SexTech – The Future Of Sexual Health Is Here

Betsy Greenleaf, DO, FACOOG (Distinguished)

Hi everybody. Welcome back to another episode of the Solving Sexual Dysfunction Summit. I am your host, Dr. Betsy Greenleaf and this is going to be such a fun session I have with us, Dr. Elliot Justin. Thank you, Dr. Elliot, for being with us today.

Elliot Justin, MD, FACEP

It is great to be here, and thanks for the opportunity.

Betsy Greenleaf, DO, FACOOG (Distinguished)

What I would like to say about Dr. Elliot before we start is that he is not just a doctor. He has started a sex tech company that is going to revolutionize pelvic health, how we look at erections, and how we look at clitoral health. Before we get into that, I will give you a little teaser, but before we get into this, I want to ask you, Dr. Elliot. How did you even get into this field?

Elliot Justin, MD, FACEP

Well, my background is that I am an emergency medicine physician. In 2015, I sold the service business and went into what was my passion at the time. Still is, which is remote patient management using technology. I was challenged by a urologist, Dr. James Hotaling, at the University of Utah, to come up with a way of counting the number of nocturnal erections that men had. 

Well, I am a doctor, and I did not know that these things were significant. Everyone knows about morning wood, and we poke our partners with it. But I had no idea, as I am sure that the vast majority of physicians do not know, that the number of nocturnal erections is a leading indicator of mass cardiovascular health, meaning before a man has a heart attack, stroke, or develops something significant, with diabetes, that number of nocturnal erections will go down. 

Now, this urologist, like most urologists, was ignorant about cock rings. They should know more about them, but they do not. Let us talk about that later on. Because we had. He said that a cock ring reference to erections. I said we can do more than that. If we embed sensors into a smart cockring, we can count the duration, firmness, measure the duration, and the firmness of all references—not just the erections overnight, but erections while we are having sex. what to mention more about how many erections they had last night or how they performed in bed. 

Utilizing that information, men can then measure the impact of diseases such as high blood pressure, diabetes, atherosclerosis, and medications. The big cocktail is antihypertensives, SSRIs, and depressants; supplements; diet exercises; and social performance. To do that, we have to fix the cockring problem. Betsy, do you know what is a cockring problem?

Betsy Greenleaf, DO, FACOOG (Distinguished)

I only know that they exist, but I do not know what the problem is.

Elliot Justin, MD, FACEP

The problem is that they suck. I am 35 years old and fortunately married to someone who is into novelty and having fun. Once a year, every year, that is, twice a year. Sometimes we buy the latest cockring, vibrating and not vibrating, and we use it once or twice, these novelties, and we get rid of them. Why, one that did not work for her but two that did not work for me because they may have had a hard silicone, so probably cockring has now been manufactured the same way for 150 years. There is essentially a hard silicone ring. Silicone pinches it. You have to have an erection first, to block the ultra-low into the penis, which is good for men who have it or have anxiety because they are already struggling. They have to have that full reaction to put this thing on, and because it cuts off the circulation, there is a choke hold in the penis. You can only work 15 to 20 minutes, and you want to take it off right away. 

To count the number of nocturnal erections, we have to make something that will be worn overnight. It had to be made out of a different material. Well, my wife had a stress ball on her desk. I said it is an elastomer, softer than that of silicone; let us make a cockring made of elastomer, and let us make it soft enough that it does not block arterial flow in, but only constrains; it does not block all but constrains that venous return. Then you would have a cockring that could be worn for hours. I also wanted to, and I thought, We are working on making the cockring better. Let us make it easy on, easy off, as opposed to a ring that looks like a rubber band, snapping onto your dick if you do not mind me using this word. But it is uncomfortable. 

I saw my wife’s bra on the ground and a scratch on her back. I think, I guess, a half of the foreplay among heterosexual relations. This guy scratched his wife’s back on his back at night because he women because women understand that silicons are uncomfortable material. They have a silicone band on the back of the bra. After 12 hours, you want the thing off, and you want that area scratched. The problem with silicone is that it makes you adapt. It was a last-minute adaptation to you; they are just different materials, what I thought I saw was the bra on the ground. I said the hook. A bra has a window that opens and closes and put it on over there. It was a sports bra, and it closed with a hook. 

