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

Hello, hello, hello. Hi. Okay. Hi, Franz, I see you there. Okay. All right, we are live. Let me do some— okay, um, looks like we're having trouble. We're having trouble. I think it looks like we're having trouble signing in with one. Okay, trouble with connection in StreamYard. Okay, all right, very good. Hey, how are— how is everyone? Hi, how's everyone doing today? Okay, let me, uh, do some setting and then we'll start our AMA. Ask Me It Today is ask me anything, um, any question you may have, I'll answer it here live. If I don't answer it, I'll answer it next week. I go live every Monday, Anne Truong MD time. And so, you know, just put it on your calendar. And I'm here for an hour. If nobody's asking, I'll pull up some questions from last week. Okay. Anybody hear me well now? Can you put yes if you Can you put that in the comment if you can hear me? Okay, can maintain. All right, can you hear me well? All right, good, good, good. Does we have some— we have some, um, people signing in. That's good, that is really good. Just make sure you subscribe to the channel, okay? Make sure you subscribe to the channel and, um, so you get notification when I go live, um, and, uh, you get a chance to ask your questions. And then we may even, uh, you know, you get a chance to ask your questions because I get very interesting questions when I go live, and then it gives me an idea on how to, um, make more videos, um, uh, as well too. Okay, all right, so All right, so we see who is here. Okay, all right, uh, Nesta Goldley. Okay, so Nesta, Nesta Goldley said, hey, can't maintain my erection for a couple months now, what might be the problem? Well, that's a whole bag of things that it could be, right? It depends on how old you are, what medical condition you have, and what's your lifestyle like. Okay, so we know that ED, the older you get, the more likely chance you're going to get ED. So if you're 50 years old, 50% of men have ED. If you're 60 years old, 60% of men have ED. At 70 years old, 70% have ED. Now, why is it that ED is more common when you get older? Because ED is dependent upon— it's not— first of all, I want to preface it by saying ED is not an inevitable end result of getting older. It is not. Okay. I see men in their 80s getting erections. So, ED is not inevitable. It's not like you're going to get it. However, it is more common when you get older because when you get older, you have more, you have medical conditions that predispose you to get ED, like medical conditions such as high blood pressure, high cholesterol, diabetes, obesity, stress, sleep disruption, as well as factors like smoking. I guess you get older, you smoke, the longer you smoke, the worse it's going to be. So you tend to have these problems when you get older. And these conditions that I mentioned earlier are the ones that contribute to ED. That's the reason why when you get older, you tend to have more ED because you tend to acquire high blood pressure, high cholesterol, diabetes, being overweight, not have time to exercise, stress, sometimes not sleeping well as well. Okay. So, ED is not an inevitable part of getting older. It's just when you get older, you start having these medical conditions which then set you up to have ED. That's number one. So according to your question, Nesta Goldie, is that, "Can't maintain an erection for a couple of months. What might be the problem?" Well, first of all, check to see if you have diabetes, high blood pressure, high cholesterol. And then also note that lifestyle factors can contribute to it as well. Lifestyle factors such as smoking. Do you smoke? Lifestyle factors such as porn. Are you watching porn? And then also sleep. How is your sleep? You need to sleep about 7 hours at nighttime, and you need to sleep at nighttime. And then the last part is alcohol. How much alcohol are you drinking? Your parts, about 14 drinks a week. And so that alcohol definitely play a role in ED, the more you drink, okay? Because alcohol affect the blood flow as well as the nerve. So those are things you need to be considering. But the good thing is, Nesta, is that you're recognizing this early. The earlier that you recognize that you have ED, And you start to look at, okay, the question is, what might be the problem? Well, I just named it, right? I said, well, first of all, are you sleeping 7 hours at night? Second of all, are you drinking more than 14 alcohol drinks a week? Or the other thing is stress. How's your stress level? Stress level could be way high and it's affecting your sleep. And the other thing is porn, watching porn will affect how you process arousal in your brain, and that will affect ED. And then the other medical condition is high blood pressure, high cholesterol, diabetes as well. And then whether you're obese or not, what's defined as obesity? Obesity is defined, I believe, BMI over 30., body mass index over 30. I understand you said you don't smoke. That's good. You don't smoke. But do you have all the other medical conditions that I mentioned? Okay. So, those are the things you need to check first. And if you're noticing you're having a problem maintaining erection, it's a sign of venous leak. Venous leak means that you're able to get the erection, but you're not able to maintain it because the blood doesn't stay in the penis, the blood kind of goes out back to your