Disclaimer: Before we begin, we'd like to let listeners know that today's episode covers sexual health and the connection between the mind and body. This educational discussion is intended for a mature audience.



Joey Wahler (Host): It represents a powerful combination. So, we're discussing the mind-body connection. Our guest is Courtney Neal, an advanced practice registered nurse and family nurse practitioner. This is WickCare Talks, the podcast from Wickenburg Community Hospital and Clinics, dedicated to helping our community lead healthier, more active lives.

In each episode, we connect you with trusted health experts sharing valuable insights on a wide range of topics from managing chronic conditions to simple tips for everyday wellness. We're here to provide practical information to support you on your health journey. So, be sure to follow us so you never miss an episode.

Thanks so much for being with us this time. I'm Joey Wahler. Hi there, Courtney. Welcome back.

Courtney Neal, APRN, FNP-C: Good morning. Long time no see. We're going to shake Wickenburg up a little bit.

Host: Well, we're going to definitely delve into something indeed that's a little bit different than the norm on health-related podcasts. So speaking of which, in a nutshell to get us started, Courtney, what is the connection between sexual health and the mind-body relationship, and why is it important for overall well-being?

Courtney Neal, APRN, FNP-C: The mind-body connection is important for every aspect of someone's health. But as it relates to sexual health, it's understanding the benefits that sex has for the body. And being connected mind, body, and spirit really allows you to experience all of those benefits from cardiovascular interval training. You burn like 100 calories during sex. So, that's easy. Who doesn't want that, right? But there are so many benefits to experiencing sexual pleasure in the body. It is a reset button for the nervous system. It's like God himself said, "Hey, I know life is going to suck sometimes. Here you go." And he called it orgasm, and it was good.

So, there are a million benefits. It lowers your cortisol by 30%. It can triple your immune globulin A levels, which makes you a powerhouse of immunity for months afterwards. It floods the body with testosterone, building muscle. It floods the body with dopamine, which is the reward pathway. So, that's the feel-good hormone, and everybody wants that. And it floods the body with oxytocin and prolactin, which will put you into the deepest, most beautiful REM sleep you'll ever have in your life. That's why so many people fall asleep right after sex. It's not a bad thing.

Host: Now, we've wondered all these years why is that. We finally have the answer right here on this very podcast.

Courtney Neal, APRN, FNP-C: It's not because we're boring. It's because the body is happy.

Host: So, I've got to ask you about a couple of those things. You say that sex is good for promoting sleep, of course. I think many of us knew that, for whatever reason. But you said it also promotes muscle tone, right, building muscle, and other things that I don't think most people realize.

Courtney Neal, APRN, FNP-C: Right. I think that people don't understand that connection and the true benefits that that kind of experience has for the body. It literally is a 100% nervous system reset. It will pull you out of fight and flight all day long. Gets rid of stress, gets rid of tension. Orgasm is the ultimate energy release for the body.

Host: So while sometimes it may be seen as a negative when someone tells another person, you know, "You really need to get some," if you will, that can be taken literally as a good thing, right?

Courtney Neal, APRN, FNP-C: Yeah, absolutely. You know, people, the way that we manifest symptoms in the body when we have not been able to have that kind of release in a long time, it shows up in extreme crankiness, tension, stress, headaches. It starts to show up in the body. So, the body keeps score of what the mind knows and what the mind thinks every day. And if you're not having regular sex, your body's keeping score of that, and it will manifest in those types of symptoms.

Host: So, you don't need an app to keep track of it, Courtney. Your body will do the work, right?

Courtney Neal, APRN, FNP-C: Your body will do it for you every time

Host: Very good to know. So, how can those joining us identify if their sexual health may be impacting their mental or physical health? You touched on it a little bit, but what are some of the main symptoms, if you will?

Courtney Neal, APRN, FNP-C: So typically, it's edginess, being short-tempered, a little bit of anxiety, maybe some depression, maybe feeling kind of disassociated from themselves or disconnected to their mind and their body. You know, when those two elements of a human being are disconnected, it is a world of trouble just waiting to happen.

