what people think doctors, especially when people in general think is that what is leading causes of erectile dysfunction aren't. If you told the woman women today, no more vibrators I really don't want using a vibrator they would think what you are you crazy? I am a firm believer that orgasm a day keeps the doctor away. men who are watching pornography and masturbating become dependent upon their own hand. Hello and welcome to Awake at the Wheel. So Valentine's Day is right around the corner and in working with my clients as often means clients coming in and talking about the anticipation of the day, but usually not terribly positively. So why is often talk about the anticipation of the disappointment of their husbands not fulfilling the perfect day for them? Husbands will often talk about the expectations that seem insurmountable and unattainable. So with this comes a great deal of unrealistic pressure and disappointment. So there we go, talking about a really happy holiday just to start out here. So oftentimes in our work with clients, the impact of psychological disorders has a great impact not only on their emotional intimacy, but also on their physical intimacy by way of things like desire, libido, and in some cases as a result of different disorders and even medications that they take to treat these, they can often be dealing with things such as erectile dysfunction and other sexual dysfunction. So on this podcast, we often talk about men's mental health and the various factors that can impact this. But in my experience working with men, I do often find that one of the most difficult things to navigate is the psychological and emotional impact that can come with difficulties and sexual performance as a result of their mental health conditions. So today we're joined by Dr. Elliot Justin, and he is the CEO and founder of Firm Tech. This is the first sex tech company that is dedicated to the improvement of men's erectile fitness. So Dr. Elliot, he is the he has a background in emergency medicine and he is a health care technology consultant as well as a serial health care entrepreneur. Dr. Justin studied Islamic studies at Harvard, as well as medicine at Boston University, and he is has been married for 35 years, is the father of three and lives in Montana, along with his family, as well as his chickens and his mares. So welcome, Dr. Elliot. Good. It's great to be here. And by the way, our mission is not just for men, it's for women, too. We are developing the world's first model of clitoral health. We presented a research paper about this a year ago at Psychosocial medicine, and we hope to have prototypes available for testing by a Q4 this year because it's really kind of shocking about for the area for probably two organs that are most wild people after the brain, the penis and the clitoris. We don't have any way right now generally monitoring their health. So without said, why don't you first tell us about how you came into this endeavor here. So working in emergency medicine, was there a connection with that work with what you're doing now or tell us how you got to where you are? Not not directly, although I certainly tell you that somebody sent us a doctor, although you're probably right, most of the therapists, there are few emergencies short of a heart attack or stroke that concern a man as much as a limp dick. So, I mean, men were only good last two erections mentally. So it's a big it was not compared to heart attack, but it's essential. Health is critical to our health and happiness. But I didn't I got into it because I felt years ago I found a company called Swift, M.D. that was the second oldest telehealth company that states after Teladoc and Doc. I'm interested in remote patient management, but remote patient management with working people. What could people do, take home cells at home if they had technology that wasn't motivated by secondary gain when they fortunate things about our health care system? US two is that it's personalized and which means that we're not really we don't take shape individually more we're taking would be plugged people into into protocol pathway so individualized and you get the you get the care that can be built for not necessarily the care that you need. So about a little over three years ago, a professor urology at the University of Utah contacted me about how to count the number of nocturnal erections that men have because it because it indicated cardiovascular health. You came to me because I was actually working on a very sophisticated catheter to regulate blood pressure after stroke. But Doctor, I was working with heard that I once worked on something that I call Project O for obvious reasons. So Project O was an attempt to neuromodulation human sexuality. The if you open textbooks, you'll see it. You'll see that the erections, arousal, erections and orgasm in men and women are due to the cavernous nerves with dental nerve. And I thought, Well, if that's true, why can't we pay them just weeks away? We can pace the heart. And I experimented on two Ram's male sheep, and we got erection ejaculation. But we also got defecation urination. So it wasn't very sexy. Bedroom friendly, I'm not sure really kinky. So I am, you know, the usual course of action would have been, Well, let's let's go out, you know, let's raise$20 million going out to Brazil or the Congo and try this on 25 men. Instead, I approached a friend of mine who was urology surgeon at University College London in Moscow and said, Let's plant the electrode in me. And we did. And I felt nothing. That's really interesting because I don't think we know. We know how erections and arousal operates to men and women. It's I think it's much more complicated than we imagine. My wife, it's more spiritual. I am like Snickers. Aphrodite. I'll say I'm agnostic about that point. But this this professor also says heard about this experiment, said he was counting over long term erections. And I said, What the fuck