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All Things Sexual Wellness Episode 2 Transcript

Kelly Englemann: Welcome to the All Things Sexual Wellness Podcast, hosted by Enhanced Wellness Living, where we’re gonna teach you everything you need to know about all things sexual wellness. Hi, I’m Kelly Engelmann, host of All Things Sexual Wellness podcast. I’m a family nurse practitioner. Board certified in anti-aging and regenerative medicine, and also certified as a sexual health practitioner through A4M.

My co-host is Amanda Carter and we practice in Ridgeland, Mississippi at Enhanced Wellness Living. I’m so blessed to have Amanda. She has brought life to our sexual health program for both men and women. So we’re gonna dig into some content, but first I have a little bit of disclaimer. This podcast, we are not here to treat any health condition.

This podcast is for information only. So if you’re having some struggles and want help, please reach out to the clinic. You can reach out to us on our website, www.enhancedwellnessliving.com, or you can give us a call (601) 364-1132, or you can reach out to your current healthcare provider.

The other disclaimer is that this is adult content. If you have littles sitting around listening to this podcast, you may wanna grab your earbuds or your headphones. We do want you to listen, but we just wanna be responsible about how this content gets out. So grab those earbuds. Let’s dig in. This is gonna be awesome.

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Today we are interviewing Lori Esarey. Lori’s a nurse practitioner certified fellow through the anti-aging regenerative medicine Associa. She’s got a tremendous practice in central Florida. I’ve known her for many years. I’m not gonna tell you how long, because that would tell you how old I am. But we met during our fellowship training.

We have a company called Synergee that we partner with to provide education and resources for other providers practicing functional medicine. But I managed to get her on today for the podcast to talk about sexual wellness. And I’m so excited because we’re gonna have some fun facts during this podcast that you probably didn’t know about, how your body functions and how to make yourself feel better.

And we’re gonna have some tips and tools all centered around lifestyle management of sexual function. So stay tuned, lean in, get something to drink, sit down and have some fun with us. Welcome. I’m Kelly Englemann, the host of All Things Wellness podcast, and with me as my co-host today is Amanda Carter.

And our guest today is Lori Esarey, nurse practitioner from The Villages, Florida. I can’t tell you how excited I am to see you here.

Lori Esarey: Thank you so much for the invite, Kelly. I’m so looking forward to this conversation with you, both of you.

Amanda: I’m excited to be here as well and I appreciate you having me on.

Kelly Englemann: Oh yeah. So, you know, one of our main goals for, you know, creating this content is to really open up the conversation about sexual health. You know, I believe that sexual health is the barometer to your overall health. So when I thought about who do I want on the podcast? You know, Lori, you were one of the first people I thought about because our metabolic health plays into our ability to function sexually in such a big way, and I think it’s something that we don’t even understand. Most people walking around have no idea the connections there. So I wanna dig into that. Pretty hot and heavy today.

Lori Esarey: Sounds like we’re gonna have some great conversations.

Kelly Englemann: Yeah. So let’s talk about, you know, what are the causes of sexual dysfunction for men? And today we’re gonna be pretty much exclusively talking about men. We may have- slide some comments here and there about females, but let’s talk primarily about men’s. What are the most common causes of sexual dysfunction?

Lori Esarey: So Kelly you know, from the standpoint of the patients that I treat, one of the most common reasons that men have sexual dysfunction is a lack of good blood flow through their penile arteries, actually, right? The smallest arteries in the body to have a, an adequate erection. So any disease state or any condition that alters blood flow. alters sexual health. So that is the primary reason that we see sexual dysfunction in our clinic.

Kelly Englemann: Absolutely. So they’s say 85% of erectile dysfunction is vascular, right? So-

Lori Esarey: Correct

Kelly Englemann: Vascular health.

So 85% vascular. And then there’s a component of of neurological health. So for men that have had prostatectomies, right? They may lose function if they don’t do a nerve sparing prostatectomy or sometimes even if they do a nerve sparing because of loss of blood flow and damage to that tissue, we’ll see changes associated and you know, some, some issues there.

And then what about metabolic? Hormonal dysfunction, right? Yeah. Metabolic diseases dysfunction as well to hormonal dysfunction. So diabetes, hypertension, all those of impact blood flow. ultimately, but in the beginning they can, you know, also contribute and then psychological, right? So change is associated with.