Host: And so, how might stress or mental health conditions initially present as sexual health concerns?

Courtney Neal, APRN, FNP-C: So, stress, I mean, we've all had stress, right? So, we know what that looks like. It's the, "Not tonight, honey, I have a headache," kind of scenario, and that's a real thing. Typically, what I see in practice is a lot of anxiety, a little bit of depression, inability to climax, inability to get aroused at all, inability to achieve and maintain an erection. All of these are symptoms of a bigger problem.

Host: So from your experience, what in fact then is the process of diagnosing sexual health problems that have that mind-body connection?

Courtney Neal, APRN, FNP-C: It all starts with a conversation, and we've touched on this multiple times throughout these podcast episodes. You know, communication is critical. And I understand that there are generations out there and cultures and religious groups that believe that talking about their sex life is very taboo, or it's not appropriate, or they were maybe raised in an environment where these conversations just didn't happen.

I wasn't raised like that. It was very much a topic. You know, learned about it early and was always able to ask questions about it. So, I don't relate to that at all, but I certainly respect it and understand it. But if you can't talk to your healthcare provider about it, then nothing's going to change. Nothing's going to improve.

So, when I have folks come in to talk to me about hormones specifically or, you know, fatigue or any of these other common symptoms, their sex life becomes very much a part of that conversation. And I'm going to ask them a lot of the details, because these are things that I need to know so that I can fully assess what the root cause is. It helps me to determine are we dealing with some sort of trauma response here, or is this truly just a physical issue that we need to deal with? Because those two treatment plans are very different.

Host: Speaking of treatment options, what are the ones available right now that focus on this integrated approach to sexual health?

Courtney Neal, APRN, FNP-C: So, that really depends on what the root cause is, you know, like I said, if we're dealing with a trauma response, then we're going to start talking about doing some trauma therapy, or get them connected with a mental health provider that can help walk them through how to resolve some of the trauma in their body.

You know, the body always keeps score of what the mind knows. Hormones, hormone replacement, sex therapy for couples, things like that. There are, you know, male enhancement drugs that we can use. There are compounded medications that we can use that, you know, reintroduce oxytocin into the body so that arousal can occur a little bit more freely. There's a ton of different options. It just really depends on what the root cause is.

Host: How about lifestyle changes to support a healthier mind-body connection in terms of sexual health.

Courtney Neal, APRN, FNP-C: All of the typical ones with any health-related ailment would be prioritizing sleep, prioritizing exercise, eating a healthy diet, all of those things. Having those things dialed in really helps with confidence. And, you know, if you go and take down a bowl of pasta and garlic bread at 8:00 at night and, you know, you're feeling kind of crappy, the last thing you want to do is get naked in front of somebody. Prioritize your health and the body will follow.

Host: How about regular check-ins and communication with healthcare providers to prevent sexual health issues before they become serious? So much of today's healthcare is about prevention in advance, right?

Courtney Neal, APRN, FNP-C: Right. And that's exactly what I do. Primary care is prevention. So when I have somebody that comes to establish with me, these are conversations we're going to have. If there's no issue, then we can just touch on it and move right past it. But, you know, I'm going to ask them, "How's your sex life? Does sex hurt? Is there vaginal dryness?" You know, if it's a male patient, you know, "Are there any difficulties with achieving erection, maintaining erection? You know, can you land the plane?" All of these things are going to be conversations that hopefully will result in me being able to determine whether or not we are headed for a problem so that we can kind of head it off at the pass before it happens.

Host: Which begs the question, have you ever said to a male patient, "So, can you land the plane?" And they're like, "Excuse me?"

Courtney Neal, APRN, FNP-C: Oh no, everybody knows what that means.

Host: Okay.

Courtney Neal, APRN, FNP-C: And yes, I do say that regularly. Like, "How's it going, buddy? Can you land the plane?" And they know exactly what I mean.

Host: All right. No miscommunication there then.

Courtney Neal, APRN, FNP-C: Nope.

