Live Q&A: Ask Me Anything (Men's Health & Performance Unfiltered)

Okay, so John, John, can you also— can you— there you go, you add me on the stage. Wonderful, wonderful. Okay, we are now live. I had trouble logging on earlier. I'm having internet problems. I might even get cut off as well, but I'm also live also on TikTok as well on my phone here. So drop in the chat if you have any question for me today. Sorry, my lighting is horrible. Okay, warning, keep your live turning your camera. Okay. Oh boy, how did that go? Did I just lost it? Did I just lost the feed? Here's one new message. Okay. Let me see if I can even see the feed on TikTok here, guys. All right, so you guys are joining. Awesome. All right, can you hear, can you see me live? Okay, so do we have the question from— if I have the question from last week, John, maybe you can put the link to the Google Doc and in the, um, in the chat, and, um, I— the private chat, and I can, uh, draw that up. So this is, um, okay, so, uh, uh, this is, um, uh, um, this is, um, our weekly live that we— I go on for, um an hour every Monday from 12 to 1, where I take all your questions that you may have. But today I'm actually going to do a brief period of time. So most common question sometimes is that, is like, is testosterone important for erection, right? So, um, what do you guys think? What do you guys think? You think testosterone is, um, important? Uh, is testosterone important for, um, erection, right? What, what's the vote? Put in the comment. What do you think? You think that testosterone is important for, um, erection, um, or not, right? Let me see. Let me hear your comment from, uh, TikTok as well. Okay, so here's one message, right? Okay. Yeah. So is testosterone important for erection? So testosterone is a male hormone that makes a man a man, right? So a man has 100 times more testosterone level than a woman. A woman, conversely, have 100 times more estrogen level than a man. And so just saying that testosterone, low testosterone can be the cause of ED. Well, erectile dysfunction is multifactorial, meaning multiple causes, multiple things can cause ED. So ED is not just one thing. One thing alone. It is multiple contributing factors. All right. Multiple contributing factors. So low testosterone. I'll go back a little bit. So the penis has multiple receptors for testosterone. And receptors like the opening to the keyhole Right? That's the receptor. Right? You put your key in, and the testosterone is the key, and the opening is the receptor. And in the penis, there are multiple receptors for testosterone. And so when you have low testosterone, it's less keys to go into the hole. So when there's less key to go into the hole, Low testosterone can contribute, but not primarily cause of ED. It will contribute to shrinkage. It will also contribute to firmness and increasing blood flow as well. And so when you have low testosterone, it's one of many causes of ED. So that's one. So low testosterone, yes, can contribute, but it's not the primary factor. Meaning if you supplement testosterone, right, if you take either testosterone injections or pellets or oral testosterone, even gel, Not necessarily that will contribute, that will fix your ED. All right. So what's the number one cause of ED? What's the number one contributor to ED? You'll be surprised to find out. You will be surprised to find out what is the number one cause of ED. Number 1 cause of ET is actually alcohol. It's more lifestyle. So there's more alcohol, excessive alcohol. I mean, you're allowed like 14 drinks a week and you can either drink 14 in one day or 14 total in a week. But excessive alcohol is one. Number 2 is smoking. Number 3 is obesity. Or overweight, BMI over 30. And number 4 is diabetes, and number 5 is high blood pressure and high cholesterol. So having said that, the things that you can cut down is smoking and alcohol consumption. Oftentimes when you take alcohol, why does alcohol contribute to ED? Because when you're drinking alcohol, it affects the nerve as well as affecting the muscle of the penis. And therefore, you actually have less sensitivity and you also have less relaxation of the penis muscle. So it contributes to erection in nerve and also in muscle. Okay. And that's something to know because, you know, there's a term called whiskey dick. If you drink too much alcohol, then it's going to affect your erection. Okay. So that's actually the number one cause of ED. And age, The older you are does not mean you're going to have ED. It's just that when you get older, you tend to acquire medical conditions such as high blood pressure, high cholesterol, diabetes, and overweight, right? And then you also get low testosterone. All of that add into contributing to erectile dysfunction. Okay. But not age, necessarily age is the cause of ED. All right, so I'm seeing a lot of people joining from TikTok right now, and so that's awesome. And so just know that ED, if you're young, like in your 30s, your 40s, starting to notice ED, first think of, are you smoking? Are you drinking too much alcohol? Are you doing porn? How is your sleep? Are you overweight? Check those things. What's defined as overweight? When your BMI is over 30. BMI means basal mass, I mean body mass index. Okay. So you can get that formula right off of the internet and calculate that formula. Okay. All right. So some quick tips there. Oftentimes, ED is reversible if you know what causes it. And I just told you the most common cause of ED. The last thing you want to do is you find out that you have ED and maybe it's contributed by alcohol or maybe porn or smoking. Well, what do you end up doing? You