The #1 Lie About ED: Why Pills Won’t Fix the Real Problem
12 Dec 2025 · 22 min
A monologue podcast by Dr. Anne Truong (intimate health MD and author) explaining that erectile dysfunction (ED) is primarily a physical, vascular problem rather than "just in your head." She outlines the biology of erection centered on nitric oxide and cyclic GMP, explains endothelial dysfunction, arterial insufficiency (small penile arteries), venous leak, metabolic contributors (insulin resistance, inflammation, atherosclerosis), nerve and hormonal roles (testosterone), and common lifestyle risk factors. Dr. Truong emphasizes that ED is often an early warning sign for cardiovascular disease, is frequently reversible by treating root causes, and promotes her programs/products (Get Heart/GET WOOD NOW, supplements, smoothie, Mediterranean diet).
Questions this episode answers
Over 7,000 men.
Erectile Dysfunction Fix.
Decreases by 50% after age 40 (host claim).
About 1 to 2 millimeters in diameter (host claim).
About 3 to 4 millimeters in diameter (host claim).
Chapters
This podcast is for you. The Modern Man I'm Dr. Anne Truong, your host. I'm an intimate health medical doctor and best selling 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@sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside.
Foreign. Hello there modern man. Have you ever been told your ED is just in your head? I'm Dr. Anne Truong. I'm a medical doctor who's helped over 7,000 men restore sexual function naturally. My own husband struggled with ED and what I discovered changed his life and and thousand others. Today I'll show you the real reason behind ED and why it's not your fault. This will save you years of frustration, fail attempt at solution, and even money. So stay tuned to the end. The reality is ED is largely a physical problem, which is good for you. And once you understand the real mechanism driving it, the actual biological breakdown happening in your body, you'll finally understand why generic advice has not worked, the pill has not worked, and what real solution actually need to address. So I'm a physician specializing in sexual medicine and regenerative medicine, and I spent over 25 years studying the astrophysiology behind ED. Today we're going real deep under real root causes that most men never hear about. So let's start by debunking the myth that got us here. For decades, medicine categorized ED into two bins. Psychological or mental or physical. As if ED is one or the other. However, this binary thinking led to a massive blind spot. When doctors couldn't find an obvious cause. They'll tell men, oh, it's just in your head or relationship stress. The patient believed that he start doubting himself and the actual physical breakdown goes untreated. So here's what the research now clearly shows. In a comprehensive analysis of nearly 2000 ED patients, 86% had a primary physical cause causing the breakdown. 86% have primary physical cause that cause ED. Only 14% have purely psychogenic causes. And get this, even those men with pure psychological ED often develop identical severity core scores to those men with organic ed. Why is this? Because when you live with dysfunction and anxiety become a physical stressor, that makes the problem worse. And the mind and the body aren't separate system, they're together and integrated. But the originating cause in the vast majority of cases is biological or physical so the takeaway, if you have ed, something in your body is broken. It's not in your mind. So this isn't theory. This is what peer review research published in journal, in Nature Journal, Sexual Medicines and Circulation consistently demonstrate that ED is a vascular event. First, it comes from blood flow. Essentially, it may trigger psychological consequences, but it originates in physiology or the physical causes. Number two, let's talk about the nitric oxide system. To understand ed, you need to understand the molecule that makes erection possible. Nitric oxide. No. Nitric oxide is a signaling molecule. It's not something you eat or supplement easily. You could take it from the supplement or supplement called arugula, because it is in its pure form, but it's produced through the body if you eat through beets. And it's the primary function, erection. So here's how it works in a healthy man. When you're sexually stimulated again, erection starts in the head. The nerves in your penis release acetylcholine, which then trigger the cells lining the penis artery, the endothelial cell, to produce nitric oxide. Nitric oxide then binds to an enzyme called soluble guanylyl cyclate, which then kind of stimulate cyclic gmp. And cyclic GMP is the actual worker molecule. It relaxes the smooth muscle and the corpus cavernosa, which is the smooth muscle, the penis, the spongy tissue that then fills up with blood during an erection. As that smooth muscle relaxes, the arteries or the blood vessel open up, blood rushes into the penis, the pressure in the penis increases, the the veins collapse, trapping the blood inside the penis, and you get a rigid erection. This entire sequence depends on adequate nitric oxide production. So what happens when you don't have enough nitric oxide? Well, the smooth muscle doesn't relax, the artery doesn't open up, the blood doesn't rush in. No erection or weak incomplete erection. But here's the problem. Does the condition and lifestyle factor destroy this capacity for you to make nitric oxide? All right, let me break this down for you. Number one, endothelial dysfunction. The endothelium is a cell that lines the inside of your blood vessel. Imagine like a pipe like this, and it lines the inside of it. This is what makes nitric oxide. These cells become damaged with aging, high blood pressure, high cholesterol, smoking, diabetes, and inflammation such as oxidative stress. These cells, when they become dysfunctional, they cannot make nitric oxide anymore, especially oxidative stress. Oxidative