S1: Warning this podcast contains explicit language and very specific discussions of sex.
S2: Hi, I’m Rich Juzwiak, I’m a writer
S1: and I’m Stoya, a writer and semi-retired pornographer.
S2: Welcome to the how to do a podcast where we try to help you with all of your sex and relationship issues twice a week. You can ask us anything about sex or your bodies or dating etiquette or whatever. We’re here to help.
S1: So we’re in New York City in the beginning of 2022, which feels a lot like New York City in the beginning of 2021, and a lot like New York City in March and April of 2020. Covid is not going away. It continues to mutate and it actually causes dick problems. So not only are we going to continue hearing about the social safety concerns around Covid, but we’re also seeing questions from people who are having problems with their dicks because of Covid.
S2: Yeah, I mean, the link between Covid and erectile dysfunction, I think, is pretty conclusive at this point. Obviously, not everybody with a penis who gets Covid will have erectile issues, but there certainly seems to be an elevated chance. And I think it just goes to show that I don’t know that we’re ever out of the woods with this thing. You know, symptoms persist. There is a concept called long Covid. Sometimes people’s symptoms persist without abating. Personally speaking, I lost my sense of taste and smell early in the pandemic in 2020. And that’s never come back entirely. I mean, it’s back enough that I enjoy food, but I would say that I’m at like a decent like 70 percent of what it was, you know, which is actually helpful when my cat used the litter box. If I’m home alone because I’m not, you know, smelling it, if there’s somebody over or somebody’s coming over. I think that’s a bigger issue to I stink. Do I need deodorant? Do I care? I don’t know. So there is like this idea that like, it sticks with you. That’s a great reason to get vaccinated, to do your best, to avoid Covid because you don’t know what’s going to stick with you. And one of those things people with penises is maybe a smaller dick. It’s a thing. So that’s what we’re talking about today.
S1: And my former job intimidates people and my current job intimidates people. So I have a lot of experience with limp penises that are because of psychological circumstance, more than physiological. And with that, you know, you just want to be like, OK, that’s fine. We don’t need your penis. We can do other things. We can have fun with a limp penis, actually. There’s all sorts of stuff that can happen. But when it’s because of a medical concern, you want to address that.
S2: Yes, for sure. And so let’s address it.
S1: Great. Let’s hear a first letter.
S3: Dear, how to do it. I’m a heterosexual man in my 30s. In July of last year, I contracted Covid and was very sick. When I got out of the hospital, I had some erectile dysfunction issues. Those gradually got better with some medical attention, but I seemed to be left with a lasting problem. My penis has shrunk before I got sick. I was above average. Not huge, but definitely bigger than normal. Now I’ve lost about an inch and a half and become decidedly less than average. It’s apparently due to vascular damage, and my doctors seem to think it’s likely permanent. It shouldn’t really matter, but it has had a profound impact on my self-confidence and my abilities in bed. I know you can’t give me back my missing length and girth. I was wondering if you could give me any advice on what to do now signed coming up short.
S2: Because there’s so much that we don’t know. I thought maybe we should reach out to an expert or two. Awesome. And so I have this urologist. Charles Welliver He is the director of Men’s Health at Albany Medical College. I use him a lot for my penis and urology related questions. And he has graciously agreed to speak with us. We just talked to him about Covid dick. And is it a thing?
S4: So yeah, you can connect these dots, actually. So, you know, one of the things we know about Cove is, of course, you know, the mass of respiratory symptoms that leads to a lot of the deaths, but there’s also pretty significant vascular issues that occur with guys. And studies have shown that both guys can get priapism, the prolonged erection that’s dangerous in its own right, and the guys can also get ED from getting Covid. So it can kind of go both directions with these vascular events. But when guys get ED, they get a lack of good erections for our right. That’s why it’s defined. But when that happens, they actually do get some, some shrinkage. We do know that guys get some trouble. So you can kind of connect the dots through that.
S2: How prevalent is a guys who experience ED post-COVID and B people who have a D who then c shrinkage? Is this common in either designation?
S4: Probably every high that has significant ED now, like every so often type of problem, that a significant need probably gets some shrinkage. We see that, particularly in guys after they have their prostate out for cancer and have zero erection for six to 12 weeks. They all get shrinkage, and there’s actually some things you can do to rehabilitate that. But to answer your other question, we don’t know what kind of the total number of guys that have had, but at this point is that so many people are asymptomatic. But I can’t say I’ve seen, like a lot of guys for like young guys with ED, and I would say it’s really, really common, but it’s certainly a possibility.
S1: So you said something a minute ago about rehabilitation. Can you give us some more information on that?
