How Sexual Health Is Connected to Overall Well-Being (Performance & Longevity Series)

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Transcript: How Sexual Health Is Connected to Overall Well-Being (Performance & Longevity Series)

Season 12, Episode 19  | March 19, 2026

Jamie Martin

Welcome to Life Time Talks. I’m Jamie Martin and I’m back with Jim LaValle for our special series on performance and longevity with MIORA.

 

Jim, we have a really big topic to talk about in this episode. It’s one we haven’t actually covered on the podcast before at all, whether it’s Life Time Talks or in this series. We’re talking about sexual health drive and performance and why they matter for health, right? So, you know, it’s so interesting when people think about sexual health, they think of it’s about more than the performance in the bedroom. It really reflects overall vitality, hormone balance, and even cardiovascular health. So we’re going to dive into it. We’re going to talk about some myths, and we’re going to dive into things we can do to support our sexual health. And we’ll get a little gender specific within this too, because that’s really important.

 

Jim LaValle

No, that’s great. Yeah, I mean, look, you know what’s really interesting? If you look at all of the online telemedicine platforms, the majority of them are focusing in this area.

 

Jamie Martin

And why do you think that is? Is it just like that’s an area of opportunity because so many people are struggling right now?

 

Jim LaValle

Yeah, I think people are in need. It’s that straightforward. And there’s good reason for that. So once you understand, why is there a shift in libido? Why is there a shift in feeling desirable? Well, you gain weight, your hormones have shifted. And we’ve talked about this in other episodes of why do your hormones, your sex hormones in particular shift. It’s dependent on what your stress level’s like, where’s your insulin levels at. Are you, you’re chronically inflamed, so you’re turning down your ability to make hormones.

 

And so all these things kind of play into the picture, along with all the emotional wellness. We don’t wanna minimize the, are you in a relationship that matters? Do you feel wanted and desirable? So there’s that layer as well.

 

But there’s some very physiologic things that start to happen, right? So when women lose hormones, for example, as they enter menopause, or if they’re even perimenopause, they notice low sex drive, it could be strictly changes in estrogen’s testosterone, which I know we’ll get to that later about what the value is for that, and progesterone. But it could also be because they’ve been under stress. Maybe that the limbic system has really become basically supercharged with stress response and they lose their oxytocin, which is a peptide hormone that your brain makes. Well, men and women make it, but I think in particular women even benefit or see the effect of it more for sexual desire.

 

Jamie Martin

Well, it isn’t, I mean, the way I’ve always thought about oxytocin, it’s kind like the bonding hormone. Like it creates that almost like, even though it’s physiological, there’s almost like an emotional component to it as well.

 

Jim LaValle

No, that’s exactly it. That’s why it’s more important for women, right? Because, you what we can get into it, but I remember when I was talking to Mary Ann Legato, who was the head of gender specific medicine at, I believe it was Columbia, and we were on an advisory board together and she was talking about the difference in the MRIs of men’s brains and women’s brains. And first of all, women are actually more wired for fight or flight than men are. And that makes sense because, you know, more women end up with needing anxiety meds and those kind of things because the nervous system is more mapped up. But more importantly, they did imaging for men and women after they had sex. And what they found was that the men was that their dopamine, their reward centers lit up. I got a reward. For women, it was the emotional bond in the limbic system that lit up, which is that feeling secure.

 

Jamie Martin

Right, that sense of security and safety.

 

Jim LaValle

Security, safety and bonding, right? So there is a difference and that’s why there’s different compounds that can be utilized to help. It’s just important to realize it still goes back to this basic construct that I know at Life Time and MIORA at Life Time is that you have to have foundational health. Good example, you mentioned cardiovascular disease.

 

Especially in men, when men start having trouble with erectile function, that is the first and earliest sign of heart disease. And I don’t think men get that explained to them. What they end up thinking is, my testosterone’s low. And I’ve been around enough of hormone replacement therapy in men, sometimes that is the answer and it works, but many times it’s more about

 

Are you that blood sugar under control? Are you exercising? Are you getting a good night’s sleep? And in fact, Baylor School of Medicine, I remember being at a talk there, and they’ve done a lot of research in men, particularly on testosterone. They said, one of the researchers said, if a man’s not going to exercise, eat better and get good sleep, don’t bother using testosterone. That’s how important their research showed that lifestyle augmented and actually made testosterone more effective.