So during the podcast, we’re gonna be digging into those concepts or those causes of erectile dysfunction, pretty hot and heavy as we get through, through the content. Today, we’re gonna talk mostly about vascular, so we’ll stick the conversation to vascular health today. So we’ve, we talked some about endothelial dysfunction. Right. Most people don’t know they have an endothelium. So tell us, Lori, what is that? What is the endothelium?

Lori Esarey: So the end- endothelial dysfunction is a type of non-obstructive coronary artery disease. And basically there, there aren’t any heart artery blockages with these individuals, but their blood vessels become very stiff. and very, very hard. And the relationship of that dysfunction, the, the primary driver of that is diabetes. And you know, if you haven’t heard this already, the statistics around diabetes are just. Jaw dropping. You know, in 20 12, 370 1 million people had diabetes, but by 2030 we actually expect 552 million to have diabetes.

So I, I, you know, I don’t know what that means to you or to our listening audience, but. To me, that means we have a epidemic, right? We have a condition that is fast on the rise, and this condition doesn’t just lead to kidney disease, right? We often hear that diabetic retinopathy, eye issues, but one of the primary disease states or dysfunctions that happen is in the area of sexual dysfunction, you know, with, with men and with women.

Kelly Englemann: Yeah. I was gonna say that’s not really gender specific, right?

Lori Esarey: No.

Kelly Englemann: So the endothelial lining affects all of your blood vessels. So all of your blood, that’s right. Vessels contain an endothelial lining that’s only one cell wall thick, so it’s fragile and can become damaged. And, you know, diabetes damages that endothelial cell lining because of the sugar content. And those red blood cells get really sticky and they clump together and they damage that endothelial lining and doesn’t allow blood flow to happen. But even before diabetes develops pre-diabetes, we’ll see endothelial dysfunction.

Lori Esarey: And that’s really what I wanted to speak about because you know, when you look at the statistics around erectile dysfunction, there’s a three times greater chance in diabetic men to have ed. . So you know, you look at just the numbers alone being 552 million people by 2030 and people that have that condition are three times more likely to have ed.

But you’re right, Kelly, it takes 10 to 15 years for ED to occur. So you can be in a state of dysfunction or what we like to call is dis disease versus disease. Right. For a long time before this presents. And so it is important. I think the other thing to explore here is just the role of inflammation.

You know, we know that inflammation, and we throw that term around all the time in integrative and functional medicine, and, and perhaps we even use it in just our common everyday language. You know, inflammation being something. You know, like an acute process, right? That the body needs to walk through to heal.

But inflammation, when we get stuck in something that’s chronic, right? It’s that inflammation process that drives our endothelial dysfunction. It drives many other things too, but it is the root, if you will, of that dysfunction. So when you look at any driver, anything that promotes inflammation, whether that be life, , you know, what we eat, what we drink, how we sleep, move, and think.

It’s what we’ve been exposed to environmentally. There’s just so many drivers of it.

Kelly Englemann: Okay, so you said that really fast. Let’s go back. Re- rewind, rewind, . So the lifestyle things that we have to consider, the way we eat, what we drink, how we move, how we sleep, and how we think. Did I get ’em all? Okay. You did.

Good job. Yes. I mean, that’s a lot to think about. . That’s a lot to navigate for most people to really think about, you know, how am I doing those things on a day-to-day basis that’s setting me up for success or failure in that area, right? Later, we’ll get into some takeaways, right? Some things that they can be doing in a positive way to perhaps change the trajectory of what’s happening to their body, right? We are, we’re here to help prevent things. You know, a lot of people listening already have these disease processes or these issues in play, erectile dysfunction’s already on their mind. But if we could, you know, affect their children, the next generation, you know, I think about things in, you know, what are we doing to prevent, I think about seven generations.

You know, if we have the potential to make changes now in this generation, it’s gonna affect generations to come. And, and even better because like you said, we’re on a trajectory for a major, major catastrophe and epidemic in our nation of epic proportion really when it comes to diabetes. And then the consequences and the downstream effects of diabetes will be long lasting.

Lori Esarey: Yeah, and I think, you know, when you think about erectile dysfunction in general, by the time. male or female, but we’re gonna speak, you know, to the male gender right now, really seeks help. It usually is a pretty profound problem, you know, and so I think it’s important for the listener to hear that these are things that we really can reverse.