for? It's not part of my language. I'm from. I grew up in York City. So again. Why do we care about nocturnal resources? We all know about one morning, would we laugh about morning? Would they said no, A healthy man should have 4 to 5, three or five nocturnal erections per night. If that number goes down, that man dose goes down drastically from, you know, four, two, two, 2 to 0. That man has a 50% chance of having a heart attack the next two years. Well, that took me back because one of my doctor never heard about this. And most doctors still don't know about this. And so I went online and saw some papers. And indeed, there's there's significant research indicating that not that national erections are indicative of cardiovascular. Well, leading indicator in medicine is really powerful because in medicine, we treat associations of high blood pressure associated with heart attack or stroke. But I really don't give a hoot whether if, you know, if either one of you are normally my only work for my patients and, you know, your systolic blood pressure went from 120 to 140. I don't really care why not. It's going to the coronary arteries you really want to know about as well, too. I don't want to chase numbers. I want to I look at the end organ. So this doctor, like most straight doctors, is what I call Cock-Ring Virgin, meaning he has never tried a cock ring in his life. And he's got the typical male reaction of I don't need that. Well, it's not about need, It's about want. And I'll get into that more later on. So my thought was to embed sensors into a cock ring but advanced sophisticated form of cock ring. One that was comfortable. One could be one for hours. One would also promote sustained erections as well as give men not just the data of their overnight erections. Because what a costly care about. Hey, honey, how was I in bed last night when I sleeping? Or what's really happening when I'm having sex? So that's that's the that's the backstory of a tech, right? Okay. We want to deliver data to people as well as performance. So you said that you initially you were the Guinea pig for this. You know, everything. For everything. So how did you make that decision? Was it is it so you can kind of talk the talk and walk the walk to deal? Exactly. Well, I I'm, I you know, I'm fortunate to be married to a woman who's into sex toys. By the way, if I was to give young people one piece of marital advice, male or female, marry someone that's interested in sex toys that should be on your checklist. Might not be a checklist. Probably should be in a checklist. So, you know, I'm up. What we're doing right now is not it's not invasive. Yeah. I mean, you've probably you can see it online at myFirmTech.com and it but have you seen this before So it's. Inside on where. You see it. Yeah. So there's a pressure sensor here and inside the hook there's a strain gauge. It goes on differently than other other cock rings, the balls drop in and wraps around, closes with a hook, and that is a TechRing the world’s first monitor, objective monitor, of sexual health. So as the penis expands in girth, it pushes on the pressure sensor, pulls on the hook, and then the computer is that those pressures, if you will, into 1-10 hardness score. So we have documented 56,000, maybe close to 57,000 erections. We have the largest dick database, we call it, in the world, and we're just trying to mine that database research purposes. And we're discovering that given your intro to the show, what people think doctors, especially when people in general think is that what is leading causes of erectile dysfunction aren't. almost my story so most cock rings are rings the pinched , they’re uncomfortable, they’re hard silicone, they slide down the penis they’re hard to get off, they’re hard to get on You know I'm I'm 71 years old. I can look down and see my penis. I me I'm dressed right now but I can look down. I can see like I see my body. I'm not I'm not going to stand up, fine I’ll stand up and prove it. See, I'm dressed. But most men my age, or Oren’s age, we look down and see belly. So just just using a ring could be a challenge for them. And so several things happened. I was scratching my wife's back after she took took off her bra. Now sticky about this problem obviously some subconcious part in my brain and on my wife's desk. So it's not this desk she had a stress ball I thought stress ball last but why we're making cock rings out of hard silicone because silicones an uncomfortable material. What. Let's make a cock ring out of elastomer because elastomers adapt us silicone makes us adapt to them. And then my thought was if we make it have Elastomer would have come over with cock ring where a guy doesn’t have to be fully hard for it to work. Okay. Like a noose on his penis. It'll let the arterial blood flow in and just constrain the venous return. It's going to be worn for a long period of time. And then came the other insight. Malini, this one's over to you. Do you recognize the origin of this? I gave you a hint just a moment ago. The clitoris. No. Good guess! I like the way your mind works. No, it's. It's a bra hook. So I scratch. You know, I would say jokingly that probably half the heterosexual sex in committed relationships is when a guy's scratching his wife's back on a hot night when she takes off a bra because it's silicone, is irritating to the back. And I saw on a bra on the ground. And I thought, it's a bra is a ring that opens a close with a hook. Why don't we make a cock ring that opens and closes that way? Be easy on easy, yours safe. No problems getting it on the appliance, getting it off. Guys who have belly would be able to just wrap around the you know, wrap around the balls, as I showed you before. So that's a backstory for the for the material and for and for the form of of the ring. So what's the most difficult, I guess, stigma for men to overcome, do you find to kind of buy into this? Because it sounds like the technology is is sound and