, for example, your erections aren’t going to be as successful. Yeah, so the penile blood vessels are only 1-2 millimeters wide. You’re once your heart are 3-4 millimeters wide, so you are going to display signs of erectile problems before. In general, you would have a heart attack, so it can be a really early marker of heart disease. So we’re really keen to get men who’ve got intermittent erectile problems. So it’s not every time. So you think, Oh no, I was just tired or oh no, I just had a couple of too many drinks or whatever. Yeah, to actually get checked out. You know, we want you to have some blood tests checking your cholesterol, your sugar levels. We want to check your blood count. We want to check all the little markers that might potentially be causing cardiovascular disease.

Dr Anand : And if your mum or dad had a heart attack or stroke under the age of 60, that’s a strong family history. So I really recommend paying attention to that. If you’re a smoker, if you’re overweight and I know people go, oh BMI is not a great measure of weight, and I get that. However, if you’re I mean, a third of London men are too obese to see their own genitals. Wow. So basically, you’re too fat to see your own Willy and you and I don’t mean erect. I mean, soft, so probably some action needs to be taken because that excess weight of that fat around your middle is the stuff that will turn testosterone into estrogen and therefore make it less useful to you. But it will also create lots of inflammatory chemicals in your body, so it increases your risk of cancers. So obesity is associated with 22 different cancers. Wow. So that’s pretty, you know, it’s pretty darn significant. And an obese man who can’t see his Willy is five times more likely to develop type two diabetes, three times more likely to develop colon cancer, and much more likely to develop high blood pressure, erectile problems or lower urinary tract symptoms like difficulty passing urine. Mm-hmm. So it’s a big deal and all of them, and obesity also causes minor damage, which worsens over time to Your little blood vessels and that’s important for your blood vessels that feed your nerves, but also the blood vessels that feed your penis. So I would really recommend getting yourself checked out.

Darren: Yeah, I think what you said there was was was a great example of why we need to be doing maintenance. And you know, I use this analogy that I would argue that 90 per cent of people probably spend more time on maintenance of their car a year than they do themselves. And I think we are in this, the way that we’ve kind of, I don’t know, medicine as developed and you may correct me on this, but it very much the approach  From my perspective, it’s very much kind of fixing and curing as opposed to, you know, being proactive and having things like that checked out because just that one thing that you said there about, you know, obviously the blood vessel size between the penis and your heart. And if you start to get erectile problems and things like that, it could be a larger indicator of cardiovascular disease. I mean, that in itself is a huge, should be a huge wake up call to people listening to this. Because, you know, even if, let’s say, for argument’s sake, you’re not worried about your erection or anything like that, you know, if you have those problems, just think that it could be a precursor to something a lot more serious. So I think that’s a very, very good point. But one thing I wanted to ask you is that when you initially get people come to see you in terms of where you start, because obviously with the people that I see, the first place that I start is diet. Diet for me is key without any exercise. And so when you’re when someone comes to you with with a with a function or dysfunction, where do you start to look at what could be causing it? Obviously, you’ve said about the lifestyle issues around stress and things like that and depression, but what other areas do you start to kind of analyze before you kind of go down in any kind of pharmaceutical route or anything like that?

Dr Anand : Yeah, absolutely. I think you’re quite right. The NHS taking both your points and the NHS was really set up to be a curative service. It was like if you’ve got an illness, then they were there to treat it after the war. However, what we realized is a lot more of us and men particularly are living a higher proportion of our lives, our lives in ill health. Yeah. So it’s all well and good living till seventy five or seventy nine. Seventy nine is the average life expectancy in the UK. But actually, if you’re spending a third of that in poor health, that’s not really great. And so I think that’s the lesson that the NHS has learned. And so what people who talk about health are talking more about is this maintenance going actually, even if you start at 50, that’s still important. But if you can have started earlier, that’s going to mean that the furring of your arteries is going to be slower and may not cause you problems until you’re much older or indeed might not cause you problems at all. Mm-hmm. And so and women tend to be better about going to see their doctor. I mean, the gap of life expectancy between men and women is is about going to be about 10 years in 2030.

Dr Anand : So, I mean, currently it’s about four years. So at seventy nine years for men and eighty three for women and also deprivation plays a role in that, as does education, because there’s a nine year greater life expectancy for men in Chelsea versus men in Sunderland. Wow. And the two key factors between that deprivation and education. So what we really need to do is be looking at what are these key factors that are potentially harming and killing our men earlier? Yeah. And some of those are mental health because three quarters of all people who suicide are men. Right. And a thousand men over the age of 50 kill themselves every year. So it’s really important that we get in there and not see it as a weakness. Masculinity is all about manning up about, you know, you have some balls, mate. It’s all about making sure that you are seen to be as strong and as manly as possible and don’t deal with emotions or you don’t deal with ill health or whatever. That’s right. And also, if you’re driven to care for other people that you caring for, other people often mean you neglect yourself. Yeah, and often men close their social circle.

Dr Anand : You know, men tend to be very, you know, the huge number of bromances and friendships between men. They’re so strong, particularly in the teenage years when you go to you, if you go to university among your sports groups, gyms, you know, they’re so good at going out for a pint or a meal or doing something together that they have to be doing. Something has to be experiential. You can’t just sit together and have a chat. You have to be having a pint. You have to go to a football match. You have to do something together, which is very masculine, whereas you would expect the feminine version would be going for a chat. You know, having a cup of tea with someone and discussing your emotions, which most men are like, what the hell? That’s not really what I do, but actually, it’s so books. If you lose those social connections because you know you get kids and therefore your focus instead of all your friends becomes your workplace and your family. And that sort of means that when you’re older, you’ve got far fewer social connections. The social connections are so important to keeping your mental health and physical health in check. 