body again. So that means that you're not able to get a full, firm erection that will compress the veins to keep the blood in there. It could also be that you have weak pelvic muscle. Now, if you have weak pelvic muscle, which are the muscles that are under the tank, right? The muscles that are involved, that contract when you start and stop urine. It's also the muscle that is involved when you have orgasm. It's also the muscle that contracts for ejaculation. Now, those muscles could also be weak. When those muscles are weak, it also will affect maintaining the erection. Fortunately, the most common presentation of ED is maintaining the erection. And usually when that happens, there's more venous leakage. Okay. So venous leakage, venous leakage means that the vein does not fully compress, like get flattened when the penis gets an erection to maintain the blood in the penis. And fortunately, it can be fixed. All right, how do you fix your venous leak? Right, how do you fix your venous leak? Well, easily, right, by your diet, right? You can change what's going on in your body by eating better, such as eating a Mediterranean diet, right? Following a Mediterranean diet. So I'm going to put a QR code here for you to um, uh, download for the Mediterranean diet, uh, as well. Let me see, uh, there is, um, here it is, Mediterranean diet. And this is the, um, the URL, eat4noed.com. All right, eat4noed.com is, uh, the Mediterranean diet. All right, um, so you can— how do you fix venous leakage? Follow the Mediterranean diet. Exercise 3 times a week. Just could just be walking 30 minutes a day, or just walk a mile or 2 miles. If you can walk a mile a day, that'll be great. If you don't smoke, that's great. Watch the porn because porn can really affect arousal, how you get your arousal. Processing. And then, you know, go get your blood pressure checked. I don't know if you have high blood pressure, but get your blood— I mean, you have high blood pressure, you have high cholesterol. Well, if you have high blood pressure and high cholesterol, if you exercise and you follow the Mediterranean diet, the blood pressure will also be controlled better. And so the cholesterol will go down. If you follow the Mediterranean diet, your cholesterol will go down. Your blood pressure will go down. If you exercise, your blood pressure will also go down as well. If you don't exercise, your blood pressure will actually go up if you don't exercise. So by exercising, following Mediterranean diet, you can actually lower your blood pressure, lower your cholesterol, and even lower your blood sugar if you're diabetic. So those are the So how do you fix venous leakage? One, Mediterranean diet. Number two, exercise 30 minutes, 3 to 4 times a week. Number three is sleep. Sleep 7 hours at night between 10:00 PM to 6:00 AM. And then decrease stress. How do you decrease stress? Exercise most of the time. And also, you know, do the things that, you know, you love to do. Sometimes it's kind of, I think that the first two levers are the strongest, which is the diet and the exercise. I know it's hard to find out, to know whether you're stressed or not. Most of us are kind of go, go, go. But stress plays an important factor. So is sleep. So is sleep. So that is what I would recommend, that you go get blood work. So here's the question, that you get blood work first to see if you're— check your blood sugar, check your cholesterol, also check your blood pressure at the doctor's office. Because if you're a man with ED, you need to get blood work. You need to check to see what your blood sugar is like, what your cholesterol level is like, how's your kidneys doing, how's your liver doing, and then also check to see if your blood level is good or your red blood cell is good. And insurance pays for it, and if you don't have insurance, Actually doesn't cost that much, maybe a few hundred dollars, all right, for the blood work. And also get your testosterone level checked if you're going to get blood work as well. So get your blood work checked, right? And then how do you fix venous leakage? Mediterranean diet, exercise, sleep 7 hours at nighttime. Stress reduction. Now, if you only had this a couple of months, the good thing is, Nesta, you can reverse it. You can reverse it if you only have it a few months. The earlier you start, the easier it is for you to reverse. If you let it go too long, then it's going to be harder to reverse it on your own. Okay, so it's like a broken car. If a car first have problem, you fix it, it'll be good. If you don't, if you wait, then it'll take longer for it to fix it, be more costly or cause more damage as well. Your body's not that much different. So if you start taking Viagra, you start taking Viagra, 70% of people only respond to Viagra. If you start taking Viagra, that's just a band-aid on an infected wound. It doesn't treat the root cause of why you have ED. It just increases nitric oxide, but it doesn't treat why you have ED. So if you take it, a few years down the road, you're still going to have ED. And your ED is actually worse because you never treated the root cause of ED. And so, you know, when you start Viagra, you're going to set yourself up on the way to have worsening ED later on. You're going to, you know, the usual track is Viagra doesn't work, go to Trimix injection, and then penile implant, right? But if you know now in a couple of months, last