In this podcast episode, Dr. Anne Truong explains that erectile dysfunction (ED) is often an early warning sign for cardiovascular disease, typically appearing about three years before heart problems manifest. She cites data that roughly 60% of men with ED will develop heart issues, with a 3% mortality risk from related events. Dr. Truong outlines the five major categories of ED causes—vascular/blood flow, nerve damage, hormonal imbalances, psychological factors, and medication or lifestyle influences—and describes how each can be identified. She emphasizes the importance of addressing the root cause rather than merely using ED pills, recommending a comprehensive diagnostic workup that includes blood panels (cholesterol, glucose, testosterone, thyroid), coronary calcium CT scans, Doppler ultrasound of penile blood flow, and EKGs. Lifestyle interventions such as adopting a Mediterranean diet, regular exercise, stress reduction, and adequate sleep are presented as foundational treatments. The episode also discusses hormonal decline, noting that testosterone drops about 1% per year after age 35, especially with obesity, stress, or poor sleep, and stresses the need for hormone testing. Dr. Truong reviews how various medications (beta‑blockers, thiazides, antidepressants, even some OTC drugs) and substances (smoking, vaping, porn, recreational drugs) can exacerbate ED. She differentiates psychogenic ED—sudden onset, performance anxiety, presence of morning erections—from physiological causes, and highlights age‑related patterns. For men seeking more intensive solutions, she promotes the “Get Hard System” and the Modern Man Club (NoEDMan.com), including a high‑cost in‑office program in Virginia that combines stem cells, shockwave therapy, Botox, hormone therapy, and lifestyle coaching. Throughout, she uses analogies (car warning lights) to encourage listeners to treat ED like chest pain—without shame, seeking medical evaluation promptly.
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Think ED is only a bedroom problem? Most men treat it that way. They grab a pill and never ask why it's happening. Here's the truth. ED often shows up about 3 years before heart trouble does. It's your body's check engine light because the arteries down there are tiny, about the size of an ant, so they clog first. Today I'll show you why. And And the simple test that caught my own husband's heart risks.
This podcast is for you, the modern man. I'm Dr. Anne Truong, your host. I'm an intimate health medical doctor and bestselling author of the book Erectile Dysfunction Fix. I'll do a deep dive into sexual health and performance and how it affects men of all ages and backgrounds. So let's get started and be sure to visit my website at sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside.
I do want to point out something, guys. So when you have ED, it signals that you're going to have heart issues down the road. You're going to have heart problems like a heart attack, like chest pain. 3 years down the road, 60% of men that have ED is going to have heart problems. So when you have ED, it is a warning sign that you can have heart issues later on. But if you keep taking ED medication and not working on the root cause of why you have ED, 60% of you are going to have heart problems later on. So it's a warning sign that, guys, take care of your erection now by changing your diet, by exercising, by decreasing your stress. Take care of your rectum now, you may even save your life later on because 60% of you are going to have heart issues and about 3% is going to have mortality from that heart event. Most men think losing peak performance is just getting old. I will tell you it's not. There's a natural proven protocol doctors rarely talk about that will restore your confidence without side effects. It is called the My Get Hard System, and you can get that by joining the Modern Man Club today. Go to noedman.com. That's noedman.com, and I'll see you there. It's really a warning sign. You gotta listen to these warning signs. Like your car, when it's making noises, you want to listen to it so you can fix it. But if you don't want to wait until a year, then you can't fix it. So that's the point I'm trying to make, is that your body is warning you future problems and you need to pay attention to it. All right. Listen to your body, guys. All right. Last thing you want to do is pop in a pill because the pill isn't going to solve your ED. It really, it may help you during the interim, but it isn't going to treat the root cause. Because if your ED is due to low testosterone, taking a pill, even though it helps you with your erection, isn't going to help raise your testosterone. And honestly, when your testosterone drops a little bit, it's going to show as like a Not a sperm erection. And most men will drop your testosterone at the age of 35. After the age of 35, your testosterone level is going to drop by 1% every year. And it will drop more quickly if you are obese or if you are stressed, if you don't have enough sleep. So testosterone is very sensitive to your lifestyle. That's why I advocate that you need to get blood work done. Because you need to know where you're at, what's deficient before you fix it. Does that