We can slow down and it’s really about looking at these symptoms and recognizing they don’t have to get worse. So I’m really looking forward to talking a little bit more of those lifestyle things, because even diabetes, 100% of the time, we have the ability to reverse it by lifestyle measures.

Kelly Englemann: So I wanna hear that again, right? There’s power in that. The ability to actually reverse diabetes tremendously. Definitely the opportunity to prevent diabetes, definitely. But to reverse diabetes, that’s pretty incredible. Mm-hmm. , correct.

Lori Esarey: So, Amanda, you know, tell me a little bit about your role in erectile dysfunction and treatment.

Amanda: So I work with men who have already experienced beginning signs of erectile dysfunction. They typically come to me when they’re beginning to notice problems. We are trying to reach out to get people when they’re noticing earlier on symptoms instead of waiting to be so long. So our educational piece really is to that identifying symptoms early and seeing what we can do to mitigate those symptoms. We do focus a lot on sexual health treatments. However, we do look at o- overall lifestyle, preventing inflammation, treating, identifying disease process, and going from there.

Kelly Englemann: So, Amanda, when you think about the early signs, you know, I mentioned earlier that your sexual health is the barometer to your overall health. What is one of the first things that men may notice and not even think about until we start asking them questions? What are the, one of the things that we. that they may, our listeners may be in tune with.

Amanda: So one thing that a lot of people have noticed is a decrease in nocturnal erections. You know, those spontaneous erections that you wake up with in the middle of the night or in the morning a decrease in those is a warning sign.

Also, a little fun fact, a cold feet often happen with a decreased blood flow. So if you’re having cold feet your feet and your penis are the two things that get blood flow the least and the last. So if you’re having cold feet, you probably have a circulation problem already.

Kelly Englemann: Oh my gosh, I love that fun fact. I love it. So men that are listening right, cold feet at night, is it primarily at night?

Amanda: Cold feet pretty much all the time. You will notice it at night and cold feet that persist, even wearing socks. If your feet are still cold, your partner’s feet are still cold, that is a warning sign of poor circulation.

Kelly Englemann: So Amanda, Lori has a really good story, and I think this will be the perfect time to share it, because what you said is just profound. So, Lori… She and I were talking earlier today and and talking about success stories we’ve had in the clinic. So, Lori, share with us what you were saying about, you know, your success story, one of your many success stories in the clinic using acoustic wave therapy for patients.

Lori Esarey: So, you know, I, I love the opportunity to hear back from gentlemen who come in very skeptical about procedures associated with improving erectile dysfunction. And so one of the things that, one of the stories, one of my favorite stories is this. over 80 year old gentleman, let me just say, he was in his mid eighties who came to a conversation that we have in our practice about erectile dysfunction.

And so that’s how we promote the conversation about it because we find that it’s very helpful to bring people in, kind of talk about it. Talk about. The disease state itself and the dysfunction and what options and what opportunities do exist for treatment. And so he was, you know, he was he, he joined us very, very skeptical.

And while the conversation was going on, I had brought a gentleman in to share his story. And it was a much younger gentleman who was talking a little bit about how he had had such a profound improvement in his overall function. But what his side story was is that he tru. Had improvement in the color, the discoloration of his lower extremities, and the fact that he could now like mow his grass and do some different things without leg pain. So after our conversation at the close of our talk, this older gentleman comes up to me and says, you know, listen, I’m excited about this procedure. But the reality is, is, I mean if you can fix and improve my, my, my sexual health, that would be great, but I’m not expecting that. But if I can get back on the tennis, I’d be really happy. So he decided to do the treatments and I was telling, as Kelly and I were talking today how now he just loves us and this is his story today. He’s like, listen. , I, you not only fixed my legs and I’m playing tennis, I now have great sexual function. And so listen, I don’t just love you, like I love you, I love your clinic. I love everything that you do. And so, so you know, to your point is there are some other benefits of pulse wave therapy and not only improving circulation to the penis itself, but also distally in the lower extremities. So people that have pain in the legs, they’re not able to. To have, you know, their exercise, they’re not able to do the things that they used to do because of that discomfort. They do have improvements in that. So that’s just one of the, the most fun stories because, you know, it is, it is definitely a joy to be able to improve. , a couple’s experience in the bedroom because we know the relationship of intimacy to happiness, joy, right. And just health of a, of a relationship to be. But to be able to get them back to activities in their life that gave them pleasure. All activities, physical activities as well, is just, it’s just, you know, I don’t know. To me as a provider of care, it just gives me great joy to do that.

