In this podcast episode, Dr. Anne Truong MD, an intimate‑health physician and author of Erectile Dysfunction Fix, breaks down why men experience low semen volume and erectile dysfunction (ED). She explains that reduced ejaculate can stem from physiological issues such as prostate enlargement, testicular problems, weak pelvic floor muscles, dehydration, and low testosterone, all of which require a urologic work‑up. Truong emphasizes that the brain is the primary sexual organ: mental health, stress, anxiety, depression, and especially excessive pornography disrupt the brain’s arousal pathways, leading to diminished libido and ejaculatory function. She outlines a comprehensive, daily protocol to restore volume: (1) medical evaluation (testosterone testing, pelvic muscle assessment, prostate exam), (2) lifestyle changes—adopting a Mediterranean diet, regular exercise, adequate sleep, and stress management, (3) behavioral adjustments—stop porn, manage mental health, and practice regular, moderate masturbation, and (4) mechanical therapy—using a penis pump three times a week to “clear the pipe” and prevent penile atrophy. Truong stresses the importance of early intervention, likening ED to a car problem that should be fixed at the first sign to avoid permanent damage. She answers a caller’s specific question about a 35‑year‑old man who has not had sex for years, recommending the same protocol: Mediterranean diet, exercise, sleep, stress reduction, weekly masturbation, and thrice‑weekly penis‑pump sessions, while monitoring morning erections as a health indicator. The episode concludes with a call to action to visit her website for resources.
Questions this episode answers
Follow a four‑step protocol: (1) adopt the Mediterranean diet, exercise regularly, get at least 7 hours of sleep, and manage stress; (2) use a penis pump three times per week to train the penis and prevent atrophy; (3) masturbate once a week to “clear the pipe” and ensure the prostate empties; (4) monitor for morning erections as a sign of healthy function. Also stop watching porn and address any depression or anxiety.
Chapters
If you've noticed a drop in semen volume, don't just blame your testosterone. Ignoring early signs of ED doesn't just hurt your performance, it can actually lead to permanent physical shrinkage. Today I am breaking down the hidden causes behind low volume, why your brain is actually your primary sexual organ, and the exact daily protocols to fix it.. We'll cover the lifestyle changes you need and why using a penis pump and regular masturbation are medically necessary to protect your function. Let's dive in.
This podcast is for you, the modern man. I'm Dr. Anne Truong MD, 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 don't have any more sperm. Nothing comes out. No feeling down there and mental stimulation. I'm not sure what meaning mental stimulation. Well, first of all, are you talking about sperm or you're talking about semen? And you said, I don't have any more sperm coming out. So I assume you're talking about semen. And so there's several reasons why if you're not able to get enough semen, right? It could even be dehydration. It could be that your prostate is enlarged. It could be something going on with your testicles. It could be that your pelvic muscles are weak and it's not able to expel out the semen volume. It could also be that your testosterone level is low. So if you're not able to ejaculate, then you really need to be evaluated by a urologist because you need to look at your prostate size, need to look at your testicles, need to look at your testosterone blood level and get your pelvic muscle checked. Because sometimes you have weak pelvic muscle that you're not able to expel out the semen from the prostate. The semen is stored in the prostate. It needs to be literally expelled out during ejaculation. But if your pelvic muscles are weak, it's not going to be able to do that. So that is the recommendation there. I'm not sure what you mean by mental stimulation, because guys, if you're feeling that you are less aroused or your libido is low, you're not as aroused with someone that usually is— you're aroused with, then one, get your testosterone level checked. You need to know what your testosterone level is because testosterone affects libido. And then two, if you're watching porn, stop it because sometimes porn will affect your arousal mechanism that starts in your brain. So porn is now more common, more easily accessible now because you can watch porn on your phone now. It's more easily accessible. And porn will mess up with your arousal mechanism in your brain. If you don't get aroused in your brain here, nothing's going to go down below the belt.
Nothing.
