The Uncomfortable Truth About Common ED Treatments

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I'm Dr. Anne Truong, MD

Dr. Anne Truong is a highly respected physician, best-selling author and internationally sought-after speaker on the topics of regenerative cell medicine, pain management, and applications for aesthetics and sexuality.

Mainstream medicine and media are not treating men with ED justice. ED is a serious problem that could lead to life-threatening heart disease. ED is regarded as shameful, inadequate, uncomfortable, and often shoved under the carpet and ignored. The truth about common ED treatments is that ED medication covers up the symptoms of ED but worsens ED over time. The drug creates a dependency on performance. There is very little education that ED is reversible and can be treated with other modalities besides medication.


Common ED Treatments Episode Contents

Episode Video

A Holistic Take On Common ED Treatments

I believe patients deserve the best care; thus, I manage all my patients’ care from the beginning and in every procedure.

When I do an evaluation, I look at the whole person.

I also use objective data like questionnaires and assessments to evaluate your sexual function at the first visit. Considerations and tests I include:

  • A thorough history of your lifestyle, medical conditions, work history, and family history.
  • Blood work to look at hormones from your brain to your genital, your organs’ function, and your inflammation level.
  • Penile Doppler ultrasound to evaluate the vascular integrity of the penis.

I do this because I want to know WHY you have ED. If I understand why you have an ED problem, I can help you solve it by treating the root cause. This is the best and right thing to do. Treating the root cause of ED is the only way to a long-term solution. Your progress is monitored by measuring blood flow and objective data along with subjective improvement.

The Role Of Lifestyle Factors

In addition to medical interventions, it’s important to address lifestyle factors that play a role in ED. Some common factors that can lead to conditions affecting blood circulation include:

  • lack of exercise
  • smoking habits
  • stress
  • drinking alcohol
  • not having sex frequently
  • lack of sleep
  • taking common medications, even some over the counter. We reviewed that in episode 5

Sixteen Small Changes to Improve ED

1. Get at least 7 hours of sleep nightly

Sleep is essential for physical and mental repair and healing for the body. Try to sleep 10pm – 6am. From 10pm-2am, your body undergoes physical repair, 2am -6am, your body undergoes mental repair.

2. Eat a healthy diet

I recommend a Mediterranean diet

3. Exercise at least 30 minutes 5 times a week

Try to exercise to a level where it is difficult to carry a conversation. Exercise improves circulation and weight control. Sexual activity is equivalent to walking 1 mile on a flat surface in 20 minutes or briskly climbing two flights of stairs in 10 seconds.

4. Decrease stress

Decreasing stress decreases cortisol -> stimulate the parasympathetic nervous system -> better erections

5. Stop smoking

Smoking causes blood vessel constriction resulting in less oxygen to penile tissues.

6. Do yoga

Yoga helps with joint pain (men with ED also tend to have joint pain and headaches). It can help you relax, tone your body, and give you more flexibility (which can be advantageous in the bedroom). In a study of 25,000 men in seven countries, it was found that those men without ED exercise and do yoga more.

7. Meditate

Meditating can help you relax, reduce anxiety and headaches.

8. Minimize watching television

No more than 2 hours a day to limit the amount of inactivity. Limit to 1 hour a day as this takes away time you can exercise and spend time with your family/partner.

9. Not too much porn

As in over > 8 hours a day. The more you watch porn, the less likely you will be stimulated by your partner.

10. Have sex at least once a week, optimally 3 times a week

Weekly intercourse has been shown to decrease ED. Men burn between 100-200 calories during intercourse, equivalent to running on 2 flights of stairs. Think of it as going to the gym. The more you go, the stronger you get. Use it or lose it.

11. Treat Obstructive Sleep Apnea

For those who have it, treat it with continuous positive airway pressure (CPAP). The CPAP delivers positive air oxygen pressure to the lungs. As a result, you get better sleep, are more likely to enter REM which helps with nighttime, spontaneous erections (like exercising your penis in your sleep!), and reduces exhaustion.

12. Treat restless legs syndrome

Treat this with magnesium, so you sleep more deeply.

13. Get hormone testosterone measured

If low, supplement with testosterone injection or pellets under a doctor’s supervision.

14. Avoid prolonged bicycling

Bicycling can affect nerves around the penis, decreasing arousal from physical stimulation and eventually limiting your ability to have erections. Prolonged biking can also limit oxygen delivery to the penis, which decreases your ability to get an erection.

15. Get treatment for hypothyroidism or hyperthyroidism

Restoring these conditions results in the return of erectile function

16. Do Kegels exercises

These result in pelvic muscles strengthening

Common ED Treatments & Their Body Systems

Common ED Treatments are derived from restoring function to the 6 body systems.