 

Jamie Martin

That’s a huge thing to understand. And I think it goes back to something we’ve talked about over and over again in our various episodes is like, it’s all a system of systems, right? And so while we might be talking about sexual health here, it is connected to a larger health and wellbeing and can be an indicator and be influenced by other systems in the body as well.

 

Jim LaValle

That’s exactly it. Yeah. And so, you know, well, what can we do about those things? Well, the obvious for insulin resistance and if they’re overweight is they to help someone to improve their weight loss. Maybe they’re on a GLP-1 program in order to do that if they have significant weight to lose. But probably the most important thing is get that comprehensive lab and look at your hormones. Where are they? And then look at where your stress response is at because, you know, your body is pretty simple.

 

When you think about how it’s wired, we as humans, we’re wired in a very primitive way. We’re wired to procreate the race or to fight off crisis. So when you think of that, the hierarchy is, well, if I have to fight off crisis, I’m not going to worry about procreation of the race because I’ve got to fight a crisis off. That’s the chronic stress of the day. An email, a text, being late for an appointment is not life or death, but it is perceived that way. And therefore people get into trouble with some of that sexual performance desire and just general circulation, blood flow, because they get stuck in that fight or flight response.

 

Jamie Martin

Well, and really when you go back to it, I mean, you think about our ancestors are, you know, they were had the fight or flight like it was in very specific instances. It was acute moments where you’re running from the tiger or whatever. The thing is defending the clan, whatever it is, where it’s now this stress that many of us are feeling is not it’s it’s unrelenting. It just is going and again, so no wonder we’re kind of living in that space.

 

Jim LaValle

That’s the gift that keeps on giving, right? Right. Yeah. And so then you think about, what categories? So there’s been a lot of innovation as it relates to helping men and women with this. so the first one, bioidentical hormone replacement therapy, fantastic to help both men and women. We’ve had an episode related to that.

 

And I think getting your hormones optimized for you, you’re working through a provider, is a great first step. And then there’s the issues of, well, how do I improve circulation? And actually, this works for both men and women. So there’s more more research coming out on using what’s called the PDE5 inhibitors, which are things like sildenafil, or better known as Viagra, the little blue pill, or tadalafil or vardenafil. All three of these are called PDE5 inhibitors.

 

And what that does is that improves blood flow circulation and vascular expansion. So you get an improved direction if you’re a man. For a woman, you get more blood flow to the clitoral area. These are all good things. But the problem is that if all you do is rely on that, once again, I’m going go back to just relying on that. It utilizes a lot of nitric oxide up in your body. Nitric oxide’s a good thing, but as we get older, we don’t make as much nitric oxide. So now we need to make sure we’re eating more beet greens and, and, know, things that contain or build nitric oxide. Uh, because if we’re going to use the blue pill or we’re going to use a combination, which I’ll talk about in a little bit, how we’re able to compound and create combinations of these. Well, you’re going to want to be able to make sure you get your nitric oxide pool, you know, to be built back up. And one of the things you could do with that.

 

I know we’ve talked about it in that previous episode is a kyolic actually helps build nitric oxide backup. That’s the aged garlic extract, so that can be helpful if you’re going to be on utilizing those types of drugs on a regular basis. And look, low dose tadalafil, for example, is being used for, you know, chronic peripheral circulatory disorders and all of the PDE5s, especially sildenaphil, they’re actually looking that for dementia prevention because it’s improving cerebral blood flow. So there’s some real value to this.

 

But in terms of sexual health, you typically have about a, it depends if you’re using a trochee or a dissolvable tablet under the tongue, usually within about 30 minutes, 30 minutes before you’re expecting to be intimate. You can utilize a trochee or a dissolvable chew tab and you can see some, you’ll see benefit obviously. Once again, more frequently you use it, and if you’re not replacing your nitric oxide and you’re over the age of 40, you’ll see that, wait, I need more. I need more.

 

Jamie Martin

So it creates this trend of like okay as time goes on more and more. So where do, you you know we talk about them all the time the lifestyle choices fit into all of this and surround sexual health?