Because an erection starts with arousal first. But if you're not getting aroused, check your testosterone level. Check if you're doing porn, stop porn. And then also, other thing too is, are you depressed? Are you anxious? You're depressed and anxious, then that's going to affect arousal as well too. Are you stressed? Because when you're stressed, that's going to also affect arousal. So there are several things that affect that because there are 6 systems that stimulate an erection. And the brain is the largest sexual organ. The brain, your brain is the largest sexual organ that stimulates an erection, not your penis. It has to start in your brain. That's why you have morning wood. Morning wood happen when you're asleep. When you're asleep, your brain is relaxed. You're relaxed. You're not thinking about things that stresses you out. You're not depressed. You're not anxious. You're relaxed and you're in deep sleep. That's why morning wood happens because you're totally relaxed. And also your body starts to make testosterone at nighttime and the peak level of your testosterone is actually around 7 AM. So the point that I'm trying to make here is that you're aroused when you're relaxed. The more relaxed you are, the more aroused you will be. And that the brain is the largest sexual organ. So everything has to start in the brain. How do you get aroused? You get aroused by 5 senses. So through touching, through seeing, through smell, through what you eat, your food will actually affect your arousal mechanism and also your ears, what you hear. Those are the sensory feedback that will send messages to your brain, which then is processed through your emotional status. Like, are you depressed? Are you anxious? Are you relaxed? That gets processed through it. And then the hormones in your brain gets released. Would then send messages to the nerve in the back of your brain, which then travel down to your heart, which then pump higher and then open up your blood vessels and then to your penis. So the penis is the last organ, but everything starts here. 3 steps starts in here in the brain. So I can't tell you how important your mental status is and relaxation is to having an erection. The more relaxed you are, the better your erection is. All right. The more relaxed, the better the erection. So that's why you have more than one. In fact, you have about 3 to 6 erections while you're sleeping without even knowing it. Okay. So it's important how the brain is impact upon the erection. And sometimes when you have no feeling down there, Anthony, it could be a sign of also low testosterone as well too. And sometimes When you're masturbating too forcefully, that can affect feeling down there as well too. How much is too forcefully? When you start having bruising, when you start having swelling in your penis, that's probably too much forcefully right there. My point here is that your sexual health is important, but it's very common to start losing it as you get older or as you get busy. And so if you start working on reversing your ED when it's early, the chance of getting it back 100% is a lot easier than if you wait 10 years. You wait until ED medicine stop working. Well, by that time, there's too much damage by that, right? It's like fixing your car. Fix your car. You want to fix it when first having problem. You don't want to wait until you're driving and the smoke start coming out of your car, right? So take care of your body like you would take care of your car, and you will find out it goes a long way. I hope that I can make that clear to you all. And don't try to chase after a shiny object. Okay? Don't try to chase after something new, something like improve man's body. It's innate program. You are programmed to have an erection and it's one of the oldest system in the body. Your body wants to have you have an erection. So you don't want to add anything different in your body for your erection. And so you don't want to have that, struggling with that. You need to know that. You need to know, start with your ED, fixing your ED early. That way you can get full reversal. You wait too late, it's going to be— take— it'll be hard to reverse it. Nothing is impossible. I work with a man and he had ED for 40 years and we're able to reverse his ED for functioning again. So nothing is impossible, but It takes work. One thing I want to point out to you is that you can reverse your ED, but it takes work from you. Yes, you, you have to put in the work. Even if you come and see me in the office, I can boost you and get things started, but you still have to put in the work of eating better, exercising, of sleeping, and then stress reduction. You do all that, you're going to reverse it. Or you don't. It may not, because we all want an easy button, but our body is not cooperating with that because our body's a lot older than the computer and an easy button. And so the key here is that you got to put in the work, but how important that is to you, that is the point that I want to make. 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 the Mediterranean diet link right here below and get that as soon as you can. Stronger testosterone and better erection. As a 35-year-old man who hasn't had sex in 3 years, going on 4, what step would you recommend I should take to ease back to a healthy sexual life? I don't have ED, or at least I hope I don't. Well, that's good. You're 35, and I hope that you're in good health. I hope that you're not obese. Obese means BMI over 30. I hope you don't have high blood pressure. I hope that you don't have diabetes, and I hope that you don't have high cholesterol. If you do, if you have diabetes, high blood pressure, high cholesterol, you can just follow the Mediterranean diet and exercise to reverse those 3 conditions. I'm just assuming you're a healthy guy, but if you do have high blood pressure, high cholesterol, and diabetes, and just follow the Mediterranean diet and exercise, you will reverse that because you're young, you can reverse. And if you haven't had sex for 3, 4 years, I hope you're not watching porn because porn will mess your arousal mechanism up. So what step would you recommend to ease back into a healthy sexual life? What step is, if you're still having morning wood, it's a good sign. Okay. You're not having morning wood. Then it's not great. But either way, I would suggest you use a penis pump 3 times a week as more like a maintenance. I would suggest you use a penis pump to kind of train, exercise your penis to show what it's like to have an erection. I don't know, you masturbate, but there's nothing wrong with masturbation. Masturbation is like exercising your penis. So use a penis pump to exercise your penis and clear the pipe. Once a week. Nothing wrong with masturbation, clearing the pipes, right? You want to clear the pipe once a week and then use the pump about 3 times a week to get you— that way your penis knows what it's like to have an erection. Because when you do the penis pump, it's going to prevent atrophy or shrinkage of the penis. It's going to prevent scar tissue because you haven't had an erection in a while. Your penis will start having scar tissue. That get developed inside the muscle and it actually prevent it from getting an erection. So the phrase use it or lose it is so true for your penis. You don't use it, you're actually gonna find that you're gonna lose it. So you really need to retrain your penis again to have an erection. How do you do that? Using the penis pump. And then number 2 is masturbate once a week to clear the pipe. Check to see if you have morning wood. Or not, most likely you are, and you're good with that. Just make sure that you follow the— eat the Mediterranean diet. I would recommend you do a Mediterranean diet. That Mediterranean diet will also help with your erection, but also help you lose weight. Sleep 7 hours at least at nighttime, and stress management. Decrease your stress. Those are the things that I would recommend for you right now, Levo, to do is that those 4 things. Mediterranean diet, Exercise, sleep, stress, use the penis pump 3 times a week, and clear the pipes once a week as well. Why do you want to clear the pipes? You want to clear the pipes because you don't want the prostate to just be inactive because the prostate is what stores semen. If you don't ejaculate, it's just going to get bogged up in prostate. So you want to kind of clear it. That's why I call it clearing the pipe. Nothing wrong with masturbation. In fact, masturbation is the innate feeling your body said, you know, you need to exercise your penis and clear the pipe.
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 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.