go online, next thing you know, you're taking Viagra pill from an online dispensary, and that's not the route that you want to go because you really— your ED can totally be reversed and treated if you really take some time to look at the cause of ED. Okay. Alright, so can you check also if there's any comment on TikTok as well too, John? I, I, my screen is weird. I dropped my phone and I can't see anything on my phone right now, but we are live, I think, on TikTok at this point. I see people join, but I don't see anything else. At this time. We have 19 likes. So let's get some of the questions here. All right. Now, guys, now keep this professional and keep this medical at this point. Okay. Okay. So this is a common question we get. From Reasoning Bean. Question says, hello, what are some causes of left testicle area being slightly sore sometimes, more like on the attachment area behind the testicle? If your testicle is sore and it's consistent every day, right, you need to get evaluated by a doctor. See a urologist who specializes in the penis and the testicles because is it sore? It could be a sign of infection. It could be a sign of blockage. It could be a sign of cancer. It could also be a sign of a cyst. All right. So it needs to be evaluated. Is it consistent day after day? I would advise you to do testicle massage the same way that women do a breast exam. You should do testicle massage every day so you can feel the texture of your testicle. You can feel the cord, the spermatic cord that goes to the the prostate. So your testicle makes testosterone and it also makes sperm, right? But it's in a sac, which is your scrotum, outside the body because the testicle needs to be 1 or 2 degrees cooler than the body to make testosterone and sperm. So, So if you are working inside, you sit down a lot, and if you wear pants, sometimes that can affect the temperature of the testicle as well. So if you have trauma to the testicle, as in some type of blunt force, or if you ride a bike a lot, you definitely need to have to be evaluated. It's kind of like a woman finding finding her breast being tender or a lump breast, it needs to be evaluated. Okay. And so you shouldn't take it lightly. So guys, if you have tenderness in the testicle, it could be a lot of things. So you need to be evaluated first. You can't just say, well, it doesn't hurt that much. I'll just, you know, lie on it. You need to get evaluated because testicular cancer is a possibility, as well as a cyst, as well as an infection. Sometimes the cord, the spermatic cord, that is a cord that goes up to bring the sperm to the prostate area, that gets a kink. That can kink and that can turn. Called torsion that can cause soreness as well. So you definitely need to be evaluated with a doctor and then something ordered as an ultrasound that can look at the structure of the testicle to see if there's any type of blockage. Oftentimes the testicle is benign. It's very easy to do. It's the same ultrasound that women have to look at babies, but they can visually see the scrotum quite well there. Okay. All right. So it can be quite well there. So, well, you know, there's another follow-up question here about testicle soreness. Again, you need to be evaluated. Okay. You can't just assume it's a blockage. You can't assume it's a blockage or lack of ejaculation. You can't assume that. Well, it's like a woman having a mass in her breast. Can't assume anything because a mass in the breast for a woman could be a cyst, could be scar tissue, could be cancer. But don't sit on it. Get evaluated. I have another question by Samuel Bond saying, well, I assume it's occasional blockage. You can't assume it. Assume anything because you need imaging to know what it is. And you can just go see the doctor, get an ultrasound, and it will show. It will show what it is. So don't sit on— don't diagnose yourself either, okay? Because I have another comment here. Well, I assume it's a blockage. How do you keep it from happening? Lack of ejaculation does not cause testicle pain. Ejaculation has nothing to do with testicle pain. Sometimes testicle pain can be from trauma, but it could be multiple causes, and that can be easily diagnosed by just an imaging test called the ultrasound. The function of the testicle is to bring the sperm up into the prostate, and the prostate stores the sperm in a sac called seminal vesicle. And then when you ejaculate, the sperm along with the seminal fluid comes out, and the seminal fluid protects the sperm allow it to survive, um, in the female, right? And, um, so that is, uh, the function of, uh, the testicle. Okay. Um, and, uh, okay, so answer 2 questions all at the same time. Um, is there any question from, uh, TikTok at all? Okay, okay. So not— I will see. Okay, no, I will see. Okay, there's some questions here. There's a question here. How, how does your pelvic region end up too stiff? To where it causes venous leakage and how to relax that area? Well, there are two separate questions. So how did the pelvic area become stiff? So when you say pelvic area, you're referring to the muscles between the anus and these muscles right here. We call that under the taint, right? Under the taint muscles. And there are two muscles that are important, the ischiocavernosus and the bulbospongiosus. Muscle. And those muscles are like little tiny muscle that goes like a triangle like this, but it goes up to the base of the penis and wrap around the base of the penis here. And its function is to keep the blood in the penis. All right. It acts like a tourniquet. It's like a tie that keeps the blood in the penis. So the pelvic muscles are down here just below