it's, you know, going to help a lot of people. But I also imagine that there's many who don't want to get into, quote unquote, get into using that. Yeah. Well, it kind of reminds me. Well, one thing we have seven papers are the publisher books publication, another 15 studies underway where doctors are using our technology to look at every area of intervention from PDE5 medications by against air testosterone, testosterone placement through shock therapy, Botox, PRP injections, helpful exercises. So eventually this will this research will penetrate people's minds. But you've just mentioned a really important point. So, look, I would draw an analogy to vibrators. So I'm a lot older, you guys. You know, my mother's vibrator, late fifties, early sixties, were stashed away in the bottom dresser drawer. It was like dresser in a garage. That kind of sort of sex life, like my father. So, you know, I don't know how, you know, back in the late seventies, early eighties, when vibrators started to become popularized, there was a certain stigma, shame, embarrassment to women. You know, you need to come without a vibrator. You know, you're going to get vibrator dependent. Well, you know, I don't know how many vibrators my wife owns and she seems to pick up a new one every two or 3 to 3 weeks. And she would say two or three months. It's like two or three weeks. But, you know, she will want a vibrator at different stages of, you know, what position she making love or what locomotives or whatever. And our daughter, who's 30 takes them on dates. So there are communities where vibrators still have a certain basis associated with them. But in our presenting to conferences all around the sexology camps, all around the world, even in India and in the Persian Gulf, Persian Gulf, vibrators are commonplace for, you know, for women, not cock rings. So one thing that has changed in cock rings to mainstream that's a ludicrous doctor being a Cock Ring Virgin, he’s still our chief medical officer but it's hard to get to overcome the notion that cock rings are for gay guys or for guys into fetish sex. And and then there's a sort of male embarrassment about needing a crutch. So think about the way in which vibrators whole thing about the way in which women's sexuality was described back in the 80s, even 90s, and I haven't heard these words in ages frigid. I haven't heard a woman described as frigid other than a personality, but something about sexuality since really since the eighties. Then there's hysteria or anarchy aspect. It's all neg with all negative and also positive. And Ms. Men's men suffer from the same issue. And so I like to use the term erectile fitness as people have their erectile fitness rather less obvious about their erectile dysfunction. And I'm trying to push that because that allows that kind of opens it up. You know, we're all on the road, men and women from fitness and fitness to dysfunction, and we know where the fuck we are in that road because we don't have any data, we don't dashboard, we have nothing. We all like to stop going down that road, ideally, make a deal, we make a U-turn, but we really can't do that without data. So how do we get men to change their minds? It's really hard. So one of the jokes we have and we are using it soon at the European Side Sexual Partners show is how they tell German sweet gay doctor straight doctor with one question How do you do use a cock ring? gay doctor? yeah. Last night. Go on and straight doctor. I might have some patients that need that, but I don't need that straight. Men personalize this. It’s kind of dumb, too, because my response to that is it's not about need. It's about what do you want to rock harder, last longer, be more confident, have more intense orgasm? And what guy doesn't want that? But I think. It's the wording of dysfunction versus fitness. Like, that's that's huge. I think that's part of the problem is that we're looking at it as dysfunction instead of promoting fitness. Yes. Yeah, it's it's a big part of the problem and men but on the whole we've you know, we've sold 16,000 devices so there's certainly a market for it. Men who who hear about it are interested. Can I give you some examples? Some of the research shows. So there's a doctor in Miami to study comparing our device to ten milligrams of tadalafil Sally's most commonly prescribed PDE5 medication. Our device is just effective and on device is not a pill and I device doesn't require seeing a doctor just requires using a ring forget about the data. It's just using the ring for the purposes of sex. Our non-tech version of the ring, which is the max PR, it's a little sleeker because it doesn't have a slow memory chip in there. There's no Bluetooth and there's not you know, there's no technology in there. But we've designed that ring for two purposes. One, we want to men don't men don't spend $275 to buy the tech ring. They just want something that works, work for them. So that that ring was worn, was tested against Cialis. It also is designed to put the right amount of pressure over the urethra to produce a more intense orgasm because I once I came up with a tech ring and when I came up with the TechRing, I wasn’t thinking about male pleasure. I just think about data for men's health so that men could measure the impact of diabetes, hypertension, cock killing, medications like anti-depressants. This arise against the sexual health. Or they could use the device before they get prostate surgery, before they consider testosterone placement therapy or reminder shockwave therapy. I'll tell you about the data, but they come up with it. There was a ring and realized I was comfortable with people for long periods of time. My thought was, how can I make more pleasure for a man and also more confidence just because it's and I want to get to what we've learned from the data just a moment. Talk about confidence. So the ring was designed to put to be tested on 21 men in Montana and and got to kind of get joke about how