S4: So the concept of rehabilitation actually started after radical prostatectomy because we knew that guys had this temporary loss. So the original step was to try and use at low dose daily Viagra or something along those lines. But more recently, we started looking at a different kind of stretching devices or traction devices. There’s one called RestoreX, which is used that the data is actually very good at about regaining length and maintaining length. And there’s other ones called vacuum erection devices, which are been used for for forever, which also have some potential benefit there, too.
S1: Yeah, our writer said, I know you can’t give me back my missing length and girth, and it sounds like actually there might be a way to get some of that back.
S4: There is very good data that shows that is possible, so I hope he’s listening.
S1: So I also reached out to an expert. Ashley G. Winter, who I found through Twitter, and she had so much to say.
S2: She’s a woman urologist, which is very rare and fascinating in itself.
S1: Ten percent of urologists are female,
S2: so we’ve got a unicorn on our hands.
S1: Yes, I love a good unicorn. Do you know anything about Covid dick shrinkage? Yeah.
S5: OK. So in terms of why there are negative effects of Covid on the penis, right? The main reason that we think this occurs is something what we call endothelial dysfunction. And I’m using like, you know, jargon words here, but that’s basically the cells that line your blood vessels. They’re like smooth muscle cells on the line or blood vessels, and they’re really important for the function of many different organs and COVID gets into those cells. And so that means it affects many different organs in your body, not just your lungs. And because the erection is, you know, a blood flow event, right? You get hard because a whole bunch of blood moves into your penis and stays there. When those blood vessels are affected, you know, and then you can get the erectile dysfunction. And there’s actually a really cool study that was done from by some urologists in Miami, where they took samples of penis tissue in men who were undergoing penile implant surgery and they looked for Covid in the penis and they found Covid, you know, virus particles in people’s penises. And this was after they had completely recovered from the disease. So we totally know that Covid DIC is like a real thing, and people aren’t just like making it up like the Covid is actually in your day.
S1: Is there like a sexually transmittable Covid risk that we should be concerned about?
S5: You know, it’s not considered to be transmitted through sex and actually you they have found Covid in the testicles. They have shown impaired testicular function after Covid infection, meaning you know it could cause your testosterone to go down. It could cause, you know, reduced fertility. And actually, this is another cool thing. There are studies comparing men before and after Covid vaccination and looking at their sperm parameters, and there was absolutely no negative effect of Covid vaccination on sperm parameters. You know, so that’s another reason to convince people to get vaccinated because it’s also bad for your balls. In addition to your
S1: gut, it can’t like live in their balls for weeks after recovery and then be like, Surprise, you’ve got Covid.
S5: It can live in your balls for weeks afterwards. But like, is there a case right of somebody who went around and had sex with a bunch of people after they had Covid and gave them all Covid like? Absolutely not. So no,
S2: when we talk about the effects of Covid, is it too early to say whether these resolve over time or are permanent?
S5: It does appear, at least with the testicles, that the negative effect is not permanent. You know, the amount of time that it will take afterwards to get your testicular performance or balls working. The way they should, you know, can probably vary. But you imagine it would be somewhere on the order of months, you know, with the penis. I don’t think that’s been well established. The problem is that if you do have erectile dysfunction, that’s really profound for a period of time. There can be some of these what we call more permanent effects, right? So you know, this guy is saying that he has shorter. It is true that having erectile dysfunction leads to shortening. Now there are two types of, for example, performance anxiety related erectile dysfunction that don’t lead to penile shortening. And the reason is because even if you get nervous and you lose your erection, but your penis is otherwise healthy, right? Like the blood vessels in your penis are healthy, then when you go to sleep at night, you’re going to have nocturnal erections or you’re going to masturbate and have nice erections. So that is really important actually for the health of your penis to bring the blood flow in, to stretch it out. And kind of that maintains the length and girth then health of your penis. So people with that type of ED are still getting like full erections at some point, whether or not they realize it. Now if you have like a real physical erectile dysfunction, you know, a classic example is like men after they’ve had their prostate removed for prostate cancer. You know, somebody who has erectile dysfunction from Covid, they may also have this very physical type where possibly they’re not even getting a full nocturnal erection, right? So you have this period of time where the penis is not stretching itself out, where it’s not, you know, getting all this full blood into it, and that can lead to scarring of the penis and shortening of the penis. And that’s probably what you know your caller is referring to now. There are things you can do to help with this. So there’s a really common concept of penile rehab and that’s done for men, you know, or prostate bearing individuals who have had prostate cancer surgery so that they don’t lose length and have scarring during that period of erectile dysfunction, so that when they come back to getting their their erections, that they maintain their penis length and how do they do that? So a typical regimen would be, you know. Starting something like Viagra or Cialis soon after their surgery or even before it again to improve blood flow. Another thing would be to buy a penis vacuum device and do kind of what we call, you know, penis exercise with it or penis push ups. And that’s where you just take the vacuum device and start. These are, you know, really commonly when you think of them, it’s it’s used, you know, for sex. And what happens is people put a constriction band a.k.a. cock ring, you know, at the base of their penis, and they put the vacuum device on and they pull blood into the penis, make it hard and have sex. But if you use it for penile rehab or, you know, penis exercise, you don’t use the constriction band. You just put the thing on, you know, suck blood into the penis to stretch it out. Those are two options. And then the last thing is using traction, and that’s essentially you buy a device that you put on your penis and it holds it in stretch. The one that I recommend to most patients is one called RestoreX. I have absolutely no financial relationship with them, but it’s a great device and they actually have their data on their website, and they’re showing men with shortening of the penis from erectile dysfunction or other kind of chronic disease that they can have improvement of penile length by, you know, one to two centimeters with consistent use of this sort of thing. So these are easy things you can do at home to either prevent shortening or actually get back length that you’ve lost.