Let us make a cock ring with a hook. We patented that. It is not worth very much, but it is, and it is a fresh design. We use soft elastomer; it is a hook. The last feature I wanted to add for men was a better orgasm. Women are vibrators, men have nothing, so vibrators in my lifetime were gone from my mother’s vibrator, stashed away in a bottom drawer dresser in a supply closet. I just thought we would never find it because we did not know what it was. But, and, my wife has three or more of our latest favorites on her night table, because they are always coming out with new things. My door takes long dates. It takes to burn, goes to Burning Man because it gives them, it uses them. 

Cock rings, on the other hand, this kind of style among straight men is regarded as this kinky. I do not need that kind of thing. Well, it is not about news about what does not match. I want it to last a little longer so I can have a better orgasm. How do we achieve a better orgasm? My goal was to put enough pressure on the urethra to increase the ejaculatory phase by 50%. 

Betsy Greenleaf, DO, FACOOG (Distinguished)

Hmm. 

Elliot Justin, MD, FACEP

We do not want to cut off because if we cut off, we get rectal ejaculation, which is painful and could lead to infection, but we want to attract it. With our device, my ejaculation goes from 4 seconds to six-plus seconds. It is a more powerful orgasm. With a new ring that we just came out this week for the max period, a little bit tighter as you and I discussed it early before we got on. It adds another second because it is a bit tighter. 

I never use cock rings regularly, and my wife and I never have sex without them. I never masturbate without one. It is a real change for men. Men need to grow up, put a ring on it, and overcome. Straight guys. One of our jokes is, I ask you, Betsy. How can you tell the difference between a gay urologist and a straight urologist? You ask them one question.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I have no clue.

Elliot Justin, MD, FACEP

Do you use a cockring? Straight urologist: It is like Superman to a Kryptonite, I do not need that. Gay urologist; Yes. Last night, you got a better one? Men need to open their minds. Now we have solved the cockring problem. I kind of digressed from you, but more profoundly, we are delivering data that was met but currently is not any data for men that makes their sexual health the objective.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I was thinking it was a Fitbit for the penis because I remember going through medical training. All we had in the past, and I always wondered about this. Does it not cause a paper cut? But we would tell men to take a strip of paper and put it around their penis with a little piece of tape on it. If they woke up in the morning and that paper had burst open, then that meant that they were getting an erection at night. But if it was not, then there was a problem, and we needed to look into it. I am, and I always thought, That has got to be uncomfortable.

Elliot Justin, MD, FACEP

Well, no one did the joke when I was in medical school, and I think I, a little bit older, knew it was a stamp test.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Yes. 

Elliot Justin, MD, FACEP

Then the joke was, Who licks the stamps? That is a variable. We do not keep that control for that variable. Who is looking at the stamps? You look at the statistics as you go. Do you look at the stamps? That is a boyfriend. 

We live in an age of healthcare wearables which is great. We have wearables for calories and wearables for your weight. We have wearables for your heart rate, for your cardiac rhythm, and for your pulse oximetry. This is a big app, though, which is sex. What a man, well, frankly, woman for two. What do we care more about? How many steps, how many calories we took yesterday, or the state of our penis or the clitoris? That is a more troubled question for both sexes, almost everyone. Most heterosexual cares more about those things. 

In an hour overnight, we count the number of total erections and so forth, the leading indicator of our scales, and more drinks to measure the duration of burns of erections. We have men utilize it, and men and their healthcare providers utilize our device to titrate their medications. Well, several uses one and I take a lower dose of my antidepressant to improve my performance. What dose of a PDE5 medication Viagra sells is best? May only you take 20 or both will work. Is testosterone working for me or is it not worth it? If so what is the right dose? 