couple of months, your erection's not as good, start working what I mentioned before and you will see an improvement. As well. So here's the Mediterranean diet, which is eat4noed.com. Uh, and also, uh, you do the Good Morning Wood Smoothie, right? Get the goodmorningwoodsmoothie.com. Um, the Good Morning Wood Smoothie will also, um, help with better blood flow too and the venous leakage. All right, so I hope that was Helpful. It's a very common question. Oftentimes men just say, well, what's going on? I don't know what's going on. Yes, you're absolutely right. You don't know. So the first thing is do what I just said, go get blood work and check to see what your lifestyle is about and then start reversing it. You can reverse your ED, guys. Yes, you can. You do not need the little blue pill to help you. With that erection. The earlier you start, the easier it is for you to reverse it. Okay. That's just the bottom line. All right. You have to reverse it. You have to treat the root cause in order for you to have lasting improvement. Okay. All right. Good question. Good question. All right. So go on to the next question. So Nesta, was that helpful? Okay. Okay. All right, Patrick Johnson, you asked that question last week. All right. All right. So I appreciate it if you're aware of that. Okay. So, okay. Question, a doctor, and it's a follow-up question. Doctor, if I'm doing good, diet and exercise, don't have— is this a question or just a statement? If I'm doing good diet and exercise, okay, so I guess you're trying to say it that if you are following the Mediterranean diet, I don't know what a good diet is. I don't know what a good diet is. All right. But if you're following the Mediterranean diet and if you exercise, I don't know what exercise means for you. But at least you need to be at least doing moderate exercise, 30 minutes at a time, 3 to 4 times a week. What's moderate exercise? Moderate exercise is when you exercise about to 70% of your maximal heart rate, right? So if you're going to calculate that, it's 220 minus your age, and then times 70% of that. All right, that's the zone that you want to be in, plus or minus 10 heart rate. So let's say if you are 60 years old, right, if you are 60 years old, and let's say 220 minus your age, which is 60, equals 160, and then times 0.7. So you want to be in a range of about 112, 112 plus or minus 10. So 102 to 122, that's moderate exercise. Okay? So that's your target range. And sometimes moderate exercise can be described as walking, having a hard time counting up to 10. You can still do it, but you're breathing in between. You're breathing in between the counting. So that's what's considered moderate exercise. So I don't know what a good diet is. I assume if you're doing moderate exercise, at least 30 minutes, 3 to 4 times a week, if you're still having a venous leakage, then you need to get blood work. You need to get blood work. You need to check your blood pressure. All right? Are you— you need to check what your blood pressure like. What's your cholesterol like? What's your blood sugar like? Right? Right? And then on top of that, those are the 3 common thing. On top of that is like, are you sleeping? Are you stressed? And then are you— Uh, drinking, um, more than 14 drinks, um, a week, right? And then, um, are you watching porn? Right? So those are the things you need to be going through, right? You have to get real with yourself. Okay, guys, I mean, your erection is an important part of your life, and if you want it back, you got to work for it, right? You got to work for it if you want it back. So if you're still having Venus leakage, the question is, how's your blood pressure? How's your blood sugar? How's your cholesterol? And then what's your alcohol consumption? How much alcohol are you drinking? And what's your porn? Are you doing porn on top of that? Okay. So there are things that you need to do to go through that list to evaluate why you're still having venous leakage. And in fact, if you check on my channel, my YouTube channel, at Dr. Anne Truong MD on my YouTube channel, you will find there's a video that I talk about venous leakage. Okay, I talk about, uh, Venus leakage. Um, where's my YouTube video? Um, here it is. So here's my YouTube channel, @DrAnneTruong MD. So I talk about Venus leakage, um, uh, um, and, and why. So guys, you know, I'm sharing you solution that it's gonna— you're gonna be able to reverse your ED.. But you got to work on it. Anything worthwhile, you got to work on it. And you're not going to reverse your ED with taking a pill. You really got to do the work. If something as important as your erection, you got to do the work. Okay. Unfortunately, there's no easy button on it as well. Now, with my treatment, with my treatment, you know, the Get Hard System, you know, with stem cells and with Botox and with with shockwave therapy. And now we're doing far infrared treatment. Far infrared. Now we're doing far infrared treatment with terahertz to decrease the sympathetic tone and increase parasympathetic tone for the nerve, for the performance anxiety. So now we're addressing the performance anxiety now, and we're adding more blood flow to the penis. We also give you a penis pump. We also give you an app that you can follow with the diet plan. But the point I'm trying to make here is that the Get Hard System will give you a boost, give you a boost, but