The science of sex with Dr Rena Malik
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Take a mirror and look at your vulva. You should know what your anatomy looks like. You should absolutely be able to identify your anatomy and know what hurts, what doesn't, what feels good, what doesn't. I mean, that's an important part of being human. As the child of Indian migrants in the US, there were topics of conversation that were completely taboo in Reena Malik's household.

We never talked about sex. Like, God forbid, you know, you're supposed to wait till you get married to have sex. Reena absorbed the message and, like a good second-generation ethnic daughter, she went to medical school, where she studied to become a urologist and pelvic surgeon. After her training, Reena wanted to share her research, so she started a YouTube channel.

She posted videos about bladder health, which is interesting, but not the most click-baity subject. But viewers soon started sending her questions about sex.

Lots of questions. I was like, wow, this is an area where people really want to know something. So Rina responded with frank, evidence-based content explaining the science of arousal, orgasms, masturbation, squirting, libido, kegels, kinks, and yes, penis size.

Like if you had asked 10 year old me if I would ever be doing anything about sex as an adult, they'd be like, no way. Her follower count started to soar.

As we record, she has more than 2 million subscribers to her channel listening to her give advice like this. There are so many things on the market like butt plugs, anal beads, dildos, but you want to make sure that these are designated for anal play. You definitely don't want to use something that doesn't have a flared base because unfortunately these things can get lost in the rectum and you don't want to spend your fun, kinky, sexy night in the ER because you lost your sex toy.

are more online so-called sex experts than you can wave a dildo at. But a lot of them are talking out of their clackers. Dr Reena is the real deal. In a storm of disinformation, she's a lighthouse of scientific rigour, helping women understand their bodies and their needs more clearly. She's frank and open about sexual health and relationship dynamics, and she wants us to be too. I'm Yumi Steins. Ladies...

We need to talk about owning your body and your pleasure with Dr. Reena Malik. If you're listening to this podcast, chances are you have a vulva and you're probably pretty comfortable with it. But Dr. Reena wants us to understand how important it is not to flinch. I implore all women to take a mirror and look at themselves.

While males and females are very similar anatomically, for instance, the clitoris and the penis are made from the same genetic material and both are born with nipples, Rena says there's a huge difference in how we're encouraged to get to know ourselves. Guys look at their penis all the time. Like my sons know what their penis looks like. They could tell me everything about it. So take a mirror and look at your vulva because you need to have a baseline. So when something changes, you're not sure what's going on. At least you know what it used to look like.

This knowledge and exposure gap between men and women continues when it comes to understanding arousal. I think the issue becomes is that our erogenous structures like the clitoris are just not as obvious, right? It's not like, hey, this thing is sticking out of me, gets hard and feels good when it's stimulated. And so there's a lot of different things there, I think, in even how we're raised.

and how we're not empowered to like look at our genitals. For boys, they figure it out easily when they're little, right? They're in the shower and they touch something like, oh, that feels good. And they keep doing it. And they figure out how to make themselves climax. Whereas for girls, it may not be that obvious.

Knowing our bodies intimately is essential in being able to feel pleasure and advocate for ourselves. So I asked Dr. Reena for a quick anatomy revision. Essentially, when you look at the vulva, it is everything that goes from that hair-bearing area, which is called the mons,

down to the anus. That whole thing is called the vulva. And let's go from top down and outside in. So when you're going from outside in, the first thing you see is the labia majora, which are the fatty sort of outer lips. And then you have the interlabial fold, and then you have the labia minora, which are the inner lips. Ladies, let's not be tight lipped about this. Culture gives us a lot of hangups about our bodies. And one of the most

pervasive and enduring is that our labia are supposed to look a certain way. Cinched, tucked in and smooth. Not unlike a Barbie doll. But...

but don't buy it. They're as individualized as your fingerprint. Sometimes they are small and sort of within the outer lip. Sometimes they hang out. Sometimes one side is bigger than the other. And this is all normal anatomical variations. I just keep having this vision of someone getting arrested and they want to take her fingerprints and she offers to sit her saddle on the stamp pad.