stress means your body has too many free radical or poor inflammation from poor diet. Smoking stress may attack and destroy Your nitric oxide molecule. That's why you're producing less nitric oxide than before. Another thing is insulin resistance. This is huge. When your cells become resistant to insulin, insulin essentially drive its hormone that drive blood sugar that floats in your blood vessel into the cell. When insulin become resistant, several things happen. So what happened is that with insulin resistance, this activation fails. So simultaneously inflammation increase which then damage the endothelium and decrease nitric oxide. Men struggling to stay hard. Most of the time it comes down to poor blood flow. That's why I put together the Good Morning Wood Smoothie, A new nutrient packed blend designed to restore blood flow naturally. My patients often notice improvement in just a few weeks when they take this part of their daily routine. Click the link below to get the recipe and start boosting your blood flow and firmness today. Or go to good morningwoodsmoothie.com inflammation. You can measure inflammation by a high CRP or C reactive protein interleukin or even other molecules such as TNF alpha. But these inflammatory markers actively damage endothelial cells, again reducing nitric oxide and no erection. So when someone tells you ED is in your head, what they're actually missing is that you have a biochemical breakdown in nitric oxide production or even availability. That's a physical problem, a real problem, one that require addressing the actual mechanism. That's why I created the nitric oxide supplement. Check it out at our store@ednomore.com when you take this nitric oxide, it will give you more nitric oxide even when your enzyme is not working. Well, know that as you age, once you get over 40, your nitric oxide production decreases by 50%. So even if your nitric oxide system is working, you still need adequate blood flow to the penis. That's where blood flow or vascular insufficiency comes in. Your penis arteries are small, about 1 to 2 millimeter in diameter. They're like a size of an ant. They are fed by larger arteries that branch off of the groin arteries. So those larger arteries are narrow or stiffened, which then happens with conditions like atherosclerosis, high blood pressure, chronic inflammation. Your penis then doesn't get enough blood flow in there. This is called arterial insufficiencies and it's one of the most common form of ed. So here's a clinical metric. Researcher measures something called peak systolic velocity and it's the speed of blood flow in your penis during arousal. If that velocity dropped below 25 centimeters per second, you have a significant arterial insufficiency. Your arteries Become too narrow, too stiff, not enough blood getting in. So now what causes the artery to narrow? A condition called atherosclerosis. Plaque buildup in your artery the same way you that plaque buildup in your heart. This happens when you have high cholesterol, diabetes, high blood pressure, smoking, overweight, and eating a poor diet. So the plaque narrowed the artery. So think of the arteries like a pipe. And the plaque is like a gunk that gets stuck on the side of the pipe. So it narrows the opening of the pipe so less blood is flowing in. Are you following me on that? Great, because this is what happens. It starts first in your penis artery, because penis is so small, it's only 1 to 2 millimeter, which is like a size of an ant. And the arteries in your heart is about 3 to 4 millimeter. Okay, so your ED is almost like a warning sign of poor blood flow. Here's the thing, the lining of your arteries become non functional. Blood doesn't flow smoothly, and plaque starts to stick and get bigger and bigger and bigger. And then after that, your arteries become stiffer, so it doesn't become flexible at all. But here's something most men don't know about. You also need outflow to work properly as well. Outflow from the penis. So for the erection to be maintained, the vein that brings out the blood out of the penis need to be compressed by by the increased pressure in the corpus cavernosa. So if this venous tone is impaired, or if the smooth muscle in those vein doesn't respond properly, the blood leaks out. So again, you no longer have a rigid erection. This is called venous leak. So if you have artery, which is incoming blood that comes in it being insufficient, then you have venous leak, which is blood going out. It's insufficient. Well, that's a double whammy. So sometimes you may need to have a Doppler ultrasound to identify is it inflow or outflow problem there. Okay, so I just want to mention that at this point, but here's something critical that changes how you should view your ed. Your penis arteries are significantly smaller and therefore your ED is really a warning sign, guys, that you're going to have some heart issues in about seven to 10 years. Keep that in mind. Don't ignore Ed. So Ed isn't just a sexual problem. It's a warning sign. Treat it properly. By addressing the root cause of it, you're going to save your heart and you're going to live longer. All right, so other causes of ED is what's called metabolic dysfunction and what it means is that it's a metabolic syndrome that if you're overweight you, you're pre diabetic or diabetic. And if you have high blood pressure and high cholesterol, Your risk of ED increases by 2.32% compared to men without metabolic disease. There are many things that can contribute to ED that really, really affect the lining of the blood vessel and your nitric oxide production. And don't forget that diabetics you are three to five times more likely to get ED than non diabetic as well. And another thing I want to mention is that testosterone also play a role in erection. However, testosterone is often blamed for ed. But here's what the research shows. Most men don't have ED problem because of low testosterone