they're all white men because, of course, the emphasis in research today, that's people yes, include people of color. But I know this works for people. If people of colour as well, too, because we had lots of customers, which has a 20, 21 men age 28 to 70, I was the oldest person in the test group with the goal of increasing the male the jacket stays by 50% to produce. The more you choke off ejaculation, you then get retrograde ejaculation which women are comfortable with mostly to infection. So my my adjudicatory phase with a maximum performance range goes from 4 seconds to 7 seconds. Well, that's an incredible change. It's it's more intense. It's authors because if I read from observing my life, pleasure, touch of pleasure, but I've never had to like that. You know, my wife says she's glad the kids are out of the house, not because I'm not I'm loud for the first time. And we hear about that from a lot of our customers, a lot of our customers that the so, you know, we guys we start whacking when we're, you know, 12 or 13 years old. And we think with that we're kind of source of our own orgasm. But to come up at age 70 with a product that actually produced the more intense orgasm, that was really cool and and something I think all men should to experience. Okay, well, I've got lots of questions because as I think I've talked about in the podcast before, I've taught human sexuality for over 20 years. My mother opened up Canada's first sex store. So all of this is very familiar to me. But I also treat many people for sexual related issues more sexually tissue. So you're talking about, you know, that a lot of the men are, let's say, getting on board with this. And of course, gay men do seem more comfortable inherently in, you know, in anything nonstandard. But I found in my practice when I was dealing with men who had either medically induced or because of medication, like medically because of some physical issue like kidneys or something or medication or psychological issues that when it came to trying to rectify the problem, let's say with a cock ring, they found they had partners who, you know, female partners who felt, you know, opposed to it because either they thought it made him less than a less of a man or and this, of course, adds to the the anxiety and stigma. Why am I not enough? Okay. They make the woman made it about themselves. Right. So so, you know, everything you're saying is so positive and your wife obviously is open minded and it's great. I mean, that's what a wonderful relationship. Right? So have you heard either from the men or from, you know, let's say, from other the research and so on that the women are getting on board just as quickly as the men, or is that an impediment? Most of the other men that come to us and I or an I open up my calendar 5 hours a week to speak to anyone who buys our products free. And so because I want obviously, I want to learn about how they use the product and how we can improve, etc.. But I'm also learning, as you have, what people are actually doing in bed together. And most of the men that come to us their wives are looking for are open minded about a solution as well too. We do have a few women who I think you know, a couple of women who complain about how they can feel it. We are skeptical of that because because the you know, this the diameter of this is pretty is pretty narrow, you know, and it's covered by with a soft elastomers, not cover hot plastic. And if it's really buried to a pure fat pat. So we haven't heard that we have guys who worried about that. So if I bring this home, you know, Schultz, you know, should think less me and my mother. What we've had men who fought it because it can be put on discreetly, unlike regular Cochrane's a man doesn't have to have to have an erection when he puts it like what I put on before dinner, you know, where you put on any time of day. So that has some some appeal. You know, when it comes to I really want to see cock rings mainstream obviously as as not as a as enhancer not your not as a crutch or an aid. And right now there's all this talk about, you know, well, look, put this way. If you told the woman women today, no more vibrators I really don't want using a vibrator they would think what the fuck you are you crazy? You know, I think I'll find another guy so but I think, you know, there is people and it's people need to overcome the embarrassment about this and see it as something, you know, something positive license. So not only diminish what you're saying, but we've not done it to be the case with our with our customers. But because the nature of customers, they're looking for a solution. They're open minded. Right. But is also the age. How are you finding like they're mostly in the older group. Are you finding, let's say, men in their twenties and thirties? Because we know these days far more men are having issues with erectile fitness, you know, in the younger age than ever before. Well, our average our average buyer of the tech ring working in the technology is 45. An average buyer of the max PR is 55. But I just got contacted by a guy in Brooklyn who got six max performance rings. He's a player. He keeps one each of his girlfriend's apartments. So I think even for young men, I mean, our data shows even young men will benefit from a ring and medication and for the best. I mean, the study that Dr. Perlman did in Miami and our own internal we did internal study as well to shows that we were the first group to study detumescence. So detumescence is the time it takes for an arrest to go down after climax and with nothing, it was like I'm at my 30 seconds with a ten to tadalafil. It was two and half minutes with our ring. It was almost 3 minutes of both together was over 5 minutes. So if men will last longer and have more fun, be more confident. That's the partners. The real takeaway is put a ring on it, take a pill. And we do have men with with premature ejaculation and younger men who enjoy the fact they