Amanda: You’re absolutely right Lori. That’s one of my favorite things about doing this. And you know, sexual function is such an important part of your entire life. I have had on patients as young as 18 years old and as old as 78. Sexual function, sexual intimacy is a huge part of our lives for our entire lives, and so many people, when they begin to experience problems, are afraid to address it, don’t know how to address it, or don’t know where to go for help.

And so they just stay silent. And because sexual health is a barometer for, you know, other health issues that you might have in your body, there’s so many things that may not be be being addressed as.

Lori Esarey: Yeah, you’re absolutely right. It is so important, as you know, clinical providers to be attentive and be asking questions because as I alluded to earlier, it is not very commonly expressed unless a patient’s being asked, they’re being asked, and it’s very similar to that of the conversation of memory loss.

Most. Don’t necessarily want to discuss that they’re having a problem, and moreover, many of them, because the decline in sexual function is so slow and it’s so insidious and slow, they don’t recognize the loss or the decline. and until they’re not necessarily performing right. And at that point it can be, you know, I’m sure multiple reasons why, and you could probably speak to this just as well, is they’re not talking about it, whether that be embarrassment, not really knowing who to talk to, you know, and can anything be done about it.

So I think as providers of care, we have to be willing to listen and ask questions. But to our listening audience, you need to be attentive. You need to be asking if you see a reduction. Like you said, Amanda, you know indiscriminate age, right? You, your youngest patient has been 18. My oldest client has been mid eighties. Yours has been 79. But across the lifespan, they need to be attentive to the slow insidious decline and just ask questions. Not to be embarrassed, you know, to be willing to talk about it because there are things that can be done and. To your point, and what I was sharing it is it is definitely a barometer of other things going on, and perhaps it’s only showing up in that aspect, but really it could be hypertension, high cholesterol, diabetes, cardiovascular risk, stroke risk, all of those things, which will decline your overall ability to function independently. Right? With a lifestyle that you enjoy.

Kelly Englemann: Absolutely. So let’s dig into, I wanna go back to the endothelial dysfunction because I think there’s some richness there. So when we think about endothelial dysfunction, one of the things that the endothelial does is it produces nitric oxide, right? So let’s talk about the role of nitric oxide when it comes to sexual performance.

Lori Esarey: So I, you know, nitric oxide is something the body naturally produces, and over time, due to chronic inflammation and multiple other reasons, there’s a decline of nitric oxide production and, and no nitric oxide is necessary to dilate those blood vessels. Right? And as a result of that lack of dilation of those blood vessels, and stiff hard blood vessels from endothelial dysfunction. We have an overall reduction in, in blood flow, so nitric oxide is extremely important and it has to be addressed as a part of, of the equation for ED.

Kelly Englemann: So Amanda, any fun facts about nitric oxide?

Amanda: So, nitric oxide is kind of the on switch for erections. So man, men are mostly visual. Sometimes also, Touch related as well, which starts that kind of whole cascade of the erection process. Dopamine is released, which is your chemical and your attraction. Hormones. Neurotransmitters. Yeah. Thank you. Also releases oxytocin, which is your bonding in your love hormone. And that causes the relaxation, the surge of blood that releases that nitric oxide. So nitric oxide is kind of your on switch.

So when you think about an erection, that’s really where that the on switch comes from, is from nitric oxide. So if you don’t have nitric oxide or you have suppressed nitric oxide then you can have a problem there with getting erections.

Kelly Englemann: Yeah. So I was reading where mouthwash prevents the conversion of nitric oxide in a way that diminishes erections.

How many men get up in the morning, brush their teeth, use their mouthwash just like they’ve been told to do. Right? Not knowing that it can affect nitric oxide utilization. And then the other thing that I read in preparation for this podcast that I was not aware of, and this is for, for both men and women, you know, our ability to make nitric oxide starts declining about age 40, right? I mentioned mouthwash may be contributing. The use of PPIs can contribute to the ability to transform nitric oxide to a usable form. So if you’re using something like Nexium, prilosec, any of those can diminish that. So how many people have reflux that are popping those pills every day?