 

Jim LaValle

Yeah, I mean, look, I think it still gets down to those basic things. You’ve got to manage your stress. You know, if you’re if you’re thinking you’re going to go to bed and be intimate and your dog tired because you’re not getting enough sleep, there’s very little desire when you’re incredibly tired and so exhausted that you can’t think about it. There’s obviously the whole psychosocial setting of how you’re setting the room and all those good things that matter. that’s but that’s part of lifestyle is building that anticipation and building that desire into that experience so that you’re putting meaningful, you know, expression into that.

 

But at the same time, once people get over a certain age or if they’re having hormone failure, they’re going to need help. So the other one that has been approved, so we talked about the PDE5 inhibitors, is PT-141. PT-141 is a fragment of a hormone that your brain makes called melanocyte stimulating hormone. And PT-141 is an approved drug for women. It’s called Vyleesi but it’s being compounded in combinations for both men and women because this doesn’t work on the vascular network like the PDE-5 inhibitors do, right? This is working on the sexual desire centers and the neuronal signaling.

 

Jamie Martin

That’s interesting. So cognitive in that space, right?

 

Jim LaValle

Yeah, it’s a little cognitive, but it’s more just arousing the sexual desire centers in the brain is what it’s doing. Now, as I didn’t mention, if you’re going to try a PDE-5 inhibitor, make sure that you’re trying something that is not max dose, because you can get headaches, you can get lightheaded. On PT-141, which by the way, I think is a fantastic compound, really seen it work fantastic for people. However, when you first take it, you want to titrate your dose. Just like we talk about titrating doses with GLP-1s, you want to titrate the dose of a PT-141. Either it’s a nasal spray or injection or it can be a chew tab. Typically when they’re in the chew tabs, they’re in a smaller dose anyway because they’re in combination with the other things we’re going to talk about. But you can get if you take it, especially by injection, and you take the full dose, know, milligram dose, you could feel sinus congestion, nausea, and your face get really red.

 

Jamie Martin

Interesting. Okay.

 

Jim LaValle

All right, so headache, know, all that can kind of happen. So by titrating the dosing, accommodating to it, know, you do maybe if it’s doing an injectable, maybe a quarter of the normal dose. So maybe an hour before your intimacy and then maybe I’ll do another quarter because I didn’t really feel it or maybe, wow, I felt it on that quarter. I don’t need anymore. Right. So that’s a really good. It does have activity. Orally.

 

And so some of the things that you get when you come to, you know, into MIORA at Life Time is there’s different types of prescriptions that you can do. For example, one that would combine compounded that would combine to Tadalafil or sildenafil with in order to get the peripheral vascular circulation to improve the liver more blood flow, get engorgement, right? Important with oxytocin create that emotion connection that’s there, right? And then PT form 41 which triggers the sexual desire centers in the brain. So you’re hitting all three notes and it’s a sublingual tablet that someone puts under their tongue about 30 minutes before the time in which they think they’ll be getting intimate. And then it becomes this incredibly more desirable experience.

 

I think that these combinations that are out there now are fantastic because you know, when you start to have these types of issues, sometimes it could be more than one of those pathways that are a problem. For example, for women, when the limbic system has subconscious stored fear, worry about former emotional trauma or physical trauma, right? That can create that subliminal or subconscious roadblock that, you know, using oxytocin to open up the ability to feel and to feel that connection, I think is really important.

 

Jamie Martin

Let’s talk about the oxytocin. Can you supplement oxytocin? I don’t think we’ve talked about that element yet. How would you . . .

 

Jim LaValle

So oxytocin can be done intranasally. Or it can be done in a tablet form like a, you know, dissolvable tablet. A lot of times it’s preference, right? So oxytocin in a nasal spray. Some people, oh, I don’t like putting things in my nose, right? Probably a little more powerful if it’s just the relying on oxytocin going as an intranasal administration. But when you combine it in a chewable tablet with PT-141, some Tadalafil. It works out to be very, very effective. I think, at least for me, what I think is important when I’m counseling people on the use of these types of drugs is it’s comfortable. Because we’ve all had issues where men, for example, took too much Sildenafil and then they got priapism, meaning that they had a an erection for more than four hours, which can be rather dangerous actually. So I think it’s the whole thing of creating comfort.