you have to kind of do the work to maintain the improvement. All right. So what's the work you need to do to maintain? Doing a Mediterranean diet, the exercise, sleep, and the stress reduction, as well as stopping smoking, porn, and moderating your alcohol. Okay? Make sure that you sleep. All right? So, okay, there you go. So, I hope I answer your question. Alright, so I don't know what this— while watching porn, there is no issue for— okay, alright, so this is kind of related to what I was saying. The question is, I get excellent erection, it is hard to maintain erection, but while watching— I assume porn, not corn— while watching porn, there there's no issue for maintenance of erection. Uh, absolutely. So your, your mind is conditioned, uh, to get an erection with porn. So your, your, your mind is, is conditioned for that. So when you have tried to get an erection, um, with a real person, uh, your— the porn has already programmed in your mind, uh, the way it processes. In order for you to get an erection, you've also got to have dopamine release as well. The dopamine is the hormone that gets spiked up when you watch porn. But when you're with a person, that dopamine level doesn't get spiked up as high. So that's why it's harder for you to get an erection. And so this is the prime example that if you're able— if you're getting an erection with porn, you're not able to get an erection with a real person, then probably need to stop porn because it's already what they call desensitizing your brain. What's happening is that the porn, watching porn, make your brain get stimulated with porn. But when you're with a real person, your brain is not able to process the stimuli, and therefore they're not able to help you with the erection. All right. So your brain is conditioned to watching on the screen, and therefore that's why porn is not good. All right. So that, that I would suggest, you know, consider dropping porn and And consider, kind of use the 4 pillars of sexual health, which is the diet, the exercise, the sleep, and meditate. Honestly, you know, if you're trying to get out of porn, but the best way is to meditate and delete all your apps. Okay. Okay. So all of that's related to what I was talking about as, uh, I was talking about as well. Okay, all right, uh, okay, just want to know, all right, let's look at another, uh, question. So it's a question now on the penis pump. Penis pump, uh, just want to know, uh, Charles, just want to know, does the penis pump help with grow and for how long for using the pump? Um, the penis pump, if you use it correctly will help with increasing length and girth. It can increase about an inch or an inch and maybe an inch and a half and about 3/4 of an inch or an inch in girth. So girth means the circumference as well as the length. And but you have to use it um, every day. Okay, uh, you have to use it every day, twice a day, um, and you'll probably start seeing results probably within a month if you do it every day. All right, however, if you stop using the penis pump, the— your penis will go back to its original size. So if you want to have that progress, you need to use the penis pump. So when it gets to the size that you want get to the size that you want, you can always— and then you go, you're back to— I would do 6 weeks of it and get to the size that you want, like an inch more. Then you can do maintenance using the penis pump for 3 times a week. Okay, 3 times a week is maintenance. But if you want more length, or if you're doing penis pump for ED, then you should use it every day, 10 minutes. 10 minutes at a time, twice a day. All right. So it does improve length and girth. But the thing is you need to continuously do it in order for it to stay that way or else it'll just go back. It's kind of like going to the gym, right? You go to gym, you do bicep curls, right? Your bicep gets stronger. But if you miss the gym for like a month, And you go back, your muscle gonna be not as bulky, right? And you're gonna be weaker. You're not able to lift the same amount of weight. Same thing with your penis. All right. Same thing with your penis with the penis pump. Okay. And so, on that note, you know, there was a study that shows that 87% of men think that they're smaller than, than the norm. But I would tell you this, there's a study that looked at 20,000 men of all different ethnicities, uh, countries all over the world, and what they found out is the average penis length is, uh, is 5.5 inches long. Average 5.5 inches long and 4.75 inches in girth. All right. So that means that 50 percentile. And so if you are over that, you above 50 percentile, you under it, then you're below a 50 percentile. Okay, so a micro penis is like 3 inch, 3 inch. This is erect. This size is erect, not flaccid. This is an erect size measurement, right? So 87% of men think they're small. But if you're over 5.5, you're pretty good. You're pretty average. And this is erect length. Okay. So take it, take it for what it is. All right. Kind of like women, you know, women think they're small in their breasts and they like to get breast implants. Right. So just kind of know what the average is. And the micropenis is defined as 3 and erect penis at 3-inch. Okay, very good. All right, I hope I answer question. Uh, you guys have a lot of questions today. Oh my goodness. Um, um, uh, oh my goodness. Okay, uh, oh, okay, let's look at this