Now moving to the top of the vagina. So you're going to see the hood of the clitoris and the clitoris. So that's above the urethra. Now the hood of the clitoris is like the foreskin for the penis. It's the exact same sort of structure. And then underneath it is the clitoris, which is like the head of the penis.

of the penis. And so the cuterus is not just what you see. It goes deep into the pelvis on top of the vagina and then bifurcates around the vagina. And if you look at anatomical sections of the cuterus and the penis, they're exactly the same. They're spongy. They fill with blood when you're aroused. They elongate, they widen. They're just a little bit more hidden in the female body.

This magical body part wasn't fully mapped until 2005, when Australian urologist Dr Helen O'Connell used MRI scans and cadavers to unfurl its mystery. Turns out the clitoris isn't small at all. It's just that only 10% of the organ sits on the outside of the body. Very demure.

O'Connell, whom we interviewed for this podcast, if you want to scroll back for a squiz, was floored by how little was written about female anatomy in textbooks when she was at medical school in the 80s. Dr. Malik says not much has changed. If you look at the word penis in literature versus the word clitoris in literature, you'll see the word penis in

in research papers about 50,000 times, but the clitoris only comes up like 2,000 times. So there's just like much less research in women's health than there is in men's health. Back to our anatomy. Below the clitoris is the urethra and that's where pee comes from. There

Then we come to the vestibule, the entrance of the vagina. It doesn't get as much press as the clitoris, but it is a pleasure centre, is linked to hormonal health, and if there's pain during sex, it might be because there's an issue with the vestibule.

And then we get into the vagina. Now the vagina is a tube-like structure that ends in the cervix and it is a very flexible, pliable tissue. It actually elongates and widens with sex. So what you see when you measure it, say right now, if you were to put your finger in and measure it, it would be even larger when it's aroused. Obviously you push babies through there. Like it's a very flexible and amazing tissue. It self-lubricates, it self-cleans. Love that.

What about the G spot? Where is it and what does it do? So there's no spot. It's actually a zone. And so the zone is an area. It's about two to three centimeters in the vagina at the top. When Reena says top, she means inside your vagina. And that essentially is an area where there's a confluence of many structures that are

So if you remember, I said the clitoris is just like the penis. So it has two cylindrical spongy bodies and they run on the top side of the vagina. So you can see that when they get engorged with blood, they're going to be also full and close to that location. There's also the Skeen's glands, which are analogous to the male prostate. Hey, just a quick note to say that so many parts of the female anatomy have been named after old white dudes who, quote, discovered them. No!

And the Skein's glands are no exception. Some women will find the stimulation of the Skein's gland area very pleasurable. And so because there's this confluence of different things that are pleasurable in that area, stimulating it for some women can lead to orgasm. It doesn't happen for everybody. I think that's really important to understand is that

If you want, if you're looking for it, it's not a button. There's no sign that says G-spot here, right? Like it's a zone and it's just an area that you stimulate. And if someone likes it, you keep doing it, right? I think we put so much emphasis like you got to find this spot. Well, guess what? You got to find the spot that works for your partner or yourself. Okay, ladies, that's your vulva. A wondrous thing. Next up in the curriculum, orgasms.

You might naturally be focused on the end result, but did you know there's actually three stages to the female orgasm? First, you have excitement, right? And during this time, your heart rate goes up, your blood pressure goes up. You're starting to get a significant amount of blood flow to the genitals.

In this excitement phase, the clitoris gets bigger because of increased blood flow, the vagina opens up and the labia get thinner to allow more space for penetration. Then stage two is called the plateau phase. There's a continuation of that where you're getting to a plateau, where it's getting higher, higher, but it's getting sort of steady. The clitoris also gets more sensitive and you'll often get more wet at this point. And then you're going to reach orgasm.

Ta-da! The resolution phase. And your body is now releasing this significant buildup of tension and the pelvic floor muscles contract in a rhythmic way. So about every 0.8 seconds. And if you're really perceptive, a lot of women can say they feel that, like they feel that throbbing feeling when they have an orgasm.