I think that is very key, and I think the world in which we live in now, where we use the terminology that we’re connected, we’re actually disconnected as a race, I believe. I totally agree. We’ve become an entrenched by the screens that are in front of our faces too often now. And I think the other point you made there about know ladies will obviously go around and have a cup of tea and chat about their emotions. Men don’t and

Dr Anand : You know, part of that stereotype. I appreciate that that’s generalised, before I get told off by people, I am very happy to go around for a cup of tea and have a chat. I am relatively. I’m pretty good with my emotions. And I think it’s very important for me when I’m very stressed to actually talk about them. But I do so only under. It’s taken me a while to get to that place. Yeah, normally I would personally hold back and go, Look, I’m all fine. It’s all good. And as a doctor, you’re not meant to show any distress on your side because I’m meant to put up with 40 people telling me their horror stories every day. And, you know, and that actually, over time, you kind of like, actually, I have to have some outlet for saying I’m a bit miserable because doctors have the highest alcoholism and suicide rates. Wow. So actually that pressure has to go somewhere. So it’s about being and so it’s really it’s important for doctors. It’s important. Also, it’s important for everyone to have an outlet to discuss what’s going on in your head, but also talking about your physical health. And I think you touched on before, before we get to medicine, before we get to tablets, before we get to that, what can we do and what do I talk about in clinic? I talk about, as you said, lifestyle. What’s going on in your life? What job do you do? What pressures does that put on you? What’s your family set up? What’s your family history? You know what? What illnesses have passed down in generations, perhaps like diabetes or heart disease? You know, are there any physical problems like you’ve had an injury when you were younger? Did you have mumps when you were a kid? You know, if you had it, for example, in your teenage years and older and mumps, you’re more likely to get infertility .

Dr Anand : So, you know, asking a whole series of questions about your prostate, whether you smoke or not, you know, I mean, tobacco is associated with such a high proportion of lung cancer, but it also damages blood vessels. So, you know, it’s super important to know about that, alcohol. You know, people men often de-stress using alcohol, and that often helps you to put on weight also drops down your testosterone. So it’s red meat, for example. Red and processed meats cause 21% percent of all colon cancers. Yeah, but processed meats are given a Class One rating, which means we know they cause cancer. Wow. Red Meat Causes is a given a Class 2A rating, which means it probably almost certainly causes cancer. So we’re knowing about your lifestyle is hugely important because that lifestyle is going to be the thing that I’m going to most support you in terms of suggesting if we get out of there, when we get out of our conversation, I will be talking to you about what the sort of foods you might be eating.

Dr Anand : I’ll be talking to you about and I appreciate you might not want to hear it, but you might decide this is me and that’s entirely your choice. But this is the stuff I’m going to recommend to you. I’m going to say, you know, if you know you need to be looking at a diet which is rich in veggies and grains with minimal wheat, minimal meat and sweets and minimal white carbs and beige food is bad for you. Yeah. So if it’s beige, try and cut it out. I know it’s not easy and I am literally the worst for this. I will have like a cheese and coleslaw sandwich virtually every single day. I have a terrible diet, but I would not recommend my diet to anyone. And I also I’m trying to make differences now. I’ve got a personal trainer, which I’m lucky to be able to afford. Don’t get you wrong. I recognize this is not for everyone, but there are lots of apps. For example, the seven app online, which basically lets seven minutes for you to do some physical exercise because if you exercise enough so that you can’t sing, so just, you know, I can even be a fast walk or cycle or a little jog for 20 minutes, that improves your sugar control for the next 16 hours. Resistance exercise, go on.

Darren: Yeah, no, I was going to say, I mean, I am particularly fascinated and that might be the wrong word actually around, you know, the sugar in diet and blood sugar. I mean, I’m not diabetic, but I actually have a continual blood glucose monitor in my arm at the moment because I am very interested in what certain foods do to our blood sugar levels and things like that. And I think that’s a whole separate podcast on its own, to be honest. And in my opinion, it’s a pandemic that nobody’s talking about.

Dr Anand : Yeah, there are dangers. So just that’s a really important point. I mean, carbohydrate rich diets are absolutely dreadful for our health. Everyone is going after fat initially, but actually there are lots of good quality fats. There are virtually no good quality processed sugars, and it’s present in so much of the food that we eat and we decide, OK, well, I won’t have I, I won’t have sweets, but I will have white bread. And that white bread gets just transformed straight into sugar. And I am the king of chips and pizza, and I’m awful and I recognize that. But I want to make these steps and I would encourage your listeners, which I’m sure you do all the time in this podcast. If you are able to make these small changes and make them real habits in your life rather than thinking they’re a chore, it’s like about, you know, how much people some people look after their cars or motorbikes or they their train sets. So I don’t know like games workshop, figurines or whatever it is that you have a passion for. If you spent that much time looking after your own body, you know who knows what it could do. The most likely thing is it’s not going to wear out on you earlier, and that’s a big thing.