make sense? You can't just blindly just pop in a pill and say, oh yeah, this will be good for my ED, but you don't know what's causing your ED. All right. When you have ED, it's like having chest pain. When you have chest pain, would you go on the internet and try to figure it out yourself? Because ED parallels heart disease. All the risk factors that contribute to ED Such as high blood pressure, high cholesterol, diabetes, obesity, smoking. All that can contribute to ED, which is the same pathology as heart disease. The only reason why it shows up as ED, because the arteries or the blood flow that supply the penis here is small. It's 1 to 2 millimeters in size. Very, very small, almost like the size of an ant. That's an artery. That's the blood that flows into your penis. It's like the size of an ant that flows in here and fills up the penis with blood. Now, if that artery is like this, if that's small and you're not getting enough blood flow and it starts in the penis first, that means that 3 years down the road, it's gonna start in the heart because the artery in the heart is 3 to 4 millimeters. It's twice as big, but it's gonna be involved in decreased blood flow as well. So that's why when you have ED, it's a warning sign for heart disease, that you're going to have heart problems 3 years down the road, not a decade, 3 years down the road. And this is a study that have shown that, that's not coming from me arbitrarily. So guys, ED is a serious thing. Can't tell you how often I see men with ED, never see a doctor. They just go online and then they just get a prescription for Viagra, Cialis, have no idea why they have ED. Quick note before we go any further. If you're a high-income man, usually the age between 45 to 85, and you're ready to invest to fix your ED without relying on pills or surgery, I have the Get Hard Protocol, in-office program where we treat you in Virginia. We combine stem cells, shockwave, Botox, hormones, and lifestyle to help restore natural erection. It's not for everyone, You must be able to travel to Virginia and be comfortable investing around $16,000 for your health. If that's you, pause this video for a moment, click the link down below in the description that says, get ED Breakthrough with Dr. Anne, and complete the application. If you're not in that position yet, no problem. Keep enjoying this video and check out our Modern Man Club at NoEDMan.com. So I want to show you the different causes of ED. So ED is multifactorial, but it can be due to 5 different causes. One, you have ED, is it because of blood flow problem? Is it a nerve problem? Is it a hormone problem? Is it psychological? The 5th part, is it due to medication, the current medication you're taking, or is it due to your lifestyle such as smoking, like porn, vaping, you're not exercising, and obesity? So it's really these 5 categories and the drivers for that. So when you have ED and the doctor have to find out, is it blood vessel? Is it nerve? Is it hormone? Is it the medication I'm taking? Or is it because I'm smoking? I'm watching porn? I'm not exercising? That's called lifestyle. The poor diet that I'm eating. So if you're on the road and you're just eating fast food all the time, that's going to affect your ED as well as your weight. This is what I think about when I evaluate someone with ED. What does it do to them? Once you know what it's due to, you can reverse engineer and treat ED and treat ED as well. So most of the time, I would say about 80% of the time, ED is due to physical causes. It's really due to blood flow or vasculogenic, and usually due to blood flow because you're diabetic or because you have high cholesterol and you have high blood pressure, you're overweight. The thing you need to know Is that it can be reversed. Yes, poor blood flow that causes ED can be reversed. So if you see this slide that I'm showing you on YouTube, the drivers: diabetes, high blood pressure, high cholesterol, obesity, smoking, metabolic syndrome. Metabolic syndrome means diabetes and obesity and sedentary lifestyle. And the workup involves the blood work that I showed you. And then also the workup could be that you should have a coronary artery CT scan test, which most of us have that covered by insurance. It costs about $100 to $150 for this test. And what it does is that it tests the calcium that is stuck in the artery of your heart. And that's exactly how my husband had an abnormal coronary calcium score. And that's how we know that he was going to have heart issues one year Down the road. Having said that, if you have ED, you should get blood work. Now, what I said before, you get blood work. Maybe not get a calcium coronary test. Get your blood work. Evaluate whether you have high cholesterol, diabetes. I mean, I can't tell you how many men I see in my office for ED and they didn't even know that they have high blood sugar or even diabetes. So most of the time it's due to poor blood flow, but it also can be due to nerve as well, which is a small percentage. Like if you're a long-term diabetic, it's uncontrolled, you're going to have nerve damage. You have nerve damage, you're definitely going to have ED. Or you have prostate surgery, the prostate being taken out, because that can cause