 

Jamie Martin

And feeling safe in the choices that you’re making.

 

Jim LaValle

Exactly. Exactly. So, you know, tremendous opportunities here to help people feel, you know, what I always talk about with what I consider triad five, estrogen, testosterone, and progesterone is do I feel desirable and am I desired? And I think when your self-esteem is good and your sexual well-being is intact and the hormones are signaling correctly,

 

It’s a beautiful thing that, hey, you may not be at your ideal weight yet, but you can still feel desirable. can still be desired. you can work on those. Well, I think it’s one of the biggest things that make us feel a sense of why we’re alive, right? Intimacy.

 

Jamie Martin

Well, right, and that connection that you want to have. I mean, I just think it’s so interesting. This is one of those topics that has kind of been brushed under the rug and not discussed a lot in mainstream culture. It’s something because it’s like, it’s over here. That’s something that we talk about. of dirty. Right. it’s not. It’s not at all. larger health issue, right? Because your sexual health can be an indicator of your overall health, right?

 

Jim LaValle

Major indicator of your overall health. You’re absolutely right. You you read things like, hold a hug for 25 seconds to get the immune benefit and the all the oxytocin to release, right? So I think, you know, even with the, you know, the blue pill, you know, and the way the ads are on TV, TVs, it’s more kind of on that, yeah, you’re going to perform better.

 

But there’s that little bit of understanding that it really, why is that performance important? It’s because of the closeness that happens afterwards and that you want that feeling of connection. You want that oxytocin coating the brain. You want to be able to feel desired, desirable love. that, look, that carries you through a lot.

 

Jamie Martin

I was gonna say there’s a trickle-down effect when those things happen in your body. It’s not just affecting that connection there. It trickles out into other aspects of your life too. So just a quick thing. mean, you mentioned like perimenopause is a common time that you start seeing some of these issues in women. How about in men? we seeing like sexual health issues? What are those starting to present? I think I remember us talking in a previous, whether it was a panel or whatever, that it seems to be getting younger and younger when these issues are starting to show.

 

Jim LaValle

Absolutely. You know, I always talk about when these drugs first came out and it where they were like people that were silver haired. Right. You know, I don’t know if you ever remember the first one where there were two silver held people in two separate bathtubs.

 

Jamie Martin

Yep, I do. I remember those ads.

 

Jim LaValle

I kind of thought, why would you have two separate bathtubs? What’s the purpose of this? I didn’t quite get that. Yep. But if you look at the advertising now, it’s people in their early forties or they’re in their thirties. And a lot of that’s because we see more and more men with hormonal hypogonadism much earlier than what we used to see. It’s not uncommon to see a man in his twenties with a 160 testosterone when it should be 800. And now there’s different reasons for that and you can help get that back. But it’s definitely a situation with men more and more today at earlier ages is that they’re having erectile dysfunction either to emotional issues and stress. Obviously, weight gain and insulin resistance is a massive problem.

 

So it’s a much more common thing than what we saw you know, gosh, I mean, I gotta be honest with you. 30 years ago, I hardly ever had a man complain. Rarely older men would ask about, what can they do? Versus when we were on the OB-GYN side and I was counseling on the medications and everything with the OB-GYN, I mean, when we’re talking about this quickly, that perimenopause time when the hormones are shifting, like, hey, I’m lost my sex drive, something’s wrong, this isn’t normal for me, right? So yeah, I think it’s almost tragic that we’re seeing how quickly men’s testosterone levels have eroded over the last decade.

 

Jamie Martin

Yeah. Well, and even on the opposite end of that, there’s just things that naturally happen in our bodies with age, right? Like there are certain nutrients that may deplete. I’m thinking like DHEA, mentioned nitric oxide. You know, what can people do to support them? I know you mentioned like there’s things we can eat foods that support the creation of nitric oxide. How about some of these other things we might want to do from a lifestyle standpoint?

 

Jim LaValle

Yeah, I mean, I’m still going go back. If you are somebody that works out a lot, you can overtrain yourself out of sexual desire. mean, it’s one of the overtraining syndrome. One of the symptoms of overtraining syndrome is loss of sexual desire and motivation. That’s right out of the Olympic manual for part of overtraining syndrome is loss of sexual desire. And that’s because when you work out really hard, your body thinks you’re in fight or flight. When you’re in fight or flight, you’re going to turn off the procreation channel, right? I know that’s a simplified way of thinking of it, but I think it, you know, after all these years of explaining it, it’s kind of the way it works.