Darren: Yeah, exactly. And I think, you know, to come back to your other point around diet, and it is it’s like anything in life as far as I’m concerned, when you have to change something none of us like, change and change is difficult and it’s awkward. And we are in a society where in the listeners will get bored of me saying this where we are in an Amazon economy. So we want we click and we want the result now. And it doesn’t work like that with health. And you need to take the approach, in my opinion, that it’s a thing that you integrate into your daily lives, you know, and you’r aware of because, you know, I think we just want that result. And I think sometimes people will just go to their doctor or go to see a GP because they’ve got a problem and they want to fix, but they don’t necessarily want to take the responsibility for that fix. And so, you know, that’s why when it comes to diet and nutrition, people struggle. I think, because, you know, like I say, because of the result and because you have to take the time to education. And I truly believe that, you know, education in this scenario is key for people to understand and educate themselves about the basics of nutrition. And it’s easy for me to say because I’ve been focusing on this for eight years, but prior to that, I was definitely not healthy. But it takes time to understand it. But if you commit to actually putting a little bit of time and effort into it each day or each week or each month, gradually over time, consistency and traction will get you there.

Dr Anand : But it’s that delayed gratification, isn’t it? Yeah. Which is what our brains are developed. They’re not evolved for delayed gratification. They’re evolved for food. Food could be lost any time. Security and safety could be lost at any time. So you’ve got to look for it. And that’s our desire to kind of wolf everything down in one go and completely clear our plates comes from because we could potentially before you’d have to hunt. That was the bit of meat or whatever food you had then and then it would run out and you wouldn’t know when your next meal was coming from. So we have to kind of overcome our wiring. And but you can teach yourself new tricks then what you’re describing by making something sort of habitual thing that you do every day. Then basically it fits inside your daily routine, and for people to have a routine is so important. I mean, yeah, retiring is thought to be one of the is the 10th top, most stressful thing you can do because everyone thinks retiring would be brilliant, but actually because you lose structure and routine and take you out of those good habits that you did have in some people and in other habits, you see similar type people and they’re running marathons. You know, you’re going, you know, you just started doing that 60.

Dr Anand : And that’s really impressive. But the majority of people, as you say, don’t necessarily want to change because it’s really difficult because you don’t see the benefits for so long. You know, my gym was telling me, Oh, look, if you start exercising now, hopefully we’ll see some changes in six to eight weeks, you know, six to eight weeks. Yeah. I can’t wait that long. I literally feel like I’m dying every time you try and get me to do a burpee, I mean, my arms. I’ve got really short arms. So like a T. rex doing a press up, it’s so embarrassing. I. I’ve got a gut as a lot of men in their forties do but I but I’m trying to sort of be an example because I’ve done all this learning now, and the issue is we don’t get taught about very much about diet and particularly not mental health as particularly sexual function in university. When you go to medical school, you kind of have to learn it afterwards. So I’ve been sort of increasing my knowledge. And in the year in 2012, I did my sort of exams and became a member of the European Committee on Sexual Function. So that’s been really helpful in terms of working in my head.

Dr Anand : And over the last eight years, it’s been about sort of getting my knowledge up to a level where I feel really confident that the information I’m giving is valid and has evidence behind it. And it’s not just, I guess and I appreciate a lot of stuff. It’s still, we don’t know. There’s loads of stuff and that’s what medicine has an issue with sometimes is those unexplained symptoms that we just don’t know. They probably won’t kill you, but we don’t know what they are and we don’t know why they’re caused. I’m not saying there’s nothing wrong with you. It’s just you’ve got them, but there’s no blood test or find it. And that’s sometimes what some of our patients get frustrated by. They feel knackered and I’m like, But I’ve done every test I know of, and I’ve always talked about every single issue. There are some changes that you’re willing to make. There’s some changes that you arent, and I don’t know if you’re not able, which is absolutely fine. Obviously, that’s your choice. I don’t know if this is going to help you or not. So you know, 99% of the time, we have both in general practice and in Harley Street. We’re very satisfied patients with information help we try to give.

Dr Anand : But inevitably there will always be some people. Then it’s not their fault, and therefore it may be. I’ve not given the information, the clear enough manner or I explained it properly or if I just don’t have the right turn of phrase and they maybe need to see one of my colleagues or even a different specialist. It’s not about saying that I’m the only person that can give you this information, and sometimes it’s about recognizing, OK, I have this problem, which no one seems to be able to diagnose as yet, but I am responsible for my health and my well-being, as you described earlier. We, I personally have to take responsibility for the fact I am a fat, middle-aged Asian man, which means that my arteries are therefore likely to be narrower, so I’m more likely to have a heart attack. I am also more likely to get diabetes, so I need to pay more attention to my risk factors. Yeah, and I think if you have if you have your own if your listeners have their own specific risk factors or, for example, they smoke or drink more than perhaps they should, then that again is something you can think about. Or can I do something about that? Is there a small change I can make?

Darren: And that’s the thing it is making those is making those small changes. And it is also about not overcomplicating it because I think as humans, we love to overcomplicate whatever symptoms we have and come up with these big elaborate reasons, but

Dr Anand : Also the solutions everyone gets like a Haynes manual out of, like how many different ways they could fix this and you’re going, well, you just need to do the basics because the other thing is its weight loss. I recognize weight loss is really difficult, don’t you? I’ve been on a diet since I was 12 years old, so I also I recognize completely what. And it’s not just exercise more and eat less. Everyone just goes, that’s that’s the cure for a lot of people, though that will work. Don’t get me wrong, that will work for a lot of people. But actually, if you are very stressed, you’re likely to eat differently. If you’re not sleeping well, you’re likely to eat differently because you want to get that sort of high. You get from sugar or from processed carbohydrates that allow you to keep functioning the same if you’re knackered and stressed, et cetera. You may get real pleasure. Some people have got a real pleasure link and other people don’t recognize when they’re full. And so again, there’s lots of reasons why you might be. You might have a thyroid problem. But yeah, there are some people that just have an overactive knife and fork like I do, and I just need to eat less and have smaller portions and do some more exercise and think about what it means to.