S1: So let’s say our guy is like, I don’t want to take pills. This machine thing weirds me out. I’d rather just like come to terms with my new penis dimensions. Do you have any advice for him on how to become comfortable with his parts as they are totally so?
S5: You know, if you look at the literature on people who are unhappy with their penis length, there’s actually like studies on this. In those same studies, they show that the partners of those people are very happy with their penis length. Right. And so, you know, in general, and I know this is a message you would agree with, you know, being a good sex partner really doesn’t have anything to do with your penis length. I mean, you know, it’s just how responsive you are to your partner and your communication and, you know, other talents. So I think, you know, keeping in mind that, you know, penis length doesn’t define somebody. And the vast majority of the time dissatisfaction with penis length is really self driven and not partner driven. And like, you know, liberating yourself from the version of yourself that you felt like you had to be, you know, to be comfortable with sexual activity is just super important.
S2: So I went into this question thinking there was no hope it could kind of siding with the writer. Apparently there is like actual hands on hope for changing or restoring penis length, which blows my mind.
S1: There’s so many options of
S2: hope, and I hope that that hope is enough in itself right now to set him on a different path. Like hope, it can be so important as a motivating force, as a way of showing you not to give up. Yeah, I feel like so much of, I don’t know, depression. So much of just a negative world view is that absence of hope. So hopefully, at the very least, listening to this there is used to be taken just from the affirmation that like, actually, it’s not over for you. You don’t need to mourn this loss, necessarily. There are things you can actively do and try, and I would really, really recommend taking our doctors word up, you know?
S1: Yeah. And if they want to see a urologist of their own, they can ask if the urologist feels comfortable talking about sexual
S2: health and if not, find a urologist who is
S1: comfortable. Yeah, I mean, visit Oregon if you have to. Dr. Ashley will be happy to see you go west.
S2: Yeah, OK. Moving on to the next question, do you?
S1: How to do it?
S6: I’m a woman in my thirties who just ended a long term, monogamous relationship. Now, a couple of months post-breakup, the idea of having sex with someone new sounds super exciting after a positive referral from a female friend. I downloaded the field app with the idea of finding someone with whom I could have a fun casual sexual experience. Here’s the catch I’m not certain I’m capable of having a fun, casual sexual experience. I’ve never once had a one night stand, and the majority of sex I’ve had has been with long term romantic partners. I often describe myself as demi sexual due to the fact that sexual attraction doesn’t generally occur for me until I know trust and feel an emotional connection with someone. For me, what makes sex good is the passion, the connection, the romance and the anticipation. My question is, am I kidding myself thinking I can get what I want from an app like field? It seems like most people who use it are within the kink poly or BDSM community, none of which I belong to. And the first person I match with try to get me to meet him that same day for a hookup, which freaked me out so much that I immediately unmatched with him. Should I just wait to have sex with my next romantic partner, wherever that ends up being? Am I too monogamous and find a home for casual hookup? Or should I continue to talk to people? Be upfront about what I’m looking for and push through the uncomfortable feelings that come from being in a completely unfamiliar territory, signed, trying to play the field?
S1: The word Demi Sexual refers to a person who’s in between all those sexual and asexual, meaning they’re interested in sex, but only in very specific contexts.
S2: Right. And in particular, an emotional connection is what would make a demi sexual feel open to you and interested in sex, right? It basically distinguishes people who would be interested in having sex first and then form the romantic connection from people who are actually interested in the romantic connection first and then the sex. So on WebMD, bisexual people only feel sexually attracted to someone when they have an emotional bond with that person. OK. But I think that you’re right in orienting it between shallow and asexual. Yeah, yeah.