And then slowly after that, you sort of have a resolution. Everything comes back to baseline. And there's some period of time where you won't want further stimulation. To help us along this path to orgasm, there are fluids that the body produces.

The female body is so amazing that we produce three different types of fluids during sex. So one is lubrication, right? So your body just starts doing these physiologic changes and emits lubricant through the walls of the vagina. There is female ejaculate, which is specifically from those skin glands. It's just sticky, white, a very small amount of substance that comes out, likely again from stimulation of the G-spot.

So lubricant and ejaculate are numbers one and two. Number three rhymes with flirting and it's not shirting and it's definitely not hurting. What could it be? Squirting. Now, squirting is a big topic. People love to talk about squirting. And squirting essentially is a clear odorless gush of fluid that occurs at the time of climax. It comes from the urethra, which is essentially where urine comes from. And it's a

But when you look at it and compare it to urine, it's a little bit different. Researchers trying to figure this stuff out injected blue dye into the bladder of a woman before she orgasmed and monitored it as it was released.

From what they can see, the fluid is likely coming from the bladder. But as Rena says, it's not we. But what exactly it is, is still a bit of a mystery. And please don't feel deficient if this is not something your body does. Some women are squirters and plenty are not.

Similarly, orgasming isn't for everyone. The data would suggest that 12% of women don't orgasm. That's a pretty high number. Why that is, is unclear. There's obviously some thought that some women just don't get adequate stimulation. And we know that 85% of women need clitoral stimulation to climax. But if you're not getting any clitoral stimulation, you're not going to orgasm. There might be some people who are not going to orgasm.

also be a physiological reason why a woman can't reach orgasm. For instance, if she has a spinal injury, signals from the pelvic floor to the brain can get disrupted. For other women, it's what's going on in their heads that's stopping them reaching the top of the mountain to take a screaming sled ride of heavenly orgasmic happiness down the other side.

For women who don't ever orgasm, the source of the absence remains unknown. But for others who might just have trouble getting there sometimes, Dr. Reena has some advice. You need to be in the headspace. You need to be ready to give and receive pleasure, which means that you can't be thinking about your to-do list and people will talk about feeling like

They're in the moment, but it's so important actually focusing on touch, the sensations, the feeling and not, oh, what does my body look like? What does my labia look like? For example. Some women also feel pressure to perform a checklist of things they've seen in porn. Am I squirting or am I not squirting or is my G-spot working? Like those are all distracting thoughts and they're not allowing you to be present. So then you can't experience full pleasure.

Tokta, what are some of the challenges that you see in healthy, happy sex in a long-term relationship? In a long-term relationship, really the biggest issue often becomes desire mismatch, which is where one partner wants sex more than the other. And oftentimes the female partner wants it less, the male partner wants it more, but that's not always the case.

And it's actually very, very common, right? Low sexual desire happens commonly in both genders. In women, though, it's very high, as high as 40% in the literature. At the start of a relationship, it is on. You can't keep your hands off each other and you're so horny for one another, you might even do it in the car at a shopping centre. There's so much sex, it's like you're marooned on Desert Island Dick. But this phase inevitably wears off. And once it does...

Sex can become like taking out the garbage, a once a week thing, and you'd kind of rather someone else did it for you. People expect sex to be this spontaneous, amazing thing that just happens. But in reality, when do we expect anything else to be spontaneous? Like we literally schedule everything.

If you think about when we were younger and dating, before you were like living with the partner, you actually are excited to see each other. You make plans to have a date. You get dressed for that date. You shave. You do whatever you got to do. And then when you do finally get together, you're like, oh, you know this might happen. You're ready for it. Your brain is ready for it. And you're like excited. So...

plan for sex to happen in a long-term relationship. Set that calendar appointment and get out of your trackies and out of your routine once in a while. You get very comfortable in a sexual script with your partner. It's the same way every time. They initiate the same way. They do the same moves. And you know what? There's a lot of comfort in that. But

it does get boring. If I fed you the same dinner every day, you'd be bored, right? So it's the same sort of thing. It's like you need to change it up. Now, it doesn't need to be crazy different. It doesn't need to be like, let's go buy the whips and chains. It can be as simple as doing it in a different room, trying a different position. Did you hear that? You can just mix things up a little. Do it in the Aldi car park instead of the Kohl's car park.

