The 6 Easy Steps to Get Hard Webinar: Q and A Portion
11 Nov 2025 · 25 min
Dr. Anne Truong, an intimate-health physician, answers questions about erectile dysfunction treatment. She covers lifestyle changes like diet and sleep, supplements including beet powder for nitric oxide production, and newer options like intrapenile Botox and platelet-rich plasma therapy.
Questions this episode answers
About 100 units (also mentions a 50-unit arm in referenced study).
Reportedly about nine months (some patients possibly longer; injections every 9–12 months).
$2,900 (approximate cost mentioned).
Range cited as 300 to 900 ng/dL; example of a patient increasing from ~300 to ~600 after lifestyle changes.
A recent study in Japan and Korea treating about 300 men who had failed ED medication (as described in the talk).
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.
I'm ready for questions. I hope you guys are in awe. Either that or I bored you to death already, so let me stop sharing now and. All right, I probably bored you to death from all this talking or I overwhelmed you too much. All right, Good. We got 11 people left. Okay.
Didn't put us all to sleep.
Any questions?
I don't know, you've done a pretty good job of explaining it. You know, I've been doing helping guys in the group for two years and, and I'm still learning stuff. Learned some stuff tonight.
What did you learn? What did you learn?
Well, I had no clue. I had no clue that botox could treat erectile dysfunction. So that was a big one. And I'm just learning how important the nitric oxide is. I got your morning wood smoothie recipe and I got all the stuff for it. I've had it for like four days and have made one yet. So now you've motivated me to get one made.
Exactly, exactly. Yeah. Somebody said here, can you type in the chat Roslyn, for everyone on the website, Dr. Is Dr. Men.club. so D R M E N dot club is how you get the free ebook. But yeah, I love to hear your feedback on the good morning wood smoothie. Like I said, the men that are in the club, he had prostate cancer, he did the smoothie, he started eating following the Mediterranean diet, started sleeping better. That's all he did. He had prostate surgery and now, you know, he's able to get morning erection again.
So one little piece of feedback for you is in your smoothie recipe you mentioned nitric oxide powder. I drove myself nuts trying to find nitric oxide powder until I realized it was nitric oxide. Beet powder.
Yes. Yeah, no, that, you're right, it is beet powder. And I give a link on where you can order that. And I'm very picky what supplement I recommend. And the supplement, the nitrous oxide powder is the. No, beet powder. That is the most effective one. Okay, those of you that are on here, I'm going to tell you do not take L citrulline and L arginine. In fact, you know their company, and you go on the Internet, they say, well, you take L Citrulline. L Arginine is going to increase your nitrous oxide. In fact, it does the opposite. When you take a supplement that has L citrulline or L Arginine, it will actually create a very inflammatory molecule. Not even nitrous oxide. It's a cousin of nitrous oxide, and that is inflammatory to your endothelium, which is the lining of your blood vessel. Do not take L Citrulline. L Arginine. All right.
I've been taking it two years, so, yeah, this is good.
Yeah.
Now, does it have. Does it have an impact on testosterone, the lr.