With data, all these things open up, and when it comes to sexual dysfunction, if half the men are over 50. I have an E.D., and with women, it is even a little bit higher, but normalize talk about female sex dysfunction because people and it is good people, I talk about women positively. We never hear the word hysteria anymore. There were originally more. I think people kind of step back from FSD female sex function for that reason, which I think is a good reason. Men should get some respect as men get talked about as impotent, limp dick, etc. For guys who have these issues, it is one thing that holds them back from seeking help or talking about it because it is embarrassing. 

But utilize this technology. People can start to see what the problem is here to extremes. You are in this world; it is psychogenic E.D. is a big problem. One of the major issues with social performance that I cannot get up on is that they get anxious and lose. It is something that they cannot get out of. They get an erection, but they lose it. It is where the ring comes in handy because a ring holds blood. If you are with a new partner or if my wife is too. I start talking about rearranging a bedroom in the middle and having sex. But I do not lose my erection. 

On the other end of it, simply a lot of men will not once the blood is in; if they would, especially the new partner, then the ring holds the poles in place. Imagine having erections at night and not struggling with male or female partners. That is psychogenic E.D., and I understand that it is valuable to a man to realize that, and to the partner as well, this is a psychological issue. It could be alcohol, it could be drugs, or girlfriends, but it is more psychological here. 

If I have data showing that he has access to night. At the other extreme, if a man has an erection of 50% hardness and has one or two weeks of nocturnal reactions, he’s getting risk fatigue atrocity for nothing because it ain’t going to happen. That guy. You see a doctor; that man has a problem. I need to see you, Dr. Greenleaf, for help because he is getting it; it could be medication, it could be disease, it could be an anatomic issue. That is valuable to people as well as destructive relationships. But in a good relationship, people start to understand where the problem is and stop blaming the wrong person or what the other wrong factor is. Data is valuable.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I think this is so important, too. Going beyond the bedroom, I was interviewing somebody, and they were telling me, statistically, once a man starts having problems with the erection, it is only going to be so many years later that they are going to start having severe cardiovascular symptoms, and maybe even 10 to 15 years later they are at risk of having a heart attack, stroke, or something. I am like, Well, if we can stop all that stuff before then,

Elliot Justin, MD, FACEP

Yes, the date is potentially life-changing. Well, sort of life is improving. It is not life-changing; it is lifesaving. I think it is. 60% of men will have a decrease in the number of nocturnal erections in the year before they have a heart attack. It is 88% since I looked at it before the stroke. This is valuable information. I am 70 and a year and a quarter ago when we came up with the prototype, I said, I have nocturnals; that is more exciting to me than going to my doctor and saying, The electric car goes, No, because.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Then I think it is fascinating that you are also working on a female device. Are you allowed to talk about that?

Elliot Justin, MD, FACEP

Sure. We are excited about this. They are going to be making presentations about this as it is necessary for a sexual medicine show this fall and the Sexual Medicine Society of North America as well. We have tested on 38 women, 18 women before, friends and family, and then engineers before we did a paper on 20 women. The paper on 20 women is independent of us. It is an academic study, but we knew it would work because they are there to explain the differences between the clitoris and the penises, but there are a lot of similarities. 

If nocturnal erections in men are indicative of a man’s cardiovascular or cardiometabolic health through metabolic diabetes, the same is true in women. No one’s looked at aside from a couple of Dutch women with ultrasounds in a lab. No one’s looked at the clitoris since Master Johnson. Every hour, they wake up women. By gross what they mean visualizing what the external clitoris, which is only a small part of it, measuring it, and then grading, looking at the tissue color of the labia minora to see how pink that was. It was crude and certainly not something that is bedroom-friendly, nor is it an ultrasound device for a bedroom. We do not expect women to take an ultrasound machine at home. While they are sleeping, wake themselves up every hour and get an ultrasound machine. 

We created a device that is comfortable, easy to use, and fits inside the vagina. The other end of the person has sensors that will measure clitoral arousal and utilize that device. We hope they bring this out next summer. I am trying to raise awareness for that right now. As I said before, women will be able to measure the impact of diseases, etc. Post-menopausal women have all the same problems that men do. They lose their hormonal protection. They have diabetes, high blood pressure, other sclerosis, worse problems, and obesity because of hormonal issues, but premenopausal women have more problems than men. Because we and I are doctors. 