question here. "I'm 36 and tend to have an erection just by running and working out. Is that natural?" Well, you know, when you're running, you're working out, you're relaxed, you're in the zone. Anytime you're relaxed, it's a feel-me-good zone for you. And so when you're running, you're having good blood flow going and you're relaxed, right? You're in the zone. When you're in the zone, you're relaxed. That is the perfect sweet spot to have an erection. All right. Because you only can have an erection if you're relaxed and you're in the zone. So it's not unusual to have this. Okay. It's not unusual to have this because you're most likely relaxed. Uh, and you're in the zone. So, um, you know, I, I wouldn't, I wouldn't think anything of it, uh, as well. So, uh, does, does this happen to most men? Probably not. But you're young, you're 36, you're probably healthy. So I wouldn't, I, I wouldn't think that it is unusual. Um, It could be natural. I wouldn't think it's unusual. Okay. So, good question. Because when you're running, you're working out, you're really stimulating more blood flow. And when you're stimulating more blood flow, it goes everywhere. It goes to your brain, your heart, your arms, your legs, and of course your penis as well too. And so, which is good, right? Which is good for you. Okay, so you're good, you're good, Steph. Um, uh, you're good, uh, Steph. Okay, um, okay, all right. So, um, okay, so, you know, it's a follow-up on, uh, uh, Sadhu that was watching it. Well, you know, uh, you're saying, doctor, it's very disheartening to see people eating bad food than me and not doing exercise and watching porn and still not have issues in erection. Why I have issues. Remember, you're different than them. Your body is different. There's only one of you. Your body is different. Your mind is different. Your experience is different. The partner is different as well. And unless you're there watching them when they're having intimacy, sometimes you don't know. You don't really know what is the situation. So don't assume somebody doing better than you because sometimes you don't know the details and your body is different than anybody else. All right. So worry about yourself. Don't compare yourself to anybody. All right. Don't compare yourself to anybody because there's only one of you in this world. And what's going on in your body is different. Your genes is different. Your genetic is different., right? And how you process food and how you process thoughts in your mind, it's also different than somebody else. So it's not apples to apples. You're not comparing apples to apples, all right? You're comparing apple to watermelon, all right? Two different animals. Even though you're saying, well, somebody else can eat bad and so forth, they have any problem. Well, you're just— they don't have the same gene as you do. They don't have the same processing as you do. So if you're feeling, you know, disheartening, you know, stop comparing yourself to another person because you're not comparing apples to apples. Okay, work on yourself. List the things that you need to do, right? Put that energy on on working on improving what you— improving your erection and what you need to do instead of trying and try to put in that energy thinking about other people and feeling disheartened because that's just negative energy that you do not need. You just need to put that focus and that energy on yourself. All right, just know there is no one out there that's like you because your genes are different, your thought processing is different, your enzyme is different, your body makeup is different. Okay? So do not compare yourself to anybody else because there's only one of you and you're not comparing apples to apples. Right? I hope that helps because I know that it's a natural tendency for us as humans to compare ourselves to other people. Right. But by doing that, you're just really putting negative energy in your body that you don't need. All right. Positive energy, gratefulness, and good thoughts are what you need. Okay. All right. Let's put that out. Let's put that out there as well. Well, you're welcome, Charles. You're welcome, uh, Def. Um, um, at this point, and so, um, so, um, you, uh, well, I hope that was helpful. Very good. Well, very good. I hope that was helpful there. And, um, here's a question on, um, "Any tips on getting over varicocele?" Varicocele is swelling of the testicle. It's swelling of the testicle. Sometimes that can be caused by trauma, where there's blunt force that hit your testicles and then your testicle swell up. So the number one thing is to get— make sure you get a CT scan to look at the testicles, right, to see where is the swelling, how big is it. And then the second thing is you could— yeah, so get a CT scan. And if it doesn't hurt and it doesn't bother you, then you leave it alone. But if it hurt, then you need to see a urologist and get the CT scan and see if it, you know, where it is and how big it is. And then also, also get your testosterone level checked because the testicle is what makes testosterone. All right. So does it damage the production of your testosterone from that testicle? So, but you have two testicles. And men get testicle removed, one testicle removed all the time. And so you want to test your testosterone level. If your testosterone level is low, then you may need supplementation. But most men with