S1: So field is actually a really great space for this. I’ve interacted with various apps in this specific question. I would recommend Field and OkCupid. Mm hmm. Because they attract people who are open to having a pretty blunt discussion about sex. Mm hmm. So, for instance, I realized I was in New York for like four months straight, and so I fired up field. Mm hmm. And I gave my profile a once over and under interests, I added, receiving oral sex. OK. Within a week, I was feet up in a hotel room, receiving oral sex for like literally two hours. It was incredible. Great. And that kind of like, here is what I’m looking for, goes a long way on both of those sites. And people also generally tend to put in their profiles what their deal is. And I think it comes from mostly being poly, queer, kinky. We tend to have more comfort discussing sex, more comfort sharing our desires.
S2: Well, it’s because you can’t take your desires in sex for granted. You understand the status quo and how you deviate from it. And that creates this ability in some people to articulate.
S1: Yes. So what I would recommend is put in your field bio. I mean, keep it succinct. Any dating app keep it pretty short. But I would say I’m possibly demi sexual and would love your help in running an experiment on whether I can be happy with a casual hookup.
S2: Yeah, that’s I think that’s really smart to set the expectations because there is some waffling in this question. It’s kind of almost hard to tease out. It’s based in conflict. It’s based on having these two distinct drives that are somewhat feeding off of each other. It’s a push pull. I think I want this. I don’t want this. Whatever being honest about that, reducing any kind of expectation that is unwarranted is going to always serve you well. Mm hmm. And you know what you talk about, you know, field no cupid. I think that’s like de rigueur. Or have you say it for men who have sex with men apps? You know, saying what? You want it probably to a fault where it becomes so transactional and it’s like, I want this thing. You won’t give me that thing. You are not right for me, and you can feel like robotic in a way when you know, when I find I fall too deep into, like one of those patterns and it’s like, Oh, no, but like part of the fun of a sexual experience could be to like, leave it up to like whatever happens, especially if you’re averse, you know. I mean, that’s the wonderful thing about like being a man who has sex with men, you can really easily do so many different things. So I kind of go back and forth, but I do think that in this particular case, stating your interests lack thereof, biases, et cetera, is the way to go.
S1: Yeah, and I would stay the hell away from Bumble and Hinge. Hmm. It’s rare to find a person there who’s like, Yeah, let’s like, talk about sex. Like, right now, I have no idea what Tinder’s like.
S2: I only use Tinder briefly years ago, and I found it to be like slow Grindr. Like, whereas like I would facilitate a Grindr hookup, you know, like that, Tinder. I usually had to go on a date and like, ease into the sex. That was inevitable anyway. And I was kind of like, OK, I mean, like, I get human connection. But it also feels kind of like a waste of time.
S1: Yeah. You know? Yeah. But be upfront about your question. Yes. Offer it as an exciting experiment. Would you like to participate in me finding something out about myself?
S2: Right? And go slow. Like, maybe today you feel like, OK, now is the day. I’m actually going to do this and post this profile. And then tomorrow you feel like, no, this is getting way too fast. I actually don’t want to do that. And then you don’t sign on to the app that day. You know what I mean?
S1: And like, OK, you met someone who wanted to move at a different speed and you immediately unmatched. Great. That’s also how I do it.
S2: Yes. And it’s really OK if at the end of this experiment, you realize what you think you know already, which is that actually, no, I’m going to enjoy sex in a romantic capacity. One night stands are not for me. That’s totally fine. You don’t. They don’t need to be. And there’s actually a lot of emotional fallout that can happen as a result of what feels like a very kind of throwaway experience. Oh gosh, yeah. So you’re not opening yourself up to like all of this on expected baggage. So there’s pluses and minuses for whatever pattern life you take, whether you want to be like a crazy slut or totally proper and virtually sexless. There’s pros and cons
S7: in every field. Yeah.
S2: OK. That’s all for now, but we’re not done this week
S1: and tomorrow’s episode, we hear from a letter writer who’s apparently so attractive that it’s getting in the way of his work and life. I’m just like, Are you professionally established sexy? Not only do you know what you want to do with your life, but you’ve executed it.
S2: Oh yeah. I think for our writer’s purposes, we’re now part of the problem. I doubt to hear that discussion. Sign up for Slate Plus for just one dollar at Slate.com. Slash HDI.
S1: Play us If you’re in need of sex advice, you can write to how to do it at Slate.com, slash how to do it, or you can leave us a voicemail at three four seven six four zero four zero two five and we may use it on the show. Everything is anonymous and nothing is too weird or embarrassing.
S2: Our show is produced by child to how to do its editor is Jeffrey Bloomer. Our letter readers are Shosh and Leonard and Benjamin Fresh. And if you’ve been loving the show, please rate and subscribe. Thanks for listening, and we’ll talk to you next time.