We doctors screw with their sexuality because they are not; they take birth control, and they take SSRI antidepressants three times as often as men do, and in doses that are often the same doses that have been given to men, which makes no sense whatsoever because we doctors are assholes. We treat everyone as if one size fits all when it comes to medicating people. We have women in this country. You and I are treating some of them. They do not even know what their natural sexuality is, because at age 15, they started taking hormones, and at age 18, they got anxious when they went to college, and now they are 30 and they have been taking hormones and whatever, some SSRI, Wellbutrin, Lexapro, whatever. They do not know that. With data, we can start to measure the impact on their sexuality and maybe improve our dosing of these things so that younger women can have more spontaneous and effective sexuality.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Now you have got my brain spinning, too, on this whole idea of blood flow, especially for women. We do not have any in traditional medicine. We do not even have any guidelines on treating women with hormones. But now that blood flow starts to decrease to the pelvic organs, the clitoris, labia, and the vagina, Once the hormones start decreasing, I am wondering if your device would help us with, Okay, look, things are not working as well. Maybe now is the time to get on the hormones. 

Elliot Justin, MD, FACEP

Yes.  

Betsy Greenleaf, DO, FACOOG (Distinguished)

I am like that. My brain starts going, and I am, okay, find other uses, and I do this. We are all going to be going to bed with our partner. We have to put our devices on so we know that we are going.

Elliot Justin, MD, FACEP

Well, I want also to devise, devices that enhance pleasure as well. I have a team of female engineers who are going to work on a vibrator attached to the women’s device. That would be very simple to use. But we have designed it; women do not want 60 speeds. They want three women who do not want 100 apps in 100 modern modes. All these things are novelties that are kind of fun, but that is not what we are about. We want to do something that gives women a hands-free experience. Giving them date data valuable for their health and also, enhancing the pleasure with a device that we use both solo and with all the partners.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I love this, and I am trying to think, you have got these devices. Where do you kind of see the future of your company going?

Elliot Justin, MD, FACEP

Well, I want to know that as we learn more, one will be able to provide data to the pharma industry and to the sex toy sector that will lead to them doing better for their clients. To folks in the sex toy sector, they are pretty good at addressing the needs of knit fetish niches, but with 35–40% of the adult population in the United States and most of the world having two or more forms of hypertension, what works best for them? 

I will give you one example. What is best for women is neurovascular damage from diabetes. Women with significant diabetes complain that regular vibrators do not work that well for them. Yes. No, no one is zero. I know. I brought this up at sex toy industry meetings.

Betsy Greenleaf, DO, FACOOG (Distinguished)

Because they lose that vibratory sense—yes, that is.

Elliot Justin, MD, FACEP

That is right. What amplitude of frequency and vibration is best? It would be best for those women. We do not know because no one has studied, and I want to study that. There are ergonomic forms in which 15% of the adult female population over the age of 50 has significant arthritis in their fingers and wrists. Well, yes, You can give these women a wand vibrator. They do not like them, though, because they get numb in this position. The position of a lateral flex The other risk is that this is uncomfortable. Even for guys,  my wife has shown me how irritating it is. Yes. so we need to have better forms. We need to address not just niches of the trans community, but this lot has this large gap with some of the sexual industry. Out of this mindset, we are toys into health, into sexual health, for the future. 

I would like to add more sensors to the fun. We then saw parameters, and we could tell people how many calories their brain has while having sex. On the medical side, we can add pulse oximetry, and we can start to help people with sleep apnea. 

Betsy Greenleaf, DO, FACOOG (Distinguished)

Yes.

Elliot Justin, MD, FACEP

Because people’s sleep apnea erections at night are a marker of sleep apnea. People who have sleep apnea do not get erections while they sleep. Also, it is a fine, unobtrusive way of measuring your cardiac rhythm. You do not have to have something on your wrist or your finger. You can have something down there. I was first in tech, and now comes smart sex tech. The tech I think people are going to enjoy and respond to the most is the techies down there. 