But nitric oxide plays into libido. So how many women are coming in with lack of libido? I mean, that’s such a common complaint that I hear. Like I just don’t know where my sex drive went. I enjoy sex. I still get engaged with sex. I can become aroused. I can have an orgasm, but I don’t desire it anymore. So how much of that is nitric oxide?

It’ll be interesting to play around with some nitric oxide foods and supplementation and see what a boost we can get with libido for both men and women.

Lori Esarey: Right. And it’s me. Right. So we have the ability to actually measure nitric oxide. Right. And it’s, it’s something that you can’t manage what you don’t measure. But when you have a concern in this area, it’s the first step would be kind of thinking about can I measure it and what’s mine doing? Right. Absolutely. So that’s a really fun fact though about mouthwash.

Kelly Englemann: I know, right? So what are the foods that increase Nitric oxide.

Lori Esarey: Well, I love talking about food. So, let’s talk about food. Yeah. So I, I don’t know about you, but if, if you like beets, beet juice, and beets definitely improve nitric oxide. For some of you who love those green leafy vegetables like spring greens, oak leaf lettuce, Swiss chard, bok choy, mustard greens, parsley, leeks, lots of good stuff there. Other vegetables like broccoli, artichokes, and then you have garlic and onions. Now, garlic and onions, you might have to use more mouthwash, so you gotta be careful with that.

Kelly Englemann: Right. . Yeah. Your garlic to onion mouthwash ratio has to be just right. .

Lori Esarey: Exactly. Exactly. But spinach improves it too. Rhubarb. Some of you, again, seasonally, we don’t have access to all of these things all the time, but there are a lot of nitric oxide supporting foods that I know that when you eat a, a food or diet, that’s that’s very diverse. That getting these things in not only improve your nutrition overall, nutritional density, vitamins, minerals, but these also improve nitric oxide. And probably why. Let’s talk about that. I mean, it lowers inflammation, right?

Kelly Englemann: Right. Absolutely right. So I hear, you know, a lot of people, they just don’t, they don’t like their vegetables, right? You hear know what Amanda? Do you hear? I just don’t like those vegetables.

Amanda: So our society today and our culture today, our food is not the best. You know, we do a lot of processed foods, we do a lot of fast foods where a lot of those nutrients and minerals are removed from the food. And that’s, I believe one of the reasons we are getting to these statistics that we have with heart disease and erectile dysfunction and diabetes that we have now. The great-

Lori Esarey: you’re absolutely right.

Amanda: The great thing about nitric oxide is as well as erectile functioning, it also is good for the entire body. It improves cognitive performance, athletic performance to your muscles also lowers blood pressure, so it does many other things in your body as well.

Kelly Englemann: Absolutely. So one of the things that we started doing, my husband and I started doing this year and really trying to maximize nutrient value and quality, is just growing some herbs and throwing ’em on top of everything.

Like, you know, because we, we had gotten into the habit of growing the herbs, but then we weren’t using the herbs. And I’m like, okay, well let’s start using the herbs, right? And. Chopping up some cilantro, whatever we’re cooking, throwing those herbs on top even after we’ve prepared the food. It’s just been really fun to play around with.

But herbs pack a powerful punch when it comes to nitric oxide production. So you know, playing, if you’re not a big vegetable eater, try to slide some things in regardless, you know, that maybe aren’t gonna require so much too time and so much thought process. So herbs can be a really good way to play around with flavor and increase that nitric oxide.

Amanda: I’m also a big fan of using smoothies.

Kelly Englemann: Oh my gosh, yes.

Amanda: To get in additional nutrition. Sometimes it’s really hard to get all those fruits and vegetables and herbs that you need in a day. So making a protein smoothie every day, you can very easily sneak some things in there that you really can’t taste. So if you’re not a big fan, sometimes just a couple of handfuls of cilantro. Or some vegetables put into that smoothie and you can customize the taste of it. We’ll really help you get those in.

Kelly Englemann: Yeah, so let me give you guys a recipe that I really love for a smoothie that’s, you know, I call it my pro libido smoothie, and I’ll make it for my husband on Friday morning.

So, you know, Friday night goes really well, , so I’ll roast some beets. Okay. So it takes a little bit of effort. It takes planning. It’s kinda like your sex life. It takes planning. But I, I’ll roast beets and just have ’em chopped up and in the freezer. So I use a handful of those beets, a handful of blueberries, a little bit of almond butter, some coconut milk or almond milk.