I'm just kidding. The car wash is way more private. And then the other big thing is talking about sex. Like no one talks about it. We just like so many of the patients come in to me and they go, how does your partner feel about this? Like, oh, I haven't talked to them about it or I don't know how they feel about it. So I think ultimately it's so important to just actually start having dialogue and not always in a negative way, right? Like it could be like, hey, I really enjoyed that time with you. I liked this.

I don't think anybody would ever say no, like, oh, I don't want our sex life to be amazing. What do you think are the biggest myths around women's sexuality? I mean, there's so many, but I think the biggest one is that we are always sort of ready to have sex because we don't have to have an erection, right? We don't have to, we're not doing the penetrating. So we just have to be ready.

willing essentially to receive it. When in fact, that's not the case. Like women need time to be aroused, to prepare for penetration. So it takes sometimes on average of 25 minutes to be fully aroused for a female partner. Did you hear that?

25 minutes. That means you need to take your time. If you have a partner, get them to slow the hell down. Yeah, it takes work, but work is noble and this is the best kind of work. During that time, all this is happening. You're getting lubricated, your vagina is lengthening and widening and preparing for sex. And so it takes a little work and like that's okay. The other

big myth that Rena comes across a lot is that women's bodies are complex, a mystery too difficult to unravel. No, we're not. Figure out what turns your partner on, do that thing. And don't like, you know what I mean? Like talk to your partner and find out what they like.

And do that. And don't be ashamed if it means they have to bring a toy in the bedroom or they have to do it themselves and show you. Like it doesn't mean that you're less of a good sexual partner. It just means that you're prioritizing their pleasure and you're figuring it out. And while we're talking about openness, Dr. Malik says it's time to stop faking orgasms, ladies. In doing so, we're telling men that what they're doing is working.

And now they think that what they're doing is working and they're taking that to their next relationship or with you in your future sexual encounters. And then it becomes even more awkward to tell them, hey, sorry, that I never really worked. Yeah.

Do you think people still do fake orgasm? I thought that was kind of, really? No, I think people still do. Look, we are a people pleasing society. When they're behind closed doors and they're with a partner, like you can say all the empowering stuff you want, but like people still want other people to like them and they want people to feel good and they don't want to hurt people's feelings. Yeah, I think still people fake orgasms. Absolutely. You know, when you're doing TV and they're about to wrap you up and they give you the wind up?

I always thought the faking orgasm was just kind of like, yeah, let's wrap it up soon. Like I'm ready for this to be over. I think that's part of it too. People are like, okay, this isn't working. They're working so hard. They're trying so hard. Let's just wrap this up. Like I just want them to be done. I mean, there's a variety of reasons that people do it. It's not just to not make them feel bad. But, you know, I think ultimately like no more fake orgasms. Yes. Please, no more fake orgasms. Dr. Reena, I wanted to ask a little bit about you. You've got this huge...

following online, YouTube channel, you're known as the sex doctor, talking very frankly about things like penis size and squirting. Was that controversial being part of the South Asian community coming from migrant parents and then being so open and public about this stuff? You know, it's so funny. I was raised in a South Asian household. We never talked about sex. Like, God forbid, you know, you're supposed to wait till you get married to have sex. It's just so weird. Like if you had asked

10-year-old me, if I would ever be doing anything about sex as an adult, they'd be like, no way. Sure, it is taboo in terms of if I was doing it in front of my parents, I think they would have a hard time.

But interestingly, they've actually never really said anything that's been negative. They've only been supportive, which is great. I think ultimately it's important. I think it's even more important as South Asians to talk about it because we're a very oddly prude society given that we came up with the Kama Sutra and all this stuff. Do you have a big following in South Asia? I do. Yeah. Cool. Cool. And it's not just South Asian communities. I think it's across the world. Yeah.