No. No, it does not. It does not have an impact on testosterone. You know what has the best impact on testosterone? Sleep. And your diet. I can't tell you how many times I see a patient, they come in with low testosterone, and I advise them to sleep better, and they change their diet. I see their blood Testosterone go from 300 to 600. The range for testosterone, 300 to 900 is the range, all right? And I've seen it go from 300 to 600. And all they did was change their diet and sleeping better. And I'm not. I'm not talking about drastic change. All they did was just, you know, eat less red meat. The red meat is very inflammatory. And eat less carb, less chips, less French fries. You know, that was it. But you still eat, you know, bread and so forth and fine, but I see it jump double. Now, you know, your doctor may look at your testosterone level and say, oh, you know, it's normal, even though it goes from three to 600. But, Galen, you may be functioning optimally at 800. That's just the way you are. But if you drop down to, like, 400, you start to have. You're starting to notice your libido changing. Your erection is not as good. Even though you're in range, that's still low for you. Every man has a sweet spot on what his testosterone level is. I've seen many men that has symptoms of low testosterone. What's low testosterone is fatigue, weight gain, not able to concentrate, Libido. Your libido is low moodiness, easily fatigued. Okay? And that could even start as early as in the 30s as well. So. But then I get the blood work, and their testosterone level is about 450. It's in range, but it's still low. For them because they're functioning at around, you know, maybe 700, 800. And then when I, when I give them more testosterone, they feel so much better. So, you know, come and see me in the office that they're done for you. But you can increase your testosterone by your diet, by your exercise, that if you do hiit exercises, then it will actually help you increase your testosterone as well. But if you can't do that, sometimes when you get older, you just can't do that. Right? You can't get older, you can't do that. You can just walk and you can just change your diet alone and that will, will actually be impactful. Can you type in drmen club at the URL there, Roslyn? Because I don't see it in the chat.
It's already here. Oh, let me just type in again. And doctor, and we have a question from iPhone8. Okay, let me read it to you. He said, could you explain more about Botox treatment and how you get access to it. Also a bit more about how it works.
Right, okay, that's a great question. That's a great, great question. So you can only get Botox from a doctor that's injected. It has to be injected into the penis and it has to be a doctor that knows how to do it. And the research just came out Galen just really last year. So the research just came out last year in a study in Japan and Korea that they treated 300 men that fail ED medication. They take ED medication. Did not. They'll have ED. That's pretty severe. Right? And they just treated them with just Botox alone, 100 unit and 50 unit and they were able to have an erection within about five to seven days. And how Botox works is that Botox increases nitrous oxide in the penis. It relaxes the penis muscle. Remember I said in order for you to get an erection, your penis muscle have to be relaxed. If your penis muscle is not relaxed, you're not going to be able to get an erection. So the same way that it's injected into the face and help with wrinkles, it helps with wrinkles because the muscles are relaxed. That's why the wrinkles go away. The muscles are relaxed. They're not contracted. When the muscle is contracted, that's what causes the wrinkle. So it relaxes the penis muscle. It increases nitrous oxide. Right. And it also increases cyclogmp cyclic GMP is psychogmp is how Viagra work is that Viagra eliminate Viagra allows cycle gmp, which is a Neurochemical to be, to be more. But so Botox works the same way. The Botox is almost like Viagra, but it's more natural. And these men, their erection is restored for nine months. Nine months.
My next question was how, how long between injections?
9 months to a year. Yeah. And that without, that's just Botox alone. So now I'm doing Botox with their own stem cell, their blood, the platelet rich plasma. So I'm doing that for, with the blood. So. So now we just started doing that last year around June and up. Patients are still having, patients are still having a good erection. So for me they haven't come back yet. So it's at least been nine months already. I'm hoping along with the thumbs up. And the Botox is lasting longer than a year. But what the best thing about the Botox is that they start to see a better erection and especially a morning wood within five days after treatment. And because how it works is that you'll see the penis being fuller and that you have about a half an inch enlargement in girth and also in length as well too. So you have to be really careful who you go see. You have to go see somebody that specializes in sexual health that understand the research and knows how to inject it into the penis. And you know what, you know Botox been used for 20 years on women. 20 years with no sign of. And these women get Botox every three months. But we know that injecting to the penis is last nine months. How does that happen? We don't know. But maybe because the penis muscle is a smooth muscle that's different than the face. The face muscle is not a smooth muscle. Face muscle is a voluntary muscle. So the smooth muscle in the penis, it work, it works differently. But we know that it lasted about nine months and you need about 100 units. All right. And you got to know there's a specialized way to inject that and that it's not going to be toxic because some doctors will say, well it's poison because it can go to your blood vessels. Also going to cause you to be paralyzed? Absolutely not. The lethal dose of Botox, it's a thousand times more than 100 unit. It's 10,000 units. So you got to be.