varicocele don't do anything about it, just leave it alone. But make sure you get a CT scan to evaluate it. Okay? And then once you know that it is just a fluid or cyst, what you could do is— but make sure it's not cancer, okay? What you could do is you can massage the testicles for it to maybe reduce some of the swelling. Because when you massage an organ, it has more blood flow. So when it has more blood flow, it will perhaps decrease the swelling as well. So how you massage the testicles is just light, gentle massage with these 3 fingers, just going around your testicles like this. Feel the top part, feel where the— it's called the spermatic cord— feel the top, feel all around, and just massage on a very light, Don't squeeze a lot, just a very light squeeze, very light touch around your testicles and just massaging it around right there. Okay? You want to do like 2 minutes to use both hands, just go around the testicles, massaging it like that around for about 2-3 minutes. Okay? You want to do that once a day and see what happens. All right? But make sure you get a CT scan first and not cancer. All right. Was that helpful? I hope that was helpful. All right. So I just talk about varicocele. Sometimes varicocele happen and it does stay there for a long time. I see patients with varicocele all the time. I see question that varicocele all the time. Um, and, um, most of the time you just leave it alone. Leave it alone. But you do want to make sure that it's not, uh, uh, uh, it's not growing and it's not causing atrophy of the, uh, of the testicle itself. That's why the CT scan help. Okay. Um, that's why CT can help. Um, Okay, all right, and, uh, I hope that was helpful, but it's common. It's actually very, very common, uh, as well. So, uh, Sidhu here said, 'Doctor, you are right, the Viagra is not a solution, especially for maintaining erection, because if arousal issue is not fixed, Viagra is useless.' Absolutely, Viagra does not address arousal. All right, where do you think the erection starts? And your erection starts here, right? It's here. Your erection starts here, not in the penis. Okay. All right. Now, when you're in your teens, when you have wet dreams, or, you know, when, when you have like a spontaneous erection because somebody brushed against it, then that kind of takes the brain out of it. But as you get older, the erection starts here. The erection starts in the brain, right? Because the arousal has to start first. You have to get aroused, right? And the erection starts in the hormone and the nerve that gets stimulated in your brain to transmit that message to the nerve in the back of your head, which then transmits that message to your heart. All right. And that way it can pump more blood out and then through your blood vessel, which has to expand, and then to your penis muscle. So that's why when I created the Get Hard System, we address the whole system that is involved in getting hard. That's called the Get Hard System. Involve the brain, right? The brain, the emotions, what emotional state you in, the hormone, all that happens in the brain. Hormones getting released, all the hormones getting released, and then the nerve, the blood vessels, and the muscle is a 6 system of the get hard. But in order for you to get an erection, you have to get aroused. And arousal starts in here. So your body is made so that way. There's 5 ways for you to get aroused. You can get aroused by what you see, what you smell, what you eat, what you hear, what you touch, and also your thoughts. Don't forget your thoughts. Your thoughts are about the 6th system. You can get aroused just thinking about it without using the 5 senses that I just talked about. So there's really 6 ways to get aroused, right? You get aroused by just thinking about it, right? So arousal starts in here, and then that gets— those messages get pulled to then mix in with the emotions that you're in, right? What are the mood you're in? Are you stressed? Are you anxious? Are you depressed? Are you relaxed? Are you relaxed? Are you worried? So that gets mixed in with the emotion and then gets filtered through that. And then from there, the hormones get released. There's a hormone that your hypothalamus gets released and it releases hormone, the dopamine, it releases oxytocin, it releases follicle stimulating. It's like all these hormones get all released. Which then, this is all occurring in the brain, would then transmit the message to the nerve in the back of your head to the parasympathetic nervous system, which is responsible for stimulating erection. And then that message goes to your heart, which tells your heart, pump harder, pump harder, so that way you get more blood coming out from the heart. But then when the heart pumps harder, it goes through your pipe, which is your blood vessel, which carry— your blood vessel carry the blood from the heart to your penis. But the blood vessel have to be flexible in order for it to accommodate the increasing pressure and increasing blood that's being produced by the rapid beating of the heart. When the heart beat more rapid to bring in more blood flow, the blood vessel have to expand. In order for it to expand, it needs to have adequate nitric oxide, right? And then it also needs to have a good endothelium, which is the lining of the blood vessel. So when it expand, then it'll go through to the penis, right? It goes to the penis