Darren: Yeah, absolutely. So when we when we think about and look at specific symptoms that guys come to you with, so for example, low test, low testosterone, what are the general symptoms tha men could look out for that would indicate that, you know, the testosterone is low? And what simple things could we do immediately before we even kind of book appointments to come and see you guys?

Dr Anand : Yeah, so. Absolutely. Good question. So there are two main ones, really, and it’s reduced sex drive. So that would be libido. So there’s this interest in sex going on around you. I’m not. I’m not suggesting I’m not saying looking at pornography because actually porn is an artificial sort of trigger of your sexuality, and it’s designed to be hyper arousing. So if I mean, I would recommend to people that they welcome not to listen to me, not to watch porn at all, because actually, it rewires you. And also just the way that you recognize sexual stimulus, it also alters your expectations. They did a whole study on teens in America, and they had one group that watched pornography, one that didn’t. And the ones that did watch pornography regularly found their partners less attractive, had less relationship satisfaction and enjoyed their sex less. So you’ll think actually, if you’re wiring yourself like that at 15, 16, 17, 18, if you’ve been using, you know what, high speed internet pornography for 20 years? Yeah. What’s your reaction to a person going to be? Absolutely who doesn’t? Also often doesn’t look like, I mean, you know, you might have someone that looks like a porn video, but the majority of people don’t.

Darren: That’s right.

Dr Anand : Yeah. So yeah, it’s it’s just I think it’s just partly removing that environment from you may actually be one of the key things that I offer is saying, OK, it’s that usage out. And it may take a while for you to go towards recognizing your own sexual cues and what your arousal system is. Because if you’ve been using pornography since you were 15, how do you know what interests you sexually?

Darren: Yeah, exactly.

Dr Anand : Yeah. Yeah. And so actually going back to it, right? So what is it that turns me on it? You might find stopping pornography for three to six months. Oh, look, my erections are starting to come back. Yeah. Oh, look, I’m starting to look at people because I’m not masturbating three times a day to pornography. And not that anything’s wrong with masturbating. I absolutely. I think it’s a very good thing. There’s an association that they did on a study that if you ejaculate more than 20 times a month, not a week, sorry, 20 times a month, you are less likely to have prostate cancer. Wow. Now that’s an association. So it’s not definitive. But those people that were more sexually active and had that number of ejaculation per month had fewer instances of prostate cancer. Whether it’s because you’re washing out, you’re basically cleaning your pipes. Basically, yeah, and you’re not letting sort of fluid sit there for longer, that can become more problematic. That’s one reason. So I would be if you are not sexually active and you want your penises to penis to work, then I would recommend getting an erection. You don’t have to masturbate with it, but once it’s there, it’s quite nice for a couple of times a week just to make sure that that’s sort of firing nicely.

Dr Anand : So those are the key things reduce sexual desire and erectile problems. So if either of those things are there, then it’s more likely you might have a testosterone problem. It’s not the only cause, but it’s something that I’d be interested. There are other things, for example, not having your night time or morning time erections and losing your muscle mass, or not being able to get any gains at the gym despite really upping your game, feeling tired all the time. Losing focus at work. Obesity falling asleep really easily. So and that can be due to sleep apnea, where we get a little bit heavy in the fat around our sort of sort of throat sort of slightly collapses our airway and we sleep. So it just you wake up multiple times. You don’t necessarily know you’ve woken up because it’s so disruptive that some people are falling asleep over their dinner. Some people fall asleep when driving. You know, other people will fall asleep in their meetings. Some people even fall asleep during sex, which is not ideal. Your partner tends to be pretty unimpressed if that’s the case.

Darren: Yeah, I can imagine.

Dr Anand : So I would definitely get checked out. Do I have a sleep problem? And there’s something called the Epworth Sleepiness Scale, which you can download a PDF online, and that’s just something you can fill in yourself and you can take to your GP if that’s a reasonable score. The things are things like depression, a change in weight. So you were very, always, very trim, and all of a sudden you put on a significant amount of weight in a relatively short period of time. Being irritable, hot flashes and sweats. And occasionally, if your testosterone is very low, you might get loss of body or beard hair. Right. But that’s not common. Okay. Yeah, that’s that’s about that’s that’s mostly the things that patients with low testosterone would come and see.

Darren: Okay, so so then if we look at diet, then in relation to testosterone, what kind of foods could contribute to the reduction in testosterone, but equally, what type of foods could actually increase that production?

Dr Anand : So I’m not fully I don’t have enough information to be able to tell you X food will be better for you in terms of exactly stimulating testosterone. However, we do know that good fats are important, so cholesterol is actually important because cholesterol is a precursor of testosterone. So I’m not saying we need to go and eat as much fish and chips as you can. I’m saying, look at the good stuff that you might get from linseeds or other good sources, olive oil, et cetera, is important to have in your diet. Yeah. So let’s start off point having a relatively low, a reasonable, safe BMI. So body to weight ratio is really important to height. Weight ratio is really, really important. So I’ve got that wrong again, heights to weight ratio. So forgive me, it’s height to weight ratio. The other thing is your body waist measurement. So if your waist measurement is over one hundred and two centimeters, you’ve got significantly higher risk of heart disease, testosterone deficiency, diabetes. So it’s keeping those things in mind. So if you are able to keep your weight down and control, I’m not suggesting being very low body weight because actually marathon runners and ultra runners tend to have a very low testosterone because they switch off their brain hormones because the body thinks it’s stressed all the time because you’re running all these miles. So the body thinks I’m just I’m just running away from things all the time, right? So there’s a saber tooth tiger at my heels constantly. So this is not a very good time for me to try and father a child, right?