Because I guess, in the wearable world, people develop positive relationships. They have a smartwatch, and they pay more attention to their exercise. People, in addition to something as simple as a digital scale, are motivated people. Well, I hope that with Great Sex Technology, people in the world will pay more attention to their diet, comply with their diabetes and hypertensive medications, be more careful, and be more specific about whatever they are taking to supplement their sexual activities, and that ranges from recreational drugs to PDE5 medications or hormones for women. I want people to have positive relationships and advice for better health. But also, I want people to enjoy a longer life of lovemaking. I hope that people love each other more as a consequence of having sex acts.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I love it. That is a very good tagline. I love that. One of the things that I experience all the time, which I find incredibly frustrating because, to me as a doctor, sex is just a normal part of life; vaginas, penises and cocks, pussies, or whatever you want to call it, are body parts. I think we all just need to get over it. But I am constantly frustrated with the censorship that still happens today when it comes to talking about anything with sex. How have you kind of navigated that world with what you are doing?

Elliot Justin, MD, FACEP

It is hard. The metaverse—Facebook, Instagram—is what it is, and there is money involved as well, too. We get banned for trying to talk about what we are doing. But talking about it or showing it, even showing a male showing a cock ring on a facsimile of a penis, cannot do it. Talking about using the word cock. It is funny that you have these companies on Facebook. Facebook, is the big one that has problems saying where a progressive company progressive what is carrying on your 17th century Puritans. 

Now I understand the desire to restrict explicit sex to talk during times when children might be involved but you are you, you did not have the obligation to act on them. Tell us how to do this. Tell us how we can talk about erectile dysfunction. realistically, so that has been a hard marketing challenge for us. We’ve been banned a half dozen times, at least. But, on the Mount, in the metaverse. I think that is the big five problem, too, which is frankly the ignorance of doctors. When I was starting to get involved with this, I was sitting down with six urologists at a major academic institution. I will not say which one. I said, Do you guys recommend cock rings? Zero. I recommend the cock rings. For them, it is a PDE5 medication. If that does not work, you can try a vacuum pump. You guys are not going to use these vacuum pumps because you have to use them for a long period. It is kind of weird pumping up your dick inside of a vacuum and you have got and then they go to well maybe you need an implant. 

Well, you are committing this. The inexpensive part of it is the fact that, as you and I both know, there is no code, there is no insurance reimbursement, and there is no prescription for cock ring. I said, Well, come on, you guys must have people ask about cock rings. What do you get? The doctors said, Well, we tell them to go to Amazon. Well, if you go to Amazon and get a sponsored ad, you are not going to get some of that work. Have you guys ever tried a cock rings? Zero. One thing that has become clear to me is that doctors do not speak to people, and they have their physicians do this all the time. They do not speak to men about the circumstances under which they lose their actions. That is a disaster. Is it with this particular partner? Is it drugs and alcohol involved? Are you getting an erection or losing an erection? 

What is, and in addition to the general doctor, the internist, family, doctors, and surgeons, they never ask anyone about their sexual health? Betsy, you and I both trained in medical school. Take the sexual history. I never, ever heard of a doctor, and I am 70 years old. Take a sexual history. No one’s ever asked me my sexual story about my marriage, and no one has ever asked my wife. She has to ask, well, what is going to be the impact of this medication on my sexuality, as 2005 was the last year in which I practiced medicine. I said, What am I going to do? I am going to start taking sexual cock rings. I would say 85–95%. You want to talk about if they want to talk about the partners in the room, and the part I want to tell you about is whether he wants to change his prescription of Viagra, whether he is drinking too much, or whether it is so important to people. We, the doctors, are to some degree responsible for the embarrassment and shame that people feel about discussing it.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I agree with you. It is, you think, as I am in the gynecology world and I worked in a urology office for a long time. I know that my male colleagues never brought it up with their male patients. and I have to say, I am just as guilty. I would ask people very quickly, but I never delved into it very much. It was not insurance-based medicine, either. You do not have as much time, but if you have any problems with sex, that would be it. then any pain with sex, those were the two questions. then, not nothing more than that, unfortunately. Yes, and it is such an important part of life and so incredible.