and then the penis muscle itself has to be flexible in order for it to expand to receive the blood. Okay. So all of that occur within, you know, second to minute. And but it's like a symphony, a symphony that require 6 players. But if one player is off tune, then it's going to affect your erection. That's why erection is common, because there are 6 things that need to occur in symphony and in alignment. In order for erection to occur. In order for erection to occur. So, the point I'm trying to make is that what does Viagra do? So, Viagra, all it does is that it increases nitric oxide in the penis so that way it can have more blood flow. But it doesn't fix the cause of the problem and it doesn't help with arousal at all. So, if you have arousal problem up here, which, what's arousal problem due to? Well, porn, stress, anxiety, right? And also distraction, right? So, it doesn't help you with arousal. If you don't have arousal, then it doesn't matter how much Viagra you take, it's not going to help you. Right? So, that's one of the things I want to mention, and I'm glad that you brought it up, Sudhan. Okay? And that's one of the reasons why Viagra only works 70% of the time, because you're not spending the time on arousal. But remember, an erection starts in the brain. So, if you really want to work on your erection, you really need to work on your emotion. Right? Because if you're— I can't tell you how many times I see my patient that we fix them up to get increased blood flow to the penis, but they're still having erection problems because they have performance anxiety. Or they have trauma, or they feel depressed from it. Right? So, even though everything is working physically, they still can't get an erection because of their emotional state. I have a patient right now that I'm working with, and now he's doing better because we are doing a treatment called far infrared, which uses terahertz, which Anne Truong MD: Then it's a treatment that goes along the nerve. It's topical, not invasive, and we use a wand. And what it does is that it calms— it brings down the sympathetic system and brings up the parasympathetic system. When the parasympathetic system is higher, then parasympathetic system induces erection. Okay, but it also will also lower his anxiety as well. So when we're doing treatment with far-infrared light with him, we address the whole spine, then we address the vagus nerve, and then we also work with acupuncture meridians to unblock it so that way he can be in a more natural balance state. Okay. So I'm going to have to do a video demonstrating how I do that. Um, uh, in the future. I would have to do that in the office. I would have to do that in the office as well. Okay, so, um, that, that, that's a good question to follow up, uh, Sudan. I'm glad you, uh, mentioned that. Okay, uh, The question here is, uh, is it safe to wear chastity cage? Um, I don't know how to answer that question because it depends on how this chastity cage is, right? Um, uh, and, um, if you're doing it because you want to not have intimacy, fine. If you do, uh, then it is fine, but it depends on how the chastity cage is made. Whether this is affecting the penis or the blood flow or not. But the thing, if you're doing it so that way you don't have intimacy, then, you know, if you're doing it for a month, you may have some atrophy there. It also depends on your makeup. On your emotional state, right? So, I don't know how to— I shouldn't cause ED, but again, there's probably a reason why you wear that, and I don't know the reason why. Okay. All right. And then, Sadhu said, "Are SSRI prescribed for premature ejaculate by doctor? Isn't this risky for the mind?" No, it's not. It's not actually, it's not risky. SSRI, all it does is serotonin reuptake inhibitor. It allows more serotonin to be available in the brain and that helps with depression. I'm not convinced that it helps very much with premature ejaculation. I'm I don't use it that much for premature ejaculation, but it's not risky in the mind. It increases your serotonin, and if you have a good serotonin level, it makes you feel better. But that in itself, that in itself, you know, alone doesn't cause ED. But if you have other issues as well, that may contributing as well. So that's one of the reasons for men to stop their SSRI or depression medicine is because it's affecting their erection. But also know that your erection starts in the brain and is processing through your emotional state as well too. So sometimes it's not the medication so much. Sometimes it could be your emotional state going on here. Okay, so don't stop your, your, your anti-depression medicine. And also know that premature ejaculation is, you know, something that most men think that they have premature ejaculation when it's not the case. Premature ejaculation is defined as after penetration and you ejaculate within less than a minute. Less than a minute. Now, most post-coital, most intercourse, once penetration lasts between 5 to 10 minutes. 