Darren: So to fight or flight mode, you’re in that you’re in, you’re in the flight mode. Exactly.

Dr Anand : So basically, the idea is to try and eat a varied, balanced diet. As I said, high end veggies and grains, minimal meats and sweets. You’re looking at lots of pulses to get a lot more of your protein, et cetera, from. Again, it’s a balanced, balanced, healthy diet, which the majority of us just don’t have.

Darren: No, exactly. And I think that, you know, comes back to again what I said previously and it’s education and understanding what that is. And I always like to use the analogy that I got from somebody else actually about looking at your plate and cutting it up into three and making sure that in the veggie side, you’ve got rainbow colours and then you’ve got a nice portion of proteins that could be fish, it could be beans and all that kind of stuff. And then on the other side, you’ve got a small ammount of carbohydrates, you know, things like quinoa or things like sweet potato, things like that. So that, for me is a good. I always steer people towards that as a starting point for getting a nutrient what I class a nutrient dense diet.

Dr Anand : Absolutely. I completely agree. So I think that having a good diet and eating a good diet. Any time, any number of times a day, depending on what your practice is of how you eat some sort of little and often and other people, you know, they like to graze and other people like their proper three meals a day. I mean, what’s particularly useful is not going to bed with a full stomach because that’s less likely that’s more like to be processed into fat. And the also more likely disturb your sleep and give you heartburn, so if you can empty your stomach, that means eating for hours before you go to bed. That will also help. So because lots of men in midlife get heartburn, and that’s often because they’re eating later at night and they’re getting a bit more of a belly and that’s again squeezing and it’s pushing sort of acid back up into their gullet and throats.

Darren: Yeah, OK. So we were talking a little bit earlier around erectile dysfunction and actually what that could potentially mean more seriously like cardiovascular health and things like that. So obviously, the symptom of this is, you know, you’re not getting an erection, but are there any other symptoms that men could be aware of that could potentially be leading towards a dysfunction?

Dr Anand : Yeah. I mean, so men, it’s not to say there’s both. They starting an erection and then there’s keeping it ,right. For example, either of those two might become a problem, so it might be difficult for you to get aroused in the first place. So actually, it’s you know, and you still may be very attracted to your partner. Although I have to say the situation, sometimes you’re not right. So the penis is very good at recognizing in some ways what you’re attracted to and what you’re not. And I don’t mean this to upset anyone. But actually, you know, if relationships last 40, 50 years, sometimes your attraction changes and the quality of that attraction can change because I think some people are expecting their sexuality to be just the same as it was in the first three months as it is in the rest of their life. But your first three months is an almost artificial sexuality. It’s kind of like an evolutionary driven passion and hunger for the other person, which then starts to decline because it’s dopamine based, so it declines over time. And hopefully it’s replaced by the oxytocin that you get after you’ve had sex, which bonds you with trust. Yeah. So if the trust is high enough, you won’t break up generally. However, if your if your dopamine, I don’t know if you you may not remember. But I mean, I’ve certainly had relationships where I’ve got to about three to six months in, and therefore there’s kind of been like a reality check. There’s been like a sort of point I’ve what I’ve got. They leave the toilet seat up or they parp in bed or whatever it is that they do, which I never noticed before. And that’s because you don’t has fallen below a certain level.

Dr Anand : So the blinkers have fallen off, the blinkers are falling off. And so, you know, there are also your friends have been in relationships where you’re looking at them going, why are you with that person? You always said you think they’re awful and they think and they won’t, they won’t listen to you. And that’s the sort of madness of passion. And that’s because dopamine puts blinkers up and because it really wants you to get pregnant, it wants you to get together to father children so that sex life that you have there is to get you pregnant and then hopefully to manage the pregnancy and be around for you, for your partner whilst they’re pregnant and then get them over the first year. And obviously, with a screaming baby, you’re very less likely to be. Sex may not be so interesting as you may not be so up for it because you’re knackered. I mean, other people obviously are, and it does vary. So you’re not suggesting people don’t want to have sex. Of course they may well do, but being aware that actually your sex partner may be very different before birth to after birth. Yeah. And then, you know, your kids start growing up and your attraction to the other person is not necessarily based on lust. It’s now based on a commonality about it’s your team, it’s you against the kids. In some way, you against work, it’s you again. It’s the two of you have bonded together so strongly, and so sex becomes often more about love and about attachment. And so sometimes love and attachment isn’t as strong as getting you an erection as pure passion and porn.

Darren: Right? Okay.

Dr Anand : So just being aware that as you get older, you know, don’t tell yourself off if that’s the case, that’s what I’m saying. I’m not saying you need to get another partner. I’m just saying, don’t tell yourself off. If you find that it’s necessarily as easy as it was to get to just recognize that you’re a bit of an Aga now , you used to be a microwave and now you’re in the. You can get turned on and it just takes longer. And remember also, when you were younger, you were sending sexy texts well you weren’t actually in those 20 years ago, I didn’t have local phone. But you know, people these days, you know, they send each other texts that send nude images. They might it might be flirting all day. So by the time you actually see each other, you’re seriously turned on. So actually, your erection is based on several hours of being sexually aroused, whereas now you’re expecting to be aroused after you’ve had a really busy day at work and you’ve fed the kids and you put them to bed and you’ve had like half an hour with each other where you’ve been irritated because you’ve both had to watch Schitt’s Creek and you both hate it if the only thing you can agree on or whatever it is that’s going on. I quite like Schitt’s Creek just for on that program.