I'm a parent. I've got three daughters and a little son who's my youngest. He's nine. And I'm finding that the conversations about sex, it's just ongoing. It never, ever ends. Yeah. Well, kudos to you for having talks about sex. I've been talking to my kids about sex. I tell them, you know, well, actually my eldest son, who's 11 now, came to me a few years ago and was like, what is sex? And I was like, what is sex?

And so I said, okay, like, give me a second. We'll talk about it. And so we then went on a walk and we started talking to him about it because one, it allows me to not look at him in the face while I have to talk to him about this very, you know, sort of awkward topic. Even for me as a sex educator, as a doctor, like having this conversation with my son, I still was feeling some hesitations. If even the most experienced people find conversations about sex with their kids awkward, take that

that as reassurance. There is no perfect way to do it. But the important thing is that we try. My youngest son, who I also have had the conversation with, after I taught him about sex, he goes, so what happens if you like fall on a girl and then you accidentally have sex? I was like, no, no, no, that's not how it happens. I said, you know, the penis has to get erect, the vagina has to get lubricated. And so then like months later, he's like,

oh yeah, you know, the penis has to get hard and the vagina has to get sweaty. And I was like, what? Who told you that? Sweaty? I had forgotten that I said it to him and I was, I was literally dying. But, but yeah, so like,

They're going to remember bits and pieces of what you tell them and you're going to mess up and you're going to say weird things. They're going to say things that maybe you wish you had said differently. But at the end of the day, like you are opening the conversation for them to come to you when they have issues. Yeah. And you're not freaked out by them being curious. That's so funny about him saying, what if you fall on someone? Because I honestly, when I was little, I thought if a penis just brushed a vulva,

Pregnancy ensued. That's it. It's on. You're having a baby, even if you're 10 years old. Just terrified. I know. It is scary, right, though, when you're a kid, like to think about that and be like, oh, no. I was like, oh, what if you saw a penis? You know, does that mean like somehow it's going to...

There's all these things your little brain can't understand. Okay, Dr. Reena, I really love this conversation and hearing you talk so candidly about women's bodies and women's pleasure. Before you go, I wanted to ask, do you have a favorite part of the female body? I think the

The most wondrous thing is that, well, there's a few, but one of them is that the clitoris is the only organ in the entire human body that is designed solely for pleasure. So while men's penis, they have to pee through it and they have semen coming through it for reproductive purposes in addition to pleasure, the clitoris is literally just there for pleasure. It has no other function at all. So clearly there's some reason for that, right? And that's pretty exciting.

The other beauty of the female body is like, there's a lot more openness to exploration. And there's so many erogenous zones in the body, where I think women tend to experiment or explore those a little bit more than men. It's very easy for men to just penetrate and have an orgasm. Whereas I think like there's more exploration and interest in that. I think that's sort of fun. And each

And it should be fun. Knowing your own body and what turns you on, being comfortable with your likes and dislikes, this stuff isn't new, but hell yeah we do sometimes need to be reminded. Reena grew up in a household where S-E-X was never A-OK. But now talking about it has made her famous, she's dealt with a lot of misinformation and helped countless people.

We're all works in progress, aren't we? Trying to figure this stuff out, make it work for ourselves and whatever partner we're allowing into our lives. Maybe by the time we're 90, we'll have nutted it out. Get it? Nutted it out in the car park on Desert Island Dick.

Hey ladies, you know how

you know how you can hear me but not see me most of the time and you can only imagine what is going on because it's all in your ears? Well, we are doing a couple of Ladies We Need To Talk live shows soon so you can come in and breathe in the energy of your favourite podcast while surrounded by a room full of like-minded ladies. Ladies We Need To Talk is going to be at Podfest as part of

Adelaide Festival on Sunday the 2nd of March. I'm hosting a panel with Gina Chick, Jessie Tu and Anna Bronowski on How to Live Dangerously. Adelaide ladies, I want to see you there.

Then, if you're in Sydney, Ladies is part of the All About Women Festival on Sunday the 9th of March. I'll be talking to Alex Gorman, Georgia Grace and Alex Lee about the burning question, is everyone having better sex than me? Sydney sisters, see you there. You can find tickets for these events on the Adelaide Festival and on the All About Women websites. Can't wait to see you. Love you.