Elliot Justin, MD, FACEP

Well, let us look at orgasms. I was speaking to three urologists on a conference call a couple of days ago, and I said, What do you do to enhance a man’s orgasm? It is all in my face. Then give it some thought. I said, well, 2 to 3 urologist women. What would you recommend to make sure that it vibrates? Let us see you. Would you have no recommendation for treating men with E.D.? I was angry about it, but so you see treatment with it, and you have no recommendation to them whatsoever. What about a cock rings? What about, etc.? It is kind of pathetic.

Betsy Greenleaf, DO, FACOOG (Distinguished)

The thing is, cock rings are not just a new invention. Yours is, which is super cool, but cock rings have been around for a very long time. which is fascinating because they have not changed up until now. Until you have changed it.

Elliot Justin, MD, FACEP

Yes, well, what I saw was that the hook on my wife’s bra got a spiral going to cock ring. My wife, who comes from a fashion design background, and customers in the background said the hook did not come into women’s fashion until the 1920s, but I am in the Stone Age. People were hanging stuff up on hooks in their caves. That is what took me back. Yes, that is kind of ridiculous, so I would never have thought about it unless I was kind of looking because I was challenged. But with Dr. Hotaling, I would come up with a way to count nocturnal reactions. That led to these, the realization that we had to reinvent the cock rings.

Betsy Greenleaf, DO, FACOOG (Distinguished)

That is amazing. It is going to be fun for you to look back on your career and go, How did I get here? But at the same time, it sounds like you are having tons of fun with what you are doing and going to be making a big difference in people’s health. 

Elliot Justin, MD, FACEP

Well, I am not comfortable with what we are doing, especially the data site, which will become the standard of care in gynecology, urology, and sexology in 3 to 5 years. Just the way, before there was a caravan machine, this doctor was listening to your heart with a stethoscope. Before the blood pressure, someone was palpitating and pulses were saying, Betsy, your pulse is strong. You are fine. Get out of here. 

But now, we can take a breath, and that is it. Imagine if you went to a urologist with pelvic pain and then went into an ultrasound. You would think, What does this 1880 mean? Give him a gene. Almost always images. if a man or woman goes to a gynecologist and urologist. and says, I want to keep my sexuality where it is, or I have a problem, and you are going to make recommendations without data? That is what it is. Just an opinion.

Betsy Greenleaf, DO, FACOOG (Distinguished)

I am excited to see all the studies that come out of this because I think we are going to get a lot of information out of these devices that are going to. Yes, you got my brain spinning. I can see so many different uses for this. Just in wrapping up, are there any questions I did not ask you that you want us to know about your devices or sex tech? 

Elliot Justin, MD, FACEP

Well, there are going to be research papers coming out on both male and female devices over the next 6 to 9 months. I would welcome the opportunity to do research with you. Let us talk about that offline, but you can find out about us at MYFIRMTECH.COM. You can reach me there. Elliot,  E-L-L-I-O-T @myfirmtech.com. If you have any questions. 

I hope you get out of class and enjoy a better life of lovemaking. The day is valuable if you have any difficulty interpreting your data. Because one of these things comes up—that is, we have people taking our data to the doctors, and the doctors go with it—what is this? They do not know about it yet. The device is being used at Baylor Massage in New York, the University of Utah, and in California and San Diego. People are finding out about it, but most doctors still do not know about it. I hope you try the devices, and I would love to collaborate with you on some research.

Betsy Greenleaf, DO, FACOOG (Distinguished)

My goodness. That would be great. I would just encourage everybody to make sure they go check out that website and get one of these devices. I think everybody should get one. I am looking forward to seeing the female device when it comes out. 

Elliot, I wanted to thank you very much for taking the time to be with us. This has been so much fun and enlightening. I just want to remind everybody to stick around because we have more great sessions coming up.