5 to 10 minutes once penetration. So, unless you time it, most men think that they have it when it's probably just not the case. And it has to occur very frequently. I mean, occurs every time and with different partners. As well. And so, one of the suggestions about premature ejaculation is take an antidepressant, but then taking an antidepressant may or may not help, and it may even contribute to getting an erection. For premature ejaculation, I would advise just putting in maybe a numbing cream like lidocaine. You can even get lidocaine over the counter and just put it on the tip Put it on the tip of the penis here to numb it up because the tip is very sensitive. So, you can put the lidocaine on the tip here. Be careful, the lidocaine can rub off on your partner as well too. You can put the lidocaine here. You can also wear a condom. But if you think you have premature ejaculation, just before you have sex, go to bathroom, right? Go to bathroom right before you have sex so you clear your bladder, right? And you go to bathroom and then you also want to— you can even use a penis pump, actually. If you use a penis pump before you have intimacy, it will actually help you last longer. So, you know, like within 30 minutes before you have sex, use the penis pump, or right before you have sex, use the penis pump. It will actually help with that. You can wear a condom, right, for premature ejaculation. But most of the time, it's really distraction, right? So, for premature ejaculation, you can Once you penetrate, you can distract your mind and think about something else to delay the ejaculatory response. So those are just little tips that you can do. But again, premature ejaculation is oftentimes not even the case. Okay. Um, most men think that they— it's like 87% of men think that they're smaller when in fact they're, they're not, um, at all. So, um, yeah, I, I see these questions asked over and over again after— when every time I do live, um, and so, uh, just know what the facts are. Subscribe to my channel if you're not. So those of you here that have asked me questions. Do me a favor. Do me a favor. And if you haven't subscribed to my channel @DrAnneTruong MD, go ahead and do that. Go ahead and subscribe. It would mean the world to me if you subscribe and put notification, put a notification on there. Every time I go live, you get notified. And share this with somebody that you know of. Because remember, ED is prevalent in 50% of men over 50. And the older you are, the more chance you're going to get ED. And just know that ED can be reversible. You don't have to live with this. It can be reversible. All right, but you got to treat the root cause of ED. You're taking a pill, you're taking Viagra, Cialis, that's not treating it. That's not really treating the root cause of ED. Okay, so it can be reversed. Start early. The earlier you start, the better you can reverse it. You keep delaying and delaying and delaying it, the problem is only going to get worse. It's kind of like a car. If your car start having problem, you get it fixed, it does great, right? But if you keep driving it until it break down, then the problem is going to be more significant and even more damage being done. Okay? And so just know that ED is not an inevitable part. It's not like you get older, you have to have ED. No. Okay, kind of like, you know, some people don't have gray hair, a lot of gray hair when they get older. Some people do, right? So it's not, uh, something that you get when you get older. I want to stress that. It's just that ED is more common when you get older because you tend to have medical conditions that set you up for ED, such as high cholesterol, um, high blood pressure, diabetes, obesity, you don't exercise, you don't sleep well, you have more stress. Those are the main things that are contributing to it. And then also your testosterone level drops too when you get older as well. Mother Nature thinks when you get older, you should die. And Mother Nature thinks you should die around 50 to 60. That's what it is. So that's why Testosterone level drop, all the hormones in your body drop. And that's why you start to see ED more prevalent. And in fact, if you're less than 35 and you start to have ED, then unless you've been a diabetic for a long time or high blood pressure and don't exercise, that may be physical. But most of the time, if you're less than 35 and you have ED, then not so much physical. It may even be more psychological as well. And psychological, I count porn in there and also lifestyle. If you're young, less than 35, you have ED, check your lifestyle. Meaning, do you smoke? Do you do marijuana? Do you sleep? How much alcohol do you drink? That's what I mean by lifestyle. And then you should get your blood sugar checked as well too. But when you're 35, even though you have high blood pressure or high cholesterol, even diabetes, it hasn't kicked in yet to a point of damage unless it's totally out of control as well. Okay. So, but just know that if you follow the Mediterranean diet and if you exercise accordingly, your blood pressure will go down, your cholesterol level will go down, and so is your blood sugar level will go down. All right, so it does help with, with high blood pressure, high cholesterol, and diabetes. Okay, so the two levers that matters the most is follow the Mediterranean diet and do moderate exercise. 3, 4 times a week. And you don't need to join a gym. You can just walk, right? You can walk outside, walk indoors as well too. So you can definitely do that. All right. Having said that, thank you for being here with me today. I will be back. I will be back next Monday, 12 PM Eastern Standard Time. You can, and we can do another Q&A questions at that time. All right. Thank you so much. I'll see you next time.