Is this something, is this something we can get done like at a university? Like I Dr. University of Colorado Health because of my heart transplant. Can a university doctor do this or is it. We're talking.
Probably not. You're probably not. Right now there's only A handful of doctors that are doing it. There's one. Well, there's one doctor in Texas that's not that far away from you, Dr. Runnels in Texas that are doing it. There's one and I'm in Virginia. There's another one in Mississippi. There's one in Texas, I think, you know, you have to go to the sexual health doctor that familiar doing it that you usually. The university, I can tell you they're more conservative. This is just new research that just came out. They're more conservative and honestly, they're restricted by the system they worked in that they probably aren't probably not doing at this point. Ride in Virginia, fly to Virginia and I'll do it for you.
My arms aren't that strong. So I'm guessing this is not covered by insurance because of. It's a cutting edge.
Right.
Treatment, so.
Right, right, right. And the cost of that run to about 2900 is the cost for the Botox injection.
Okay, one question I have and it's not. You haven't covered it tonight and is that. That's red light therapy. Testosterone improvement. What's your take on that? I think my university, my University of Colorado urologist, he said, nah, I can't remember recommend that.
I can't. That. I totally second that. And if I haven't talked about it, I haven't seen the researcher support that.
Okay.
Okay. So that's. Don't waste your money. All right? Red light therapy is like something that, you know, sexy.
Well, I can get me a red light at Walmart for 10 bucks.
Exactly. You know what the best thing is? Sleep. Eat more vegetable fruit, decrease the red meat and take a walk 30 minutes a day. All right? No, seriously, don't spend any money in red light. Don't even spend money on both. House, I'm telling you, just start doing that, you're going to start feeling better. That's what my morning wood smoothie. Egg. My morning wood smoothie. I think you put that in the Facebook group. It's free. And that, you know, you put antioxidant vegetables in there and fruits in there. And antioxidant, it's what repairs that endothelium, which is the lining of the blood vessels. So oftentimes, you know, the men like to try something new, something innovative, something, you know, tech. It's not that high tech. It's really back to the basics. Back to the basics of diet, exercise, sleep, stress reduction, stop smoking, moderate alcohol. So watch the alcohol. Alcohol is inflammatory. Yes. When you initially drink alcohol, it Relaxes you so that when you become disinhibited. But too much alcohol, guess what? Right, Whiskey dick, Right? The alcohol actually will kind of numb the nerve in your brain as well as numb the nerve in your penis. And that's why you, that's why you get whiskey dick. And it also, too much alcohol will actually cause the blood vessel not to open up. It's just not responsive. So you have to be really careful. And it is alcohol toxic for your liver? Not that I'm advocating stop alcohol. I love my wine too, as well. It's just, you know, there's a certain number. Keep it under 10 a week if you can. And, but, but best thing is, you know, it's what you're eating and sleep. It's the best medicine for you. Have good sleep. Make sure you dream when you're sleeping. A REM sleep will reset your circadian rhythm. And also, don't, don't ever neglect the power of nature. Why is that? In the morning when you. I'm going to give you a hint on how to do your morning routine. In the morning when you first wake up. Within the first hour, go outside, stand outside for 20 minutes and open your eyes and look straight ahead. Let the sun shine on you. Because when you have the sun that shines in your eyes, it's called photobiology. The sun will actually go to your, your retina and it actually reset your circadian rhythm again. It actually will help stimulate more testosterone and it decreases cortisol hormone, which is. Cortisol hormone is the stress hormone. All right, so Mother Nature going out in the sun within the first hour will help. And you know what else will help increase testosterone too, and would increase your metabolism. It's a cold shower. We research, recent research that just came out says if you take like a cold shower, stand a cold shower, let the cold water. I'm talking about very cold. I'm talking about like 37 degrees Fahrenheit. Cold. That's cold. 37 degrees Fahrenheit. Cold. Cold, cold water run down your, your head, down