stay hard, comfortably hard on unlike conventional cock rings, comfortably hard after they climax if they need more time to satisfy their partners. At my age, it's very different what we hear from customers or what I've told my wife, which is a natural climate, you know, and healthy marriage. The woman comes first and third. You know, afterwards I feel I climax. I'm still hard and the male mindset has come and gone. But if you still hard you're in a different, different state of mind. So we spend more time intimately after climax than we've done with it before, which is great. And I think I mean, one thing that's, as you were saying, revolutionary about it is the fact that you can put it on at any time. Because, you know, again, with a lot of my patients, you know, any type, even just putting on a condom, it's just that they're in their head and they're so worried about maintaining an erection, So trying to fiddle with this and everything like that, they're so worried. So if you could do it beforehand and then, you know, again, as you get as you get the tumescent, it just kind of as I say, it, I guess, melds to the penis or it shapes you know, it goes along with the penis. It grows with the penis. That's revolutionary. It keeps the blood in as it's growing. You know, here's here's a huge mistake that we've learned from. Well, but we've learned from it from our data. So urologists grouped two types of men together as having it and are actually very, very different. And this this I said most on crusade about this there are men who can't there are men who can attain an erection that's to my mind, real erectile dysfunction. You are if you can't attain erection, you've got dysfunction. And those men need the help of cardiologists, urologist. They need it. They need a team approach because those men and I'm guessing that percentage about 15% of men who have it, the vast majority of them are happy to get an erection and then they lose it. They attain it and they lose it. Well, this is a very different group. And the course, the reasons why, why, why that could happen range from psychosocial factors. We get that instead a moment to cock killing medications and depressed sense of hypertensive flow message, often in common, often in combination. And you can use a data to sort that out or you know, there are small number then up to A to A to our testosterone. It's the hypo gonadal. It doesn't have to they need testosterone plays in therapy. But so this but the minute you get an erection and then you lose it, that means you're getting blood in So the PDE5 medications Viagra cialis they they put more blood into the penis that that really good keeping fear and urologist need to acknowledge that their focus has been on the arterial side the circulation of the heart it's a pump Well if person has heart disease we need to make that pump more effective. Pump blood better. And then we got the problem in the pipes. We've got now the pipes, hypertension and diabetes, Atherosclerosis. And we so we need to dilute the light, dilate that to get more blood in. But they've told a neglected the venous side of the circulation all men, all women have deterioration of the inside. The circulation as they get older is something that we've discovered from from from our data. And the answer for that is are in course, we want to push our ring so that our rings are comfortable ordering is the only ring that's been research proven to be safe, to belong to one overnight or for prolonged sex sessions. But the doctors haven't figured this out. Can I illustrate my hands for something? Something? Yes. So the notion is that the incidence of erectile dysfunction goes up 10% per decade after age 40. So thinking the doctors might like you to. Before I get the data, was it as as that goes up, the number of nocturnal erections will go down and thus the firmness and duration of erections will go down during sex. That's not the case. What we're seeing is that the slight decrease in firmness around eight, seven, eight, slight, a noticeable 10%, who knows, 10%, 10% less hard and is nocturnal. Erections remain relatively constant in the seventies and then they fall off if there's some precipitous event, a heart attack, hypertension, our control type is our control and our ring action to help detect those things that at those things earlier in combination with blood pressure and blood tests, etc.. So what does that mean? So what's so what is going up? And these heart factors and or actual blood flow factors are not being not the problem. What else is going on? Well, what's going on is deterioration in two things. And it plays off the confidence issue, the confidence issue that's so important in terms of deteriorate reactions that you're seeing in your clients. So we all get venous leak of aging and you guys, even you young guys might have this. If I sit in a plane for five or 6 hours, my socks might get a little tight, my rings might get a little bit tight. Women are more aware of this. And then because of microvascular and the penis size, more fragile, fragile, intense. So the smooth muscle as you get older, smooth muscle around a little veins in your skin gets weaker and the females themselves get stiffer in in your in your feet. The answer is you get a little bit of leakage of servants into it's sort of space. You get a little bit of swelling. What the impact in the penis? Well, the clitoris is a blood leads to the penis a clitoris faster. Now in women, it's not as much of a problem because the clitoris appearance the as an as an organ sexual pleasure with the vibrate via vibrators maintain blood flow that's this put inside the pleasure aspects of vibrators on the neurological system the vibrators vibrations keep small arteries arteries open to keep the blood flowing. They men don't have men. Vibrators don't work that way for men. So men need a ring And then, of course, when men lose confidence in their erections, the attainment, they lose them. Then it feeds