Dr Anand : But you compromise, don’t you? And it’s not necessarily what either of you necessarily want, and then you try and get to bed and you’re just meant to have sex. Well, that’s just not realistic. You need to be making time for each other. You need to have date nights. And if you spend time with each other and recognize each other as sexual human beings who are separate to their role of mother or father or. Or Carer or fixer? And you actually think, oh, you know what, we are also those people that got together at twenty three or at 30. We are the sexy, interesting people. We just need to find that way back again. So it’s about arousal, so arousal can take a bit of time as clearly as my conversation, because I go on tangents, I apologize. So arousal something and then they sustaining the erection. So some people find it’s no problem getting the erection. It’s just they can’t keep it whilst they’re having sex. And therefore it basically softens. And either they can keep going with the soft Willy, really, or it’s soft and so much that they can’t. Now, for some people, they’re not bothered about that because actually they’re outer course game is really strong. You know, they’re all about the clitoris and they’re all about, you know, or if they go, that’s listening about playing with whatever, whatever bits that fit, they’re all about that, making sure their partner is sexually satisfied.

Dr Anand : So then penetration isn’t necessarily the end game. And I think men are taught that penetration is everything, whereas actually women don’t have, particularly women don’t have particularly many. Sort of all the pleasure for women generally is on the surface because all their sexual organs are on the surface. And so if you’re penetrating in Wright’s book Vagina Reeducation, one person talks about penetrative sex being like a tampon being repeatedly plunged in and out of me. Just so, and that was fascinating for me because I thought, Oh, of course, women should enjoy penetrative sex, why wouldn’t they? And you’re like, Oh, actually, if your sexual stimulation isn’t actually via vaginal penetration, then perhaps we need to not be fixating so much on penetration. Yeah. And if that’s OK, you’re not fixated so much on penetration, then actually how hard your penis is isn’t necessarily such a problem. But I also recognize it’s a symbol of masculinity. It’s something that you’ve been very keen on. And actually, you and your partner might really enjoy penetrative sex. So I’m not trying to tell you your sex life is wrong. I’m just saying it’s not everything, and there are lots of lots of other things on the buffet table of sex that don’t involve you sticking your penis in something.

Darren: Yeah, I think I think it’s really interesting, though, because it’s the way that you’ve described it there, I think is very valuable from the perspective of recognizing that it is this evolution. It is this journey and to and to still be sending the sexy texts and just kind of focusing completely on your partner like you did in your twenties, thirties or whenever you did it, then to expect to still do the same. When you’ve got screaming kids, you’ve had a rubbish day at work and all the rest of it is is unrealistic. But I think all too often in a relationship, we think that it should be like that. It should be how it was when we were first starting dating. But you know, it’s recognizing that, you know, you’re at a different stage in your life. So it doesn’t necessarily mean to say that that can’t happen. It just happens in a different way.

Dr Anand : Yeah. I mean, if you think you’re used to having sex every day, you could still have sex, potentially every day, but it won’t necessarily be a drawn out all nighter. It might be a quickie in the airing cupboard when the kids are finally, just because they finally got off to school. And you’ve got ten minutes before you go to work and there’s nothing wrong with that. It’s just different. You just have to work out different ways of fitting your sex life into what is your family life. Now, obviously, if you are a single person, then that’s probably slightly different. If you’re a single parent, you’ve come out of a relationship because lots of relationships. I mean, there’s, you know, there’s a relatively high rate of divorce. A relationship breakup that happens is where people are on their second or third major relationship in their lives. So if you are looking for that and you have erectile problems, that could be more problematic because there may be you may have the expectation to be ready for everything, and your partner may have the expectation that you will be ready and be able to get an erection. And that will not be a sign of their attractiveness, you know? They want to be found attractive, I’m sure, and they want that validated by a hard penis. And if you can’t give them that in some people, they will see that as a failing of you and you may see it as a failing if you not everyone, and that has to be made really clear. Actually, a lot of people. Sex isn’t their primary motivator. No, no. But I think that some people.

Darren: Yeah. But that’s also another thing to kind of just recognize really that again, as what depending on the age and the certain stage that you’re at in your life, absolutely. It might not be just all about the sex. It’s more about the connection and the intimate intimacy. And you know, sex is not just the barometer that it used to be, perhaps. So I think, yeah, I think that’s another important point that you raise there. So in terms of, you know, other sexual health conditions or anything else that us men should or could be looking out for.

Dr Anand : So premature ejaculation is actually one of the most common sexual dysfunctions in the UK. It’s just that people don’t talk about it. You know, when you’re younger, you are so hyper aroused, so easily aroused that often people are just like on a trigger that they just I mean, there’s one called anti-portat ejaculation, which is you don’t even get to penetrate and you ejaculate, right? And premature ejaculation is ejaculated within the first 60 seconds of penetration. That’s the technical term, but for some people, for example, if they ejaculate within the first five minutes, that’s that’s too quick for them. Other people I’ve had coming in saying, Oh, you know what? I’m a premature ejaculator. What do you mean? Tell me exactly how long it takes from from insertion to ejaculation? Oh, about an hour an hour. Because most people don’t recognize that the average in the UK, because this brilliant study, I think done by Waldinger, it was five point four minutes from penetration to ejaculation. Wow is the average in the UK. So the median, not the average, but the median the UK is that some people are watching a lot of pornography and not necessarily recognizing that that sex is stunt sex and being filmed over several hours. Yeah. And and they’re often taking Viagra or other support medication to keep that erection there. And they may have fluffers to keep them erect. So it’s not like you have all of that support around you unless you are particularly lucky or have an unusual relationship.