your scrotum. And sometimes the pelvic muscle gets stiff because oftentimes you don't stretch it. Men often do not do Kegel exercises. And it also gets stiff and tight with stress. Anxiety or depression. Okay, so it gets— most of the time, men with ED actually have tight muscles there, down there, and weak muscles, tight and weak. So pelvic muscles are tight and weak. It doesn't effectively wrap around the penis to keep the blood in the penis. Okay, so, um, it, it does affect the functionality of your erection. Uh, and but then let me ask you this, how often do you do Kegel? Probably not a lot, right? So you guys, um, uh, it's, it's probably not a lot at this time, uh, that you will do, uh, Kegel. Most men don't do Kegel. Most men do Kegel exercises wrong. So there is a video. Can you put that link there? There's a video in my YouTube channel at Dr. Truong MD that you can watch where I walk you through doing the Kegel exercises. However, We also have, if you get lazy, there is a Kegel stimulator that does exercises for you that stimulate the pelvic muscles to make it stronger. Okay. So that's pelvic muscles at this time. Okay. And let me check to see if there's any more comment. Okay, so my team put the YouTube video, the YouTube on there, how to fix ED with Kegel exercises. You can take a picture of that and enter that URL in, and you will actually see All right, you actually see, um, see, I know how to do, uh, Kegel exercises. Um, all right, so another question here from Samuel Bond. All right, um, all right, so with Samuel Bond, it says here, how regular should a man get a testicle penis test from a doctor? What kind of test, what they do, they need to write? Well, it's, uh, you, you need to probably, when you're over, uh, 40, you need to get checked annually. Get your prostate checked. I encourage you to do your own testicle massage so you know what it feels like and when it's normal and when it's not normal. It's like women doing breast exam. Well, you should also be doing your scrotal exam, your testicle exam. And, um, um, what I'm getting with this is that, um, routinely the doctor don't screen for testicle, uh, uh, uh, problem unless you tell them. Um, it's really more of, okay, you tell them, hey, I'm having testicle pain, the doctor decide whether, uh, he draw blood plus or minus, uh, ordering the ultrasound. As well. So an ultrasound will help and blood work, but the test that usually is assessed for testicle is ultrasound. Okay. An ultrasound of the testicle. And usually doctors don't routinely order ultrasound unless you have symptoms like scrotal pain or scrotum swelling. Usually doctors don't do Doppler ultrasound unless they go to a urologist or go to somebody like myself, sexual health specialist, or radiology that also does that. I do a Doppler ultrasound, duplex ultrasound of the penis every time I evaluate a patient. That will allow me to look at the blood flow. And functionality of the penis. Okay. And okay, very good. So that is the question we get asked about testicle pain every week. It's very, very interesting. So that was the question from last week that I didn't I didn't get to. Okay, any more questions in the comments that I may have missed? Okay, so I'm gonna answer one more question and that will be it for us today. Look at this, I got like 20 hearts already on TikTok. We got 10 people here from YouTube here. Okay, so What causes a venous leakage? What causes venous leakage? Multiple factors. Again, venous leakage means that the penis muscle is not expanding enough to engorge your blood, that it collapses the vein to keep the blood in the penis. When the penis doesn't expand enough to collapse that vein, that's what's called venous leakage. There's no leakage per se, but that just means that the veins that are in between two compartments of the penis or the fascia, um, incompletely collapse. Because you want it to be completely collapsed so the blood stays in the penis. But if it's inconsistently, like that, then the blood won't stay in the penis for long. So what contributes to venous leakage? The same thing that I mentioned earlier, right? Which is alcohol will affect it, low testosterone will affect it, obesity, smoking will affect it, and diabetes, high blood pressure, and high cholesterol. Kind of like they're all the same risk factors., that you would have, uh, with, uh, you would have, um, uh, that you would have, uh, in, uh, like other causes of ED. It's the same thing. All right. Um, okay, let's see if there's any more. All right, so there, there is a video that, that you see the in the comment about common causes of, uh, venous leakage right here. I talk about it. And, um, if you're not— if you're not subscribing to my channel, TikTok, Twitter, and Facebook, subscribe to my YouTube channel at, uh, uh, just go to YouTube and type in, uh, @DrAnneTruong MD, like my name, and you will be able to, uh— that will pull up my, my channel. Uh, so I'll be grateful if you are listening, uh, that, uh, you go and subscribe and push notification and share, uh, some of the, the best episode, uh, with, uh, someone you care about, maybe your wife or your brother, um, all that. Okay, um, uh, um, so having said that I am actually going to end quite early today because I have another commitment. But I kept my— I answered some questions for today. Those are the ones that we didn't answer. We'll pick up next time. All right, so I appreciate you guys being here with me today, finally going live on TikTok. Hey, Lynn, I dropped the phone. I don't know what happened, but I'm doing a live on TikTok here, and we should also go live on Instagram too. And so See you guys next week.