nerve injury as well. Or if you have conditions such as multiple sclerosis or spinal cord injury, that's when you need to be evaluated with blood work and seeing a doctor for your history. And then of course, when you do blood work, you look at your testosterone total and free, and you also evaluate your thyroid. Thyroid as well too, because thyroid is important. Controls testosterone. If it's not balanced, it will affect your testosterone as well too. How do you tell about erection due to psychogenic, due to mental, or is it due to physical? Well, usually mental is if your ED occurs suddenly, like one day or within a week it occurred. You went from a good erection to no erection. And then if you're having a lot of stress or you have a history of depression or anxiety or PTSD. And then also if you're doing solo, You can get an erection, but with a partner you can't get an erection. That is psychological as well. You're still getting morning wood, good morning wood, but then when you're with a partner, you can't get an erection. So most likely it's psychological. And if you're under 40, most likely it's psychological as well, or stress as well. Kind of 40 is kind of the cutoff because if you're under 40 and you have ED, first thing we evaluate is it psychological. And second thing is You're doing porn, or you smoke, or you're taking recreational drugs that may be contributed to that as well. And then of course your lifestyle, guys. Smoking is bad, or taking pain medicine is bad, or doing illegal drugs. All those will affect your erection. And if you're taking medicine like beta blockers or the medicine that help with your heart but slow your heart rate, those medicine will affect your erection because it slows down your heart rate. So it's hard for you to get a rigid erection. And then medication like thiazide. Diuretics are medications that help with blood pressure. So those medications can contribute to ED. Now, I'm not saying don't get off those medications. You got to talk with your doctor and to think about other alternatives. But most depression medicines actually contribute to ED. And believe it or not, even over-the-counter antifungal medication and antacid medication can contribute to ED as well. So put it all together. What I'm trying to say, guys, is that do blood work and evaluate what's causing your ED. And when you go see the doctor, they do an EKG. It does not hurt at all. And honestly, if you're over 40, you need to go see a doctor. You need to get blood work done. You need to evaluate your heart, your lung function. Okay. We live now in 2026. We're not in 1900 anymore. All right, we can do blood work to see what's going on inside your body. And we have testing now to even look at the arteries of your heart. We can do a test that's called the Doppler ultrasound to look at the blood flow in your penis. You know, there is workup that can be done, but you guys just need to take the initiative to go see the doctor for that. And I know sometimes it's embarrassing to admit that you may have a problem. It's It's a little ashamed with that, but you know what? Treat it like as if you have chest pain because us physicians, we're used to talking about personal issues. You have ED, there is no shame in that.
All right?
Because when you have ED, it's as if you have chest pain. You have heart disease, treat it as if you're like have diabetes. There's no shame in that whatsoever. I know sometimes it's uncomfortable to say, but all you have to do is you have to say, I feel like I have ED and I want to work up as to why I have ED. And it starts with doing blood work, checking your blood pressure. When you're at the doctor's office, they always measure your blood pressure anyway, right? They look at your weight, look at your height. So those are things that you need to start doing first before you take an ED pill. Okay, modern man, if you're struggling with weak erection, low energy, the food you eat could be the big part of the problem. One of the best research-backed ways to boost circulation, support healthy testosterone, And improve sexual performance is the Mediterranean diet. It's packed with food that open up your blood vessel, lower inflammation, and fuel your hormone naturally. I've seen men notice real improvement in both energy and erection within weeks when they shift to this style of eating. So check out this Mediterranean diet link right here below and get that as soon as you can, stronger testosterone and better erection.
Thanks for listening to the Sexual Health for Men podcast. If you love this episode, then please take a screenshot on your phone and post it on Facebook, Instagram, or wherever you post. And be sure to tag me and let me know why you like this episode and what you'd like to hear in the future. That will help me know what's great for you. And I would love to give you the most incredible free gift designed to help you improve performance quickly. Go to my website at sexualhealthformenpodcast.com to get the book, The 5 Common Costly Mistakes Men Make When Facing ED. I would appreciate it if you subscribe, leave a review on Apple Podcasts or wherever you listen, and just know that you can have sexual vitality for life. I appreciate you. Until next time.