Darren: Yeah, exactly. Ok, so I mean, that’s interesting and something that I hadn’t actually considered, so what would you say are five key actions that men can take, you know, or be aware of to improve their sexual health?

Dr Anand : I was thinking about this because you very kindly sent me that through earlier and I would just because I don’t want to sound like I’ve already know this on the top of my head. I’ve actually prepared this, so I think I’ve got 10, if that’s all right, but you’ll still be fine. So the first would be exercise regularly losing your abdominal fat, gaining some muscle and therefore bone density. If you do some physical exercise and particularly this is resistance exercise where you’re working large and muscles like doing squats or doing sort of chin ups or pull ups, you are going to be exercising lost muscle groups, which increases your release of anabolic steroids. Your own personal anabolic steroids and will enhance your testosterone naturally. It also strengthens your bones, so that’s a key thing to be doing it day, if you can, and not overdoing it, we’re not. I’m not expecting to work at one hundred per cent of your exercise tolerance and think, actually, if you can just do some for 10 to 15 minutes each day, that’s plenty. I eat a diet that’s veggie and grains rich with minimal meat and sweets. Thirdly, try and sleep well because it improves your diet and eating improves your general well-being. Improves your memory because you code memory at night and it promotes your recovery. Yeah, before I talk about managing your stress, so that’s mindfulness considering your work life balance.

Dr Anand : I’m trying to get some time with your partner. And five, promoting your social connections because men lose them as they get older and social isolation is a big issue from mental well-being. Six Reduce your alcohol partly because it helps you sleep as well, but also alcohol is a depressent, and lots of Middle-Aged drinkers unfortunately damage their livers because they go for a slightly larger glass than what typical? Yeah. Seven. Don’t smoke. Eight. Communicate with your partner about scheduling sex OK, so if it’s important to you, do it. It’s certainly important to your penis to get an erection, but you don’t have to have sex to get an erection. But actually, if it’s important for your sex is often really important for couples bonding. So communicate with your partner. Ask what sort of stuff you want. Remember after the menopause? If you’re hetrosexual, your partner after the menopause, your partner’s skin texture sensation, the skin sensation may change. So you touching them on their arm or their back of their knee or the back of their neck may not be as exciting as it used to be, or it might be too sensitive. So you’ve got to keep checking in about because our bodies are landscapes and they evolve, and they also need to be reassessed over time. So checking in is this still fun? Know, do you want to have sex a different way? Is it more fun if we do a different way? If you’ve had certain pelvic operations for women, for example, it may be that penetration can be too deep and it can.

Dr Anand : That can be uncomfortable. So there is a sex aid that can sort of reduce the depth of penetration as women go through the menopause. They can often get drier, and that can be more painful. But just being aware of lubricant use that kind of thing. So it’s just being aware of going, look, it’s not just sticking it in. There is more to sex than that. Nine. I would really recommend you seeing your GP if you have a health concern now, if it’s a if it’s something short and it goes away fine, you know, if you had erectile problem and it lasted three or four weeks whilst you were doing, you were changing job, that’s normal. You don’t need to see someone for that. If, however, you’ve got a problem, you know you’ve lost your focus at work, you’ve not had any sexual desire and you’re not having a night time erections, and that’s been the case for three to six months. Right. That’s pretty consistent. Yeah, yeah. So and think about that. And then finally, please do not take anabolic steroids or testosterone without medical advice with medical advice. They’re never going to give you anabolic steroids anyway. But if you are receiving testosterone therapy because it makes you infertile.

Dr Anand : Testosterone in up to two thirds of cases will make you infertile, and the treatment and up to one third of cases are permanently infertile. So, yeah, and we’ve got lots of 90. We’ve got case studies from eighteen to twenty five year olds in particular that have been picking stuff up on the gray market from gyms. Wow. And they are using all this Testarossa because, you know, they’re seeing all the Henry Cavill’s of the world. They’re seeing all these men with really big buff bodies and they’re going, Well, how do I get that body? And actually, you know, a lot of the bodies you see on TV are artificially enhanced. They have they go through boom and bust cycles, which is why you see some film stars and they have these on Heat magazine or whatever with bellies and that being flabby and out of shape. And you’re like, Well, they’re just on their bust cycle and then they’ll do stuff again. And some of those will be taking extra medications like anabolic steroids and testosterone to be bulking themselves up. That will cause potentially long term damage to your skin, to your heart, to your bones, to your muscle, you know, to your sexual function. You know, your testicles will generally shrink in size and you may lose your fertility. So that’s a really sort. “Please don’t” message from me.

Darren: Yeah, yeah. Well, if we’ve got any young guys listening to this, maybe we do. Maybe we don’t. I don’t know. But they should definitely take heed to that advice. And I think point five that you picked up on social connections, I think that’s very important and I think I’m as guilty of this as anybody. And you’re right. You know, we do as we as we get older, we tend to lose connections with people. But I think, you know, if you look at the kind of environment now, there are a lot more clubs and things popping up the, you know, aligned with either certain sports or certain interests. And so if you have lost that social connection, that’s a great way of reconnecting with people who have a common interest.