the back of your neck, the back and your upper shoulder area was only two minutes. That's two minutes. Not that long. Two minutes. Let it run for two minutes. For about total, about two minutes a day, you will actually see an improvement in increasing metabolism, healing, and increasing testosterone. So a little hack like that in the morning, turn the water all the way to cold. May not be 37, but cold, whatever. That's why you hear about, like cold immersion, you know, ice or like polar, Polar dip. In ice cold water for like two minutes. You can definitely do two minutes. And you hear about cold therapy. You know, that's a good way to stimulate your testosterone as well too. So I've given you a lot of tips on how to increase your hormone that you can do naturally. And it's all about what the diet. Because the penis actually, when. When the penis become erect, it increases blood vessel 40 times. 40 times. All right, so when you have an erect penis, it has 40 times the blood vessel, the blood flowing into it. So what's flowing in the blood? What you eat. Right? What you eat is what's flowing in your blood. What you ate this morning is now flown in the blood. It takes about 8 hours to about 12 hours for it to be floating in your blood, whatever you've been eating. So if you've been eating french fries and a donut followed by, you know, dessert and all that, that's inflammatory, that's floating in your blood. When you have an erection, it become toxic to the endothelium. Again, the lining of the blood vessels is what causes the leakage of the blood or that the blood vessels not being elastic. And that venous leak. Venous leak present as you're able to get an erection, but then you lose the erection after penetration or you lose the erection when you have an erection. That's the venous leak. That's the most common. That's the most common presentation of ed, okay? And especially the one that, you know, the one that they're not able to get firm enough. But the venous leak, fortunately at the one that's easiest to fix with diet and exercise and stuff. And so that's why my message to you all is that, you know, there's no easy fix, no medications and easy fix. And that there are six system in your. And that, that is in your body that created beautiful erectile response. And it's not only for men, but also for women as well. Women have the same erectile response as well too. It's just that they don't have a penis. So that way they can see it. They do have a penis. It's called the clitoris. The clitoris is a woman's penis. The clitoris is. The only function of the clitoris is pleasure. That's it. There's no other function except for pleasure versus your, your penis, a man's penis. The function is you also urinate, right? It's also for your erection. But you also, it's also a way for you to get semen as well. So to Procreate. You also procreate, but you also have to urinate. You guys have an erection. For a woman, her clitoris is her penis, and it's only for pleasure. And a lot of women don't realize that. So, you know, we're made that way. That's. That's what's made for pleasure. So. Any other question? I appreciate you guys being here with me for the hour and a half. And we put the link on there for the document doc club. For the modern man club. And it's all. Oh, my trunk rehab. That's right, for the modern man club. And if a site on there for the nitrous oxide powder. Because if you're not getting. If you're not eating, you have to eat five servings of vegetable a day to get enough nitrous oxide. And if you're not getting enough nitrous oxide, you can supplement it with the powder. And I will guarantee you, once you start doing that, you doing the smoothie twice a day, Galen, you. You will actually see an improvement. And I hope that you do that. Report to me how you're doing with that and what I know, that some of the things you're doing is working for you.
Yeah. So I'm guessing that that nitrous oxide will also help, you know, with my immune system suppression. I'm catching every darn little bug going around. So it'll help me, you know, stay healthier.
Exactly. It actually does increase immunity. Nitrous oxide is the holy grail of blood flow for your heart. It help with your heart, actually increases immunity as well. So it's not only just for ed. It's really for its longevity and heart health.
Okay.
Yeah.
Well, thank you so much. I'll post these out on. On the group and so all my guys can take the ones that weren't able to make it on such short notice.
Right, Right.
Take advantage of this because you.
Thank you.
Have given us a treasure tonight, so.
