5 Common Mistakes Men Make When Facing ED


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.

ED affects at least 30 million men in the US, and there are 600,000 new cases a year. ED is common, but 67% of men do not know they have ED. In addition, ED treatment is often mystified and misunderstood. In this episode, we will talk about The 5 Common Mistakes Men Make When Facing Erectile Dysfunction.

Treating ED can help you live a better and longer life. We will discuss ED treatments that will help restore your sexual confidence without medication or surgery. This episode will also provide you information that can help you improve your erectile function and overall health. We will also cover why taking ED medications can worsen your ED, how ED can affect men of all ages, not just older men, and how adjusting lifestyle changes can go a long way in treating ED. Additionally, find out why ED does not go away without intervention. This episode will help those men who are embarrassed to seek help from their medical provider and explain why ordering ED medication from an online dispensary is the worst thing they can do.

ED is a serious problem that affects men of all ages and their partners, but with the right approach, it's very treatable. Some modalities and treatments are available today that can offer you a focused, personalized treatment plan. We will discuss finding the appropriate doctor that can treat ED competently and schedule an appointment with your sexual wellness physician to discuss your best options for treatment.

[KEYWORD] Episode Contents

Common Mistakes Episode Video

A Different Episode Format

Anne: Hello everyone, welcome to our show, Sexual Health for Men podcast. Today we're going to do a little different format. It's going to be myself and my husband. I'm Dr. Anne Truong.

Bao: I'm Bao, her husband, as she mentioned. I'm also the executive director for