Brain

Brain: psychological- makes up 10% of ED. Primary guilt, depression, anxiety, fear of intimacy. Secondary- in most cases, means erections have been normal but become problematic performance anxiety. Treatment- counseling, and therapy. We’ll go over it in more detail in a future episode. Situation: Partner. Stress, performance-related

Nerves

Nerves: the connection from the brain to the neck, spinal cord, and nerve to the penis. The neurotransmitters are the chemical transmitter or chemical messenger, a group of chemical agents released by nerve cells to stimulate neighboring nerves or muscle or gland cells, thus allowing impulses to be passed from one cell to the next throughout the nervous system. Peptide therapy like PT 141 stimulates the nerve of the penis, the pudendal nerve.

Heart

Heart: Arteriosclerosis occurs when the blood vessels that carry oxygen and nutrients from your heart to the rest of your body (arteries) become thick and stiff — sometimes restricting blood flow to your organs and tissues. Healthy arteries are flexible and elastic, but the walls in your arteries can harden over time, a condition commonly called hardening of the arteries.

Atherosclerosis is the buildup of fats, cholesterol, and other substances in and on your artery walls. This buildup is called plaque. The plaque can cause your arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.

Although atherosclerosis is often considered a heart problem, it can affect arteries anywhere in your body. Atherosclerosis can be treated. Healthy lifestyle habits like a good diet, exercise, stress reduction can help prevent and stop the progression of atherosclerosis.

Blood Vessels & Arteries

Blood vessels: arteries, veins, the blood, A lot of modalities to treat ED are in this category. The penis arteries are only 1-2mm in diameter, the smallest in the body. They are the first ones to have plaque buildup. The sign of arterial blood flow restriction is difficulty getting an erection or unable to get one at all. On the other hand, if there is a vein leakage, it present as an inability to maintain an erection.

Low-intensity shockwave therapy for sexual medicine is a novelty and is an emerging innovation for non-pharmacological therapy treatment for erectile dysfunction. It uses energy from sound waves to trigger a process called Neovascularization (restoring blood flow) in certain parts of the body. When neovascularization occurs, new blood vessels form. New blood vessels help improve blood flow to the penis. This treatment involves a handheld probe device held to the penis to deliver low shock waves.

The penis pump: device consists of an acrylic tube and a pumping mechanism. The resulting vacuum increases blood flow into the erectile tissue as the user pumps air out of the tube. The negative pressure creates an erection. It is like going to the gym and doing biceps curls. You are bringing blood to the muscles.

The Priapism Shot or P Shot is an injection of concentrated platelets (PRP) in your blood into the penis. This innovative technique uses your blood to restore blood flow in the penis. The best treatment for long-term ED treatment and rejuvenating the penis. We’ll dive more into this.

ED medication such as Viagra, Cialis increase nitric oxide in release in the blood vessel to increase blood flow/

Trimix is an injection of 3 substances, alprostadil, phentolamin, papavarine. These chemicals increase blood flow.

Hormones

Hormones: low testosterone, high prolactin, and low or high thyroid hormones cause ED. Typically Hormones are released from the brain of the pituitary gland -prolactin, and testicles -testosterone. The thyroid is released in a gland located in the neck.

Testosterone is supplemented through injections, pellets implants, skin patches, gels, or tablets placed between the cheek and gums. The pellets implant is an insertion of bioidentical testosterone hormone made into a tick tack size. These tiny pellets are inserted under the skin on the buttock.

Pellet Implants are my preferred method for testosterone supplementation.

This allows testosterone release daily in a consistent concentration with the least side effects.

Penile Muscles

Penile muscles: the muscles of the penis are smooth muscles that are controlled by the parasympathetic and sympathetic nervous systems. It has to expand and constrict. If the muscles do not expand for an erection over time, the muscles atrophy and are scarred down. Loss of compliance of the penile muscles associated with increased deposition of collagen and decreased elastic fibers may be seen in diabetes, hypercholesterolemia, vascular disease, penile injury, or old age.

Low-intensity shock wave therapy reduces scar tissue and rejuvenates the muscle tissue. This is used in conjunction with pumping.

Kegels exercises contract the muscles of the bulbocavernosus and ischiocavernosus, muscles near the scrotum and the rectum. They are involved in helping maintain erection and ejaculation

Vascular surgery to reconnect arteries to the penis and penile implants.

Conclusion, Resources & Links

The bottom line is a continued understanding of the organic causes of erectile dysfunction will allow the doctor to discover therapies for correction and provide reassurance to the patient facing a very personal and devastating problem.

Here are some educational as well as entertaining PDF links:

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