Dr Anand : Absolutely. If you’re interested in something, keep being interested in it . You know, if you like table tennis, I like table tennis is quite random example, but you like table tennis. There will be clubs generally in your area that you might be able to get to. I appreciate some of them might be a schlep to get to, but it’s actually maintaining those friendships. I know everyone sort of they don’t mock necessarily, but they’re sort of fond mocking of older people playing bowls. Yeah, that’s the thing you don’t do when you’re young. Do you do it? It’s like a thing that you’ll do, but actually, that’s so important. There’s not just it’s a relatively physically functional thing that you can probably do as we get older, but it’s also community wise, really important. Definitely.

Darren: Yeah, and it gives you that routine as well, doesn’t it? It gives you that purpose, it gives you that reason to be at a certain place, at a certain time, you know, having to do certain things or prepare for it and things like that. And you mentioned back at the beginning of the recording around, you know, having when you retire, you know, you kind of lose that structure. And I think, you know, having working worked from home for the last five years, you know, it’s having that structure is so, so important. So, yeah, I think that’s fantastic. So before we wrap up then and what didn’t I ask you that you feel I should have asked you which would benefit the listeners?

Dr Anand : I’m going to have a little think if That’s all right.

Darren: Yeah, absolutely.

Dr Anand : I think I think we’ve probably covered all of it, really. And I think the key theme is that if your body is out of shape or if you think it’s out of shape, there is the ability to rehabilitate it. It’s not permanently like that. If you’ve got a gut, it’s not just sitting with your hands, hands wrapped around it going, Oh look, I’ve got my food baby. Exactly. And just it is possible for you to get to a different place now. Sometimes that’s really hard and particularly if you’ve had an injury. So, for example, if your knees been busted playing football or whatever or however you did it, that’s going to make it difficult for you to exercise in certain ways, which means it’s more difficult to keep your weight off and all of this. I absolutely understand that. But actually, in some ways, it’s even more important for that person then to focus on maintaining their health and maintaining their waistline and maintaining their what’s going into their body and the type of exercise they do. And then perhaps working with an occupational physical therapist or a personal trainer is so important trying to go, Look, what can I do to exercise this body that limits the amount of impact on my joint or whatever? And yeah, so that’s, I think, recognizing that you are never past it and that you want to be your best physical and mental self for as long as you possibly can be. And you know, please do contact your GP or doctor or some form of health care, professional and maybe mental health, for example, talking therapies, if you need to. We don’t want you to sort of suffer in silence.

Darren: Absolutely. Yeah, I think that’s a great, great way to end and that is suffering in silence. And don’t let your ego or your masculinity get in the way.

Dr Anand : So I’m sorry, one last thing – Capitalism is values men for their bodies and what they can do and what’s bad about. I mean, there’s lots of things about classes and forgive me, I am. I am. I am. I recognize that can be a problem for some people, but because capitalism values you for your body and your output. It means that often men value themselves on the work they do and their output. What is not valued is spending time with other people. What’s not? You know, that’s not considered a positive thing was actually your body requires it. Your body requires time for you to switch off and sleep. Your body requires you to spend time with other people in a non-work capacity. So if you can do that, you are doing exactly what your body needs. But it doesn’t mean you’ve got to push back against sort of masculine capitalist ideals.

Darren: Absolutely, yeah, I think that’s very important, and I’m glad you raised that point. So how can people connect with you? You’ve got your own podcast if you want to share what that is.

Dr Anand : I mean, I do a podcast called The Pleasure Podcast with my co-host Naomi Sheldon, who’s an actor and writer. And we talk about all things sexual. It’s kind of basically you. I mean, I had rubbish sex education. So this is kind of the sex education I wish I had, right? So it’s basically relationships. What happens after you’ve been together for several years? What happens during pregnancy? What happens after we’re just doing it? We just done a mini series on on what happens during and after pregnancy and motherhood. Right? There’s lots that we do have a lot of women speakers, but actually, I think that’s really important. Men listening to women actually is really important because I think men often don’t talk to women about the sex that they want to have, and that’s a detriment. Men could be having a lot better sex and a lot more of it if women were much more engaged in the act and much more involved in what was happening. And this is just for the people I see. I’m sure lots of your listeners are having amazing, incredible sex lives, but from some of the women we talk to, they’re not having incredible sex lives. So there’s a mismatch somewhere. There’s a mismatch somewhere. Definitely. And also, I’ve got I’ve got my Twitter is @therealDrAnand and I’ve got a clinic at the Center for Men’s Health. If anyone feels that they want to. 

Darren: Lot of stigma. Lovely. Well, I definitely recommend guys check out the pleasure pod. You know, you’re going to get some great information and advice and you know, you may, may even well be able to improve your own sex life for actually communicating with your partner and finding out exactly what it is that they do and don’t want. So thank you very much for joining me on the podcast today. It’s a fantastic episode and great speaking to you. So I look forward to catching up with you again in the future.

Dr Anand : Thanks so much. That’s really nice. Nice speaking to you.

Darren: Thanks for listening to the Fitter Healthier Dad Podcast. If you enjoyed today’s episode, please hit subscribe. And I would really appreciate if you could leave a review on iTunes. All the things mentioned in the episode will be in the show notes, and a full transcription is over at Fitter Healthier Dad Podcast.

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