into the whole confidence issue. That is so right. You know, I feel at my age now, I'm 71. My wife and I make love. If I were to five or six times the week I am a firm believer that orgasm a day keeps the doctor away. But I. I want to ice this nice look can feel loss of confidence, you know. she's tired. I might not get the attention I want or I'm tired or we've had a few drinks or it just. It's just. It's almost like a toxin. The brain and your patients have this much, much worse than I do. So my patients, you know, do is do as well. But a ring once that once they once they they get an erection that they have to put a ring on you don't worry about losing it. So and that's all that changes the whole dynamic of lovemaking because if a man gets 85, 90% erect, it has a ring on and the blood's being held. That means I worry about these erection me more so solely that whole the whole sympathetic nervous system shutdown. It goes away. I've experience it and I hear about this in two or three customers a week about this is this is I use the F-word again this is think this is a game changer. My wife and I make love. to three times as long as used to It used to be, you know, ten, 15 minutes. We're old people. You. we both got turned on what gets to vibrate, what position? Going to make love and quick negotiation. Now, there's no pressure. There's no rush to orgasm. So a common complaint I hear from men and I'm going to get a little graphic is if I talk bothering you. It's okay. Okay. We have elk outside. Sorry. If I. If if once I had the ring on, if I go down on my wife previously, I would have lost my reaction and the word for as well. Now we're done with that. Now we've got to get to adorning Bob on this with a ring on. I'll stay heart the minimal stimulation 45-50 minutes. And our customers say the same thing to us. They stop a guy yesterday 25-30 minutesthat totally changes the game So I question for you then about medication versus the ring because I think that this there's there's parallels too with our work where there's the side effects that come along with medication. But between marketing and the ease of use of medication, people do oftentimes tend to be on medication as opposed to lifestyle changes or more natural approaches. Can you tell our listeners a bit about the science behind some of the medication and maybe what the risks are as opposed using something like a ring? Well, to my mind, with PDE5 medications, it's not so much the risk, it's the minimal benefit. So if you go back to the original Viagra, so it's Sildenafil, papers and it's the FDA. And as I recall, there were seven in two of those papers. There was no benefit, no more benefit than placebo. I mean, I've got guys I prescribe it to who say it works in their wallet, it works on the night table because it's a confidence builder for them, placebo effect is powerful. And if someone tells me that having the medicine in a night table works, then I will write a prescription for them. So I'll stand by. My goal here is to help these people, as you probably feel the same way too. So too. The paper showed no no benefit versus placebo. The average paper showed a benefit of about 20 20%. Well, that's not a dramatic improvement. It's like you take a pill and you get an erection. The biggest benefit was, was it men who were status post or who had radiotherapy or have prostate surgery? Well, they clearly, clearly benefit from the increased blood flow to blood flow, you know, from the pills. So far as the side effects go, I frankly, the only ones I've seen have been in men who take too much, you know, in the younger guys because young guys, you don't really need this. They take it for recreational purposes. It's estimated United States that more than 50% of prescriptions for PDE5 medications just play, you know, just partying. And I have personally experienced that I can drink more and take a pill and perform and but for kids my son's age and that's nearly 30 years old now they that's that's why they're doing it sometimes they they take too many you know if you going to take if you're going to take 200 of Viagra, you're going to have a problem. We could pass. You can lower your blood pressure. But my eldest son is a a retina surgeon. I spoke with him about about the visual side, visual effects. And he works in the military health care system, which is the largest per capita provider of PDE5 medications the world is, he says. And he's never seen a visuals, a sustained visual problem. So my issue is PDE5 medications, because they're not particularly effective. I do think, though, that they that are, I think, a ring, again I can attain erection getting my blood in, especially younger men. That's not the issue. It's keeping the blood in the ring is actually a more effective solution. Yeah, and I'm curious, I mean, this might be I'm not sure this is, you know, in your realm, but, you know, I because of the work that I do and Malini and I are on a listserv with a large number of sexologists, and there's a lot of debate about this. But so again, I don't know if that's too far off topic, but I'm curious what your thoughts are with the role of, let's say, pornography in, you know, hurting men's abilities to either maintain an erection or get an erection, maintain erection, stay hard as as long as they want or be able to finish. So I'm curious what your thoughts are that Is it mostly psychological? Are they rewiring the brain? You know, I this I hear a lot about this and I've read some of the literature and I've read both sides. But I'm you know, there are people on the on the pro side who point to a couple of studies showing that men who watch pornography are more likely get married. So on the other hand, there are there also there are negative studies as well, too. I should like to make a couple of points about that. I, I think and look, if someone if they can only satisfy their sexual desires by watching women with stiletto heels on an onlyfans channel, I don't know. That's