And then, and then the protein powder and just blend that up. Oh, and a little bit of ginger, so like a little bitty pinch of ginger and throw that into the vitamin. Blend it up and it’s really good. It’s one of my favorites. It’s one of his favorites. And it does give a little nitric oxide punch.

Lori Esarey: And let’s not forget protein. You had said that when you make that smoothie, right, you’re adding some protein in there. Remember, that’s amino acids and we know that amino acids have a lot to do with improvements of nitric oxide as well. So that’s a great power pack smoothie. And it, it sounds like it tastes really good too.

Kelly Englemann: Yeah, that’s a good one. So we’ve talked about diet being, you know, fundamental. In helping with nitric oxide, what are some other things, lifestyle-wise that we can really be thinking about in the way of improving male sexual health and performance?

Lori Esarey: One of the things that, that really improve, but maybe not our thought of to improve our sex life, is our, our exercise patterns. It is very, very important. You know, it’s not optional. It’s necessary to move on a regular basis to improve blood flow, right?

Kelly Englemann: Yes.

Lori Esarey: And to improve overall just cardiovascular status. So definitely movement of the body is a, an imperative of lifestyle every day. Additionally, we can’t forget sleep. Yeah, we just can’t forget sleep, you know, we gotta be sleeping. Anything again that promotes lowering of inflammation and so sleep is critical to recovery of the body, particularly sleep quality sleep from 10:00 PM to 2:00 AM I didn’t mean that you just sleep from 10 to two, but. Making sure that we’re getting to bed early enough and getting adequate sleep, deep sleep recovery, sleep, waking up refreshed in the morning.

Kelly Englemann: So we think we can cheat sleep, right? We have so much to do that we don’t have time to sleep. But sleep is your superpower, you know, it’s your time to repair and restore. And as you mentioned, that time between 10 and two is really our time for deep sleep. So what happens during deep sleep? Anybody wanna talk about it?

Lori Esarey: Amanda, what happens during deep sleep?

Kelly Englemann: So our hormones get regulated. You know, melatonin’s are key regulatory hormone, and so melatonin regulates other hormone productions. So talk about those nighttime erections, right? If you’re getting into those reparative sleep cycles, then we’re gonna see more activity happen. For that erection. So as Amanda mentioned earlier, one of the first signs of challenge is not having this nighttime or early morning erections.

Amanda: Correct. And if you’re not getting that good restorative sleep, particularly the REM sleep, you’re not going to have the opportunity to get those nighttime erections because during REM sleep is when those erections happen, they typically happen three to six erections per night lasting about five to 10 minutes each.

And that’s really your body’s way of exercising. You know, that tissue filling those tissues, stretching that helps prevent stiffness and scarring of those tissues to. Erections going forward. So if you’re not getting that good restorative sleep, you’re not giving your body even the opportunity to get that exercise at night.

And I do see that often and sometimes we can, you know, do other measures to help with that, such as penis pump therapy is one thing that we can do to help assist in that. But of course, anything closest to nature is going to be best so getting that sleep is very important.

Kelly Englemann: We can’t cheat sleep. I mean, we real, we we’re not gonna win that game, right?

There’s, there’s no way to catch up on sleep once you’ve lost the sleep. And so we really do need to prioritize that time for sleep and restore.

Lori Esarey: And, and considering too, you know, the, our jobs, you know, some people do work shift work and in my experience, they often have more overall inflammatory disease states, hypertension, high cholesterol, diabetes. And so it is very, very important to kind of make overall lifestyle considerations of what is my job, right? How does that impact my sleep and my other things that I’m, I do like my exercise and such, and is there a shift that has to happen in my, in my overall, my plan, my life? to improve these things so that I have less risk. But working with individuals and working with men in particular that do work, shift work, they’re a little bit harder to treat. Do you ladies see that as well?

Kelly Englemann: Absolutely. You know, that’s a challenge. And you know, they’re paid more for a reason. You know, they’re basically trading time for their, for their longevity of life. You know, longevity studies do show us that their lifespan is not as great because of the shift work. So it’s often time a conversation that we’ll have about, okay, how long are you planning on doing this? How are you buffering yourself from these, the demands, physical demands of the shift work? And then are you okay with making that decision Right to work those shifts?