Host: Gotcha. Couple of other things. How about motivational advice here for those struggling to address these concerns? Because let's face it, not everyone is as blunt and open talking about these subjects as you are, right?

Courtney Neal, APRN, FNP-C: Right. And I just don't understand why. I mean, it's a very easy topic for me to talk about. But I do get it. There are people out there that just aren't comfortable having these conversations, and there are some that kind of, you know, squirm in their chair when I ask them these questions too, and I'm completely emotionally disconnected from it. So, I understand that completely.

One the ways that I tell people to start initially being able to open themselves up to conversations about this is to explore their body. Look, if you don't know what feels good to you, what amount of pressure feels good, what angle, what position, what tempo, if you don't know any of those things and you can't tell your partner those things, don't expect them to know. They don't have a crystal ball.

So for God's sakes, we talked about this yesterday with the social norms that are just beyond ridiculous that we need to get rid of. But, you know, masturbation is one of them. You know, everybody does it. Nobody talks about it. Do it. How do you expect to have a really healthy and robust sex life if you don't know what feels good to your body? So, start exploring so that you can tell your partner exactly how you like to be touched.

Host: And so to follow up on that, in terms of open communication with your partner regarding sex, I mean, as you well know, there are partners that have a lot of sex, maybe even great sex, but don't necessarily talk about it. They do it, but they don't discuss it. How do you initiate a conversation with a partner if you feel that one is needed?

Courtney Neal, APRN, FNP-C: I have a lot of couples that come in to see me together. So, I kind of can act as a mediator to help open them up and have these conversations. Because for a lot of people, it is awkward. It's something that they just were taught never to talk about. But you have to talk about it. It's like talking about your bills and your future and, you know, picking out a house together.

This is a normal part of your everyday life. And if you can't talk to your partner about the most intimate part of your life together, that's a whole world of trouble. You're just looking to be disconnected, not only from your partner, but from yourself. It's okay to be vocal. It's okay to explore your body. It's okay to talk about what it is that gets you there.

Host: In summary here, Courtney, what are one or two key steps those joining us can take if they believe their sexual health is affecting their overall well-being? If someone's thinking, "Okay, you've given a lot of good advice here, but where do I start?"

Courtney Neal, APRN, FNP-C: It starts with a conversation either with your partner or your healthcare provider. You know, one of the things that I tell people on a regular basis is, you know, point number one, if you're not horny, you're not healthy, period. Let's figure out why. And unless there's a safe word involved, sex should never hurt.

So if there is a physical issue that is keeping you from having a very healthy and active sex life, talk to your provider about it. There are things that we can do and things that we can, you know, recommend and medications that we can help with that can eliminate so much of this stress and pressure.

You know, not being able to communicate with your partner, not being able to enjoy a healthy sex life puts an enormous amount of stress and pressure on the mind and the body, and it just drives you further apart for no reason. Have the conversation. That's where it starts

Host: Well, folks, she says, "If you're not horny, you're not happy." Sounds like a bumper sticker in the making to me. Do they still have stickers? I mean, not even sure on that, but sounds like it would make a good one. In any event, something certainly to keep in mind going forward. Courtney, if only we could get you to open up a little bit during these conversations, I'd like to work on that.

Courtney Neal, APRN, FNP-C: I'll be a little less shy next time. I'll work on that.

Host: Well, folks, we trust you're now more familiar with the mind-body connection. Courtney, in all seriousness, great advice. Certainly an important topic that affects just about everyone, whether they admit it or not, as you alluded to. And so as always, great stuff. Thanks so much again.

Courtney Neal, APRN, FNP-C: Thanks, Joey. Always a pleasure

Host: Same here. And for more information, please do visit wickhosp.com/wickcaretalks. We hope today's discussion has provided you with valuable insights to support your well-being. Remember, every step you take is a step toward a healthier life. So to ensure you don't miss future episodes, please follow us on your favorite podcast platform. If you found this episode helpful, please share it on your social media. I'm Joey Wahler, and thanks again for being part of WickCare Talks. Until next time, be well.