 

Jamie Martin

No. Oh, OK. Last question. You’ve talked about some of the testing. How do we know? Obviously, a blood test can look at it. It’s not just going to look at your sex hormones, but look at a broader picture of your health. that what you would consider the precision testing that you would want to have done for looking at hormone health that influences sexual health?

 

Jim LaValle

So when it comes to this, think there is a need for a very comprehensive lab test, knowing your blood pressure, right? You should know your blood pressure, because if your blood pressure is up, it tells you that your blood vessels are constricting. So managing your blood pressure is important, because now that means that you’re not able to get those blood vessels to expand. And then it takes a good symptom survey. It takes an assessment. I think a lot of times people think symptom surveys aren’t that valuable. They’re actually being looked at with more value even than lab tests now, because it’s a big argument I’ve always made is a lot of times people have symptoms before their labs are going bad. So they have symptoms for three or four years before the lab values start changing. So it’s really looking at all of it. And this is particularly involved in the, I, you know, what is my level of stress? You know, am I able to achieve orgasm if I’m a woman? Do I have trouble with maintaining an erection if I’m a man?

 

Like you gotta ask questions in this category and look at the labs, right? And understand the lifestyle pattern. You what are you doing that would be contributing to this? Are you under a lot of stress? Are you getting enough sleep? Do you get any kind of exercise so that you can really start to rebuild your health? Because particularly, and I always have concern with men on erectile dysfunction because they just think it’s all, yeah, it’s a Viagra deficiency. It means you have early atherosclerosis.

 

Jamie Martin

Right. So heed the warning there, right? Like maybe go take a closer look.

 

Jim LaValle

Exactly, exactly.

 

Jamie Martin

And then finally, mean, I think it’s really, we’ve talked a little bit about how MIORA can help with these like various health conditions, but like if you’re working with patients or how could MIORA help individuals really address this aspect of their health and do it in a way that helps them feel safe and comfortable. They don’t have to be embarrassed to come in and talk about this aspect of health.

 

Jim LaValle

Well, obviously when you’re coming into a MIORA clinic at Life Time, first of all, everything’s HIPAA secured. It’s private. It’s going to be very private. The information that you’re sharing will never go anywhere other than with your provider. And you’ll be able to actually maybe, and I think this is a big piece too. When you figure out that it’s not your fault, when you get you know, some knowledge about, this is where your hormones are in your body and this is why you feel the way you do. I think it takes the guilt out of it and starts to even immediately. And I know this just from, I mean, seeing hundreds and hundreds of people a week at one point. When I can give a person hope and explain why something is happening, self-esteem starts to build back right away because they’re no longer blaming themselves.

 

Jamie Martin

Right, they’re really understanding again with another thing, it’s chemistry, right? And what’s really going on in their bodies.

 

Jim LaValle

That’s right. And the only thing I would add to it is, you know, if for some reason it’s really emotionally based that, you know, going for counseling, getting with an individual that can help unlock that limbic system, maybe using EMDR therapy, there’s certainly things that can be done to help that as well.

 

Jamie Martin

Yep. All right, Jim, this is a big topic. feel like we got through a lot, but did we miss anything before we close out this episode?

 

Jim LaValle

You know, I think the most important thing that relates to this episode is if you’re experiencing issues around sexual performance, libido, desire, get checked out, address it. You know, I say attack it because there’s nothing more important than being able to be intimate. There’s nothing more important than being able to create that bonding with our significant others. And it could be the early warning signs that there is a future health issue that you’re going to be at risk with. And so, you know, look at this as something that’s serious and sober and not something to be ashamed of in any way.

 

Jamie Martin

Right, just another aspect of your health to be aware of and proactive about. right, Jim. All right, if people want to learn more, we’ve got more at miora.lifetime.life. We’ve got other podcasts and all sorts of other content about this and a variety of health issues. So tune in over there. And Jim, thank you as always.

 

Jim LaValle

Yes, it was great.