Lori Esarey: Definitely. So what about, you know, Go ahead. Sorry. I was just gonna say, in going back to diet I, I, I think there are a few things I just wanted to mention that oftentimes we don’t think about as well. Proper omega-3 fish oils and, and getting good quality fish in our diet are very important as well in our diet, right?

Regularly. So yes, we talked about protein, we talked about those dreams, and then just making sure that a good supplement plan might also be necessary because I think all of us address the fact that dietary intake can be difficult, whether that be our lifestyle. Too quick. Wanting everything fast, right?

Fast and furious, and not being able to get quality nutrients in. So a good supplement plan is a part of that lifestyle transition that has to be made to make sure that we’re filling in those nutritional gaps with things that we are not able to eat.

Amanda: Right. One thing I’ve also read, Lori, that was very interesting is even when we are doing the things that we are supposed to do and eating the foods that we are supposed to eat, our food is not the same as it was generations ago.

I read one statistic that said you would have to eat seven carrots today to equal the carrot. One carrot of our ancestors nutrition. You know, our soil is depleted. You know, we’re not getting those proper foods. It’s not the same nutrient dense as it was in the past. So even if you are doing what you’re supposed to do, sometimes you’re going to need that extra supplementation to really get what you’re, what you’re needing.

Kelly Englemann: Yeah. I think one of the things that both of our practices do really well, Lori’s practices in the villages, Florida, central Florida. Sure. The retirement capital of the nation. And then of course our practices here in regional Mississippi. One of the things that we both really invest in with our patients is making sure they understand that food is first, but then also plugging those holes where there are nutritional gaps.

And that’s one of the things that Amanda sits with our patients and spends a lot of time reviewing with them a proper supplement plan that is individualized. You know, not everyone needs the same supplementation plan. I think baseline nutrition as Lori. Omega-3 S are almost necessary today with the way our food quality is getting a good quality protein supplement almost necessary for most people to maintain their muscle mass as they get a little bit older.

But beyond that, it’s customized, right? We wanna make sure that we’re speaking to what that individual needs for that time and that season.

Lori Esarey: So let’s, you are so right. Customization is very, very important as well as having that unique, individualized approach because, E every person is very, very different.

What our likes, our dislikes are, what our lifestyle is, what our time allows for and what season of our life that we’re in. And so really sitting with them, it’s so refreshing to hear that. That you continually do that, you make it a priority in your practice to do that because anybody can go online these days and click and have something shipped, right?

But that doesn’t necessarily mean that it is right for them. In fact, there are many supplements, although good for some. Can honestly be harmful to others. So keeping that a priority and really having that conversation, testing when necessary rather than guessing, right? That all of that can be very costly.

Kelly Englemann: So Lori we love to talk about the things we should be doing, but what about the things we shouldn’t be doing in the way of. You know, I’m thinking about, you know, the two devils coffee and alcohol, and I say devils because you know, we all have the tendency to indulge from time to time and some more than others. How do those affect sexual function and endothelial health in general? .

Lori Esarey: Well, you know, I, I’m gonna speak to, yes, I think I love, I love coffee, but most people that drink coffee they drink it as a primary food group, right. And it’s constant. And so it can definitely affect our adrenal health, our fight flight, and oftentimes it’s masking bigger issues and so it can become a habit that can be very detrimental to our overall health. And, you know, alcohol, gosh, you know. Oftentimes as a default pattern you know, we turn to alcohol, but alcohol’s very, very hard on sleep. You know, most people that do, even if it’s a single drink towards evening time, it’s very, very disruptive to deep sleep.

And so that restorative sleep also, you know, many people that drink alcohol, they are drinking, you know, fruitier, glucose, sugary drinks, right? And so we know that’s sugar. Those are the things that. Absolutely terrible when it comes to being a primary driver of inflammation and, and disease state. So alcohol is a general rule.

I just really, if, if we’re gonna drink, it’s extremely important to have very little, have it less often if we really wanna improve our performance in the bedroom. For sure.

Kelly Englemann: Absolutely. So, you know, alcohol’s kind of that double-edged. You know, some people feel like they need to have some alcohol to relax and engage with their partner, you know? Yes. It kind of helps, you know, at the end of the week, kind of chill, but too much alcohol actually can affect sexual performance right on the spot. So kind of knowing what your limits are, knowing how much is too much so that you don’t deter sexual function in the moment, I think is important too.