Oh, thank you. And that's my goal. My goal is to spread the message that, you know, guys, that, you know, you can restore your sex life again. You can. There are ways to do it on your own, and you don't have to live with the side effect of the ED medication. It's horrible. I've seen men is that tolerate the headache, the blurry vision, the. The flushing just so that they can get an erection. I go in the Facebook group and they're all, like, asking questions about the medication and so forth. And I just. It just kills me that, you know, there are Ways that you can do it, not easy, you got to work at. But with anything that's worthwhile, you got to work at it. Right?
Yeah. Yeah. And my. My urologist answer. When I started getting. I was on 100 milligrams of. Of Sidaneville, and my. When I started having failures at that level, my urologist says, oh, you're healthy enough to take 300 milligrams. And so I. I've dealt with the funky color vision and the headaches and.
Right. Be really careful. The higher the dosage, the higher the side effect.
Right.
I hear cases of men die from taking the ED medication. What happened is that when they take the ED medication, their blood pressure drops so much, they're not getting enough oxygen to their heart and brain and they collapse. Right. Because that's how Viagra works. It opens up the blood vessel. But remember Viagra, ED medication was made for pulmonary hypertension or a high blood pressure in the lung. And how does that work? It works by opening up the blood vessels. So when you take too much of that, it decreases your blood pressure. When you decrease your blood pressure, you pass out. You're not getting enough oxygen to the heart. I. I know, you know, at least many patients who knew, who has friends, and they just told me that last week that passed away because of taking. And I don't know whether they took 300 or 100 milligram or what, but when you're mixing Tadalafil and you're mixing sudinophil together and PT141, what other things that are. Yeah, you know, it's like, you guys got to know that you're playing around with very potent medication here, all right? And you don't want to mess around with that. All right? And that's not including what other medication you have that you're taking along with that as well, too. And it's the same thing. If you have chest pain, would you try to go to the Internet and try to find out what medication to take? No. Right. You should regard. Same way with, with ed, it's really. Sometimes start with the basics. It. Get your blood work first and start changing your diet and be realistic and do an introspection, like, what are you eating, Are you sleeping? Are you exercising? Go for walks? You know, sometimes little things like that work a long way. Take your partner with you, you know, and what I'll do is I'll also post the Mediterranean diet, put it in the file as well. That has, you know, food choices. And the Mediterranean diets had been advocated by the American Heart Association, American Diabetic association, or the pre. As the preferred diet for reversing diabetes and for reversing cardiac disease. Now, how good is that? Right? It's not the ketogenic diet. Not the ketogenic, not the paleo diet. It's the Mediterranean diet. I'll leave that information. I'll put that in the Facebook group, so that way then you can put it in the other Facebook group as well. My. My mission is to make education information like this available. You can easily access it, and hopefully it will help as many men as possible and their partners. Not just men alone, but, you know, their partners as well.
Okay. And you'll. You'll be able to find that in the file section of my main group, guys. So kind of make that the repository for Anne's treasures.
Right. Well, thank you for being an admin in those group and donating your time because it takes a lot of hours to respond like the way you did.
Yeah. You asked my wife about it.
Yeah. It's not. It. It's not easy. And thank you for being the champion in helping other men. Now I hope that you can tell them what you learned today and. And spread the good word, because it only take a little ripple and we create a movement. And it only starts with a few of us right here, the nine of us, you know, in this room. But I'm hoping to create a movement that you have to fight against. Pharma. Right. They want you to be sick. They want you to be sick. They want you to be ill. So, you know, you can go to hospital, you can get open heart surgery. My husband had a stent. He had two vessels stent, and he's only 55, you know, so they want you to get sick because they want you to be a victim, you know, and be relying on medication. So having said that, thank you for being here and stay in touch. I'll give you the zoom link. You can. We can post it on there.
Okay.
Good night.
Good night.
Thank you, doctor.
Thanks, Roslyn.
Thank you. You're welcome. Thank you.
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Inside 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 design 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 Podcast or wherever you listen and just know that you can have sexual vitality for life. I appreciate you. Until next time.