alone. Hypogonadism or true testosterone deficiency is a rare cause of ed. However, testosterone influences erectile function through multiple mechanism which is nitric oxide production is regulated by testosterone as well. Penile nerve function is also maintained by testosterone. And the vascular health or the endothelium also is controlled by testosterone and even psychological arousal. Testosterone played a huge part in desire motivation, which then trigger the whole erection cascade. So while low testosterone isn't usually the primary cause, it is often the contributing cause. And addressing it can improve outcome when combined with other treatment for blood flow. What's important is to know that ED is caused by vascular hormone inflammation. And now we're going to talk about nerve. The erection function also depends upon the nerve signaling as well. If the nerve has to travel all the way from your brain down to your penis. Conditions that affect your nerves are diabetes and a nerve injury such as spinal cord injury. Pelvic surgery like prostate surgery or bladder surgery or rectal surgery can lead to ed. And even peripheral neuropathy can lead to ED as well. So interestingly, research shows that improved vascular health or blood vessel health often improve nerve dysfunction that causes ed, because the nerve and the blood vessel are correct dependent on one another. So essentially, if you improve your blood flow, you also will improve your nerve as well too. And don't forget the psychological layer. So I'm not dismissing psychology. The mind and body connection is real and powerful. But here's the accurate picture. Psychological stress and anxiety don't usually cause ED in men with healthy blood flow, healthy metabolic system. Instead they often emerge as a consequence of ed. So a man experiences ED once and then have anxiety about it, which increases the anxiety trigger his sympathetic nervous system, which is fight or flight, which means it's a stress system. And then that system will Narrow the blood vessel and therefore decrease blood flow. Now he has a genuine performance anxiety problem layer on top of his original blood flow and metabolic problem. Do you follow me with this? So it really do tie together. So if performance anxiety is a real complicating factor, but it's rarely, rarely a root cause in men over 40. But, but here's what's critical. If you treat the anxiety but don't address underlying vascular blood flow or hormone problem, your ED will persist. You might feel better, but the physical part still remains. So that's why the common scenario for ED is usually mixed a combination of physical and psychological and you need to treat both. And that why treating the root cause matters, because when you restore proper blood flow and metabolic function, the psychological component often resolved on its own as well. Other risk factors, you know, I want to mention too is smoking, poor diet, diet that's high in fat, high in sugar, and then sedentary lifestyle, no exercise, and then increased body fat or obesity and uncontrolled high blood pressure and, and uncontrolled blood sugar and chronic stress and sleep deprivation. Don't forget alcohol abuse. Drinking more than 14 drinks a week is not good as well too. 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 back ways to boost circulation, support healthy testosterone and improve sex extra 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. Testosterone and better erection. So the critical insight is most med ED is reversible. I want to say that again, reversible. By addressing these modifiable factors, you're not stuck. Your body can heal with the right intervention. So this is what I did for my husband. I used the Get Heart system to address the 6 system between the brain, the hormones, the nerve, the, the blood vessels and the muscle to treat his ed. That is our GET heart system. And I've been doing this for a long time. I've seen thousands of patients, I've seen them improve by us treating the root cause. Okay, so when you treat the root cause, you take care of the problem permanently and then you get restored function again. That's the reason why I created the GET heart system to treat ED at its root function. Find out if You're a candidate for the Get Heart system to restore erection again and kill ED at its root cause. Check down the link down below right here on how to work with me to get out of that. And also check there's an ebook that I wrote the five mistakes Men with ED make because don't make those mistakes. Just know that ED is reversible when it's treated early and that you don't have to live with it. There are natural alternative that will get you out of ED and you are not broken, right? There is nothing shameful about this address this head. We are here to help you. Having said that guys, I will see you in the next episode. Make sure you subscribe to our channel. That will make my day if you do so. Thank you so much. Okay modern man. You are not alone and you don't have to suffer anymore. ED can feel isolating, frustrating and even defeating. The endless guessing, the quiet shame, the weight of not feeling like yourself. It's exhausting. But here's the truth. You are not broken. You are not alone. You don't have to figure this out alone anymore. The Get Wood Now Boost program is your step by step path to sexual confidence and restoration. No more suffering in silence. No more trial and error. Just real solution, real result and the confidence you deserve. It's time to take back your power on your term. Let's get this journey started together. Check out the corner course@getwoodnow.com I'll see you there.
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 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@sexualhealthformenpodcast.com to get the book the Five 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.
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Until next time.