Lori Esarey: Yeah. You know, there are a few few cliches, a few words that, you know, most men, they, they laughingly say, but there was a point to which, most know when they, they need to stop. And oftentimes it goes beyond that. And then, you know, they had high hopes for themselves and unfortunately weren’t able to perform. And that was definitely a, a big ego. An ego drop. Right? . So it is really important to be attentive.

Kelly Englemann: And be aware of that. Yeah. Cause and effect. Mm-hmm. , so you mentioned sugar and we can’t, we can’t end the podcast without talking about sugar because we know sugar’s the number one inflammation when it comes to what we put in our bodies. Sugar does directly affect the endothelial function and so, and we’re getting a lot of sugar in our diets just on a daily basis. And some of it we’re not even really aware that we’re getting sugar. , right? Hidden sugars, things that, that look healthy on the packaging. And then you look at the back of the packaging where they list all the ingredients and the micronutrient facts and you’re, you’re like, horrified.

Amanda: So Kelly, I’m guilty myself. Even being in the medical field for 10 years, I thought I knew what healthy was. I thought I was eating healthy and I going through my. Alone along with other patients. You know, it’s amazing what we think is healthy and what we are eating these days, thinking that we are doing a good job and it’s just not true.

We just don’t have that good nutrient base and we think we do. It’s marketed to us as healthy. We think we’re doing the right things and we’re just not. So we do speak a lot to the nutritional side of things. Like Kelly said, it’s a food first approach.

Lori Esarey: Absolutely. Amanda, you are so right. You know, I, you asked 10 people in the room what constitutes a healthy diet and all 10 of them will give you a different answer so you know what is healthy.

And again, that gets back to that individuality. with each and every person. You know, there are certain core principles to eating healthy, right? Certain core principles, but at the end of the day, it can be very different because there are foods that each of us may like or not like or have access to, you know, based on where we are geographically and what season.

And so it is real important to focus on that, that food first approach and choosing, choosing those right foods. But Kelly, to your point, I love talking about sugar. Sugar is the primary driver of inflammation, and it’s not just eating the sugar. It’s anything that alters or causes blood sugar disturbances.

And so we know that stress can promote, you know, cortisol, which is a primary, a glucocorticoid, which is a sugar in the body. It raises one’s blood sugar. Constantly stressed. And so our lifestyles really can create that as well. So sugar’s not fun. It’s, I mean, it’s good. Everyone, everyone loves it. I too, Amanda loves sugar.

But at the end of the day, we’ve gotta really look at, look at our numbers and look at what we’re eating.

Kelly Englemann: Absolutely. Well, Lori, thank you so much for joining us on today’s podcast. You know, before we end, I want you to say a little bit about Total Nutrition and Therapeutics and how people can reach you.

I mentioned that you’re in the Center of Florida and the Villages, but you do offer some virtual works. I want people to know how to in you because you’ve got some really good content and obviously a major passion for what you do.

Lori Esarey: Thanks Kelly. I really appreciate you having me on here today. Yes, so my practice is here in central Florida, Total Nutrition and Theraputics. You can reach our practice on the web at www.tnt4me.com, so that’s TNT, the number four, me.com. Our number here is (352) 259-5190. We truly have a desire to help people reach their optimal level of health. Taking that food first approach. And so if someone’s out there really struggling with that and they are interested in learning a little bit more about what we do, I really encourage you to, to go take a look and let us know. Reach out to us. We’re here and love serving.

Kelly Englemann: Thank you. So any parting words, any words of wisdom that you wanna share with our our guest?

Lori Esarey: Don’t hesitate If this is an area for you of interest and you find with less performance. Don’t be shy. Call Enhanced Wellness Living. Reach out and if you’re already a patient there, ask questions. Explore this area, because to the point of all of what we’ve said is that this area of sexual health and performance affects intimacy in all areas of our life.

Kelly Englemann: Absolutely. Well again, thanks for being here and we’ll talk soon!

Lori Esarey: Excellent. You guys have a great day.

Kelly Englemann: Thanks guys, for listening. I hope this information really sparked some interesting curiosity in you. If you liked what you heard, please follow us on your favorite podcast platform. Again, you can reach out to us at Enhanced Wellness Living enhancedwellnessliving.com, and then of course you can give us a call, (601) 364-1132.