you know, I want to put aside the people. I mean, obviously, if someone just, you know, only watches strap on sex, so that becomes that that becomes, you know, their obsession. I think I think pornography can be dangerous. But a lot of the issue here has to do with the hand, the notion that men who are watching pornography and masturbating become dependent upon their own hand. And I think I, I think the problem here is we're not addressing for some men its worth and this is a question I ask patients, of course, customers about who are who are concerned about this issue and the spouse and the spouse as well. To us, there are three things that men complain about women but don't want to discuss with women. In my experience, maybe you can ask this. Maybe this is for your expense. Well, to one is friction. They don't get the friction from penetrative sex they get from the hands. And if their wives think that sex is just about penetrative sex or the men or the couples decide that sex just about penetrative sex, they're missing out on the fact. So I will talk about my own marriage and the impact of the ring upon us. And also this. I my wife’s had three children, she seventy years old, I don't get friction, certain positions that she likes. And and I'm a guy and I would get irritated. So four years after I get our second child, I thought about decades having sex in the missionary position or from behind was for me one. I don't get the friction. I want to you know, I'm going to lose my reaction to 3 minutes to it's boring. So I think people though people people don't talk about with men. Who wants to talk about the partners? Hey, you're pussy's too loose and I'm bored. I'm not going to tell what man is going to tell it. A woman and think, now she's going to be really? she's like, Thank you for telling me about that. Let's try something new. That's that's kind of a buzzkill. So there's boredom. There's lots of friction. It's the third one I'll get to in just a moment. But, you know, I started suggesting to some just both patients and customers, your wife, this is her hand. And I said, most women object to that. You know, it's it's it's when people think I got an erection Now, after has sex in a position, then they lose erection. I just I just I just spoke to a guy in Missouri last week who had spent a lifetime he's wealthy, spent $15,000 with shockwave therapy, TRT red light therapy, popping injections for exercise because he would penetrate and lose his erection. And so he got the ring. We saw they had strong nocturnal erections. So this issue was not physical therapy because the problem the problem was he was going first. His wife had five kids and. Her idea of sex is just basically missionary position or or rear entry. And you put the maximum performance ring on. And that was hard. And that's what I'm doing. My expression, my wife to now have sex the positions that before reflects my being irritated. I know well because I now know if I have sex and literally position out the ring on, okay, I'll stay like 15 or 20 minutes. I love my wife and that's that's going to play, so I'll do it. She also knows I'm not interested in climax in that way because I'm not going to get the type of testing elation you know, more tests, stimulation, trying to get from a hand-to-mouth. So so we as therapists need to explore and doctors need to explore these issues with people because that's really what's going on. He's the last of his last complaint that I hear from men about women, which is distraction amount, I'm sure not this way. I'm not going to ask down to tattle you right now, but a lot of men complain and my wife is one of these issues. Yeah. She laugh about it that in the middle of sexy when they really turned on women start talking about something else you know someone all with the kids so put their mother something at work could be a creative idea that's got to get off their head right away. Guys. Reaction That is what the fuck can hold that thought, You know, for 5 minutes. We're having some fun here and that's another area where the ring is is a game changer in my marriage. So my, my, my wife just had a two sisters over here for a couple of days ago. This seems to be almost genetic trait in her family. All these women confessed that they all talk about things when they were turned on. And the ring, you know, my wife is tested it with the ring on. I can go up and down the steps and get her a cocktail. It's does that come back upstairs hard? Whereas in the past it would've been, Do you want to get you a cocktail right now? Come on. So a ring is a ring is What do I get? Is a ring a strong confidence builder. That's one that the doctors have not taken to consideration. The doctor came by the graphs I showed you. The doctors are thinking that the medicalizing it it's a cardiovascular issue. Maybe it's maybe about a medication issue for circulation on the arterial side of circulation. They're not thinking there's a leak on the venous side that can be fixed with a ring. And now that will start to correct the confidence issue that men are experiencing or born. And I'm certain you've you've experienced that when you were 13, 14 years old, you could hold a girl's hand and get a hard on for an hour in our house and then go home after jerk off because blue was well, doesn't happen anymore to, you know, you're much younger than me. What happened to me in years that's just hasn't happened because we stopped. We're still getting turned on by sex. We we just don't hold the blood in the penis long for a whole variety of factors. we don't. Too much time. Of course, if you're to a totally unsexy topic, but I'm just curious about this. So, you know, a number of my colleagues do research with both. Plethesmographs and Penile strain gauge. So that is just for people who don't know physiological measurement of sexual arousal. They're stimulated or they're they're viewing movies or pictures and, and seeing how they get turned on. So the way you're describing the, you know, this penis rings ability to, you know, to measure the, you know, the the strength of the the erection and so on. Do you think it's as sensitive or more sensitive as these strain gauges, and do you think that you're going to try to apply it to that kind of research? it's it's the device is being used in research as a replacement for for for the registry. And certainly I, I mean, look, we're shooting a pleasant study on someone. They're in a lab in a totally artificial, artificial circumstance or device for use at home, in privacy on the real life circumstances. Do I think the occupies and also where those machines when you're having sex easily. I don't know about you, but I think I thought of having everyone get in the way. Yeah, yeah. Otherwise get in the way. Exactly like something. Dr. Frankenstein, put your dick. I mean, it's there. So I don't, you know, if it's, you know, people are still using that. And I will say hilarious old fashioned 20th century technology and not using like technology. These are contact me because we provide our devices for research. Give them a just price. or free if we think the research is going to be valuable. So yes, I do. I device is that home device too. That gets at the same factors, but also our device can also be used during sex. Yeah but just well and that's thing when I was I interviewed on Mike Jay Michael Bailey years ago as he was doing this research and he was saying that the difficulty is not only is it a lab, it's artificial, but he said you can't move at all. You're supposed to sit very still in order to get the proper readings. So I think this, you know, would change the game as well and make it more accurate. Yeah. We're in the Google and Apple store. She wants to see what the data looks like this. There's a recording of my average nocturnal erections over the last year. I'll show you what individual recordings like just to get a sense of what people are getting and you'll see immediately how this is superior to to what you've been to, what the studies you're doing. So if you look around midnight for midnight, that's my wife, I'm having sex and then I'm having one small, nocturnal, one strong, and the two very strong nocturnal erections and then morning wood. So that's good cardiovascular, good sexual health. And men my age, I practice more interesting to me. A lot more fun than my electrocardiogram. So, yeah, we we tend to end this podcasts. We throw a lot of information at our listeners, a lot of science, which is great, but we like to send people away with something that they can do with all of this. So with everything that you've learned from this research and from even what you share with us today, what can people do? Like what's a logical next step for somebody who's maybe having some difficulty with their erectile fitness or their sexual health? What can they do? Find out what's causing it. Stop speculating. Get data that's objective, actionable, and most important, personal. Because we doctor mistakes that we doctors make because we and one size fits all. There are three of us on this podcast right now. Different ages, different gender, take different medications and if you all high blood pressure or erectile dysfunction if a men they put on the same pill and the same dose and that's dumb. But if you're over the age of 45 or 50 or even younger and you have issues with your erectile fitness, get data because that data will help you to start to sort out is psychological. If it's due to pills, you can titrate the dose. What's the right dose? Me want take this pill pills at all. And finally, I would say to men, if you want to increase your confidence, last longer, have more intense orgasm as your partner to be more satisfied, get over any any notions you might have but rings not being for you. These rings can help every man of any age. He And how can our listeners find you find your product. Sure you can find us at my m y f i r m t e c h myfirmtech.com you can contact me personally Elliot Elliot at my firm tech.com and if you're interested in the female device, just join our email list. It's called the Classic and we hope deliver the same benefits to women about the objective health of the clitoris that we're delivering to men like you. For this, you. Put that information in the description so people can access that more easily. Okay. Okay. So thank you very much for coming on. I mean, it was great talking to you about these topics. I love to hear people who are so, let's say, open minded and so free in their expression of these things because, you know, it is the year 2025, but many people do feel shame and, you know, shyness about these things. So it's so refreshing when I see the opposite of that. So thank you for that. even I speak to a world renowned urologist and it's hard for them one or two things to say. Well, maybe happened to. Maybe we missed out on the this. But it's really hard for these men, male doctors to say because I would want that is still that mindset. I don't I don't do that or they don't want they don't want to really reflect on their own personal experiences. It's when you start to reflect your own personal experiences. I just like to get wisdom to my mind about yourself. And then you project that onto the greater world. So many to open their minds to get their data and open the minds about rings of women have that vibrators parachute. Well. One thing I don't know I was that your website? I don't know if I saw this. Okay but you know the old expression that you know you know when men as a really great woman, their man, you know, put a ring on that. I think that's a perfect marketing for your device if you haven't already said that. But I think that's changing the curve for straight men. Women going have to get get on board with it as well, too. Yeah. Okay. Well, on that note, everyone, until next time, keep your eyes on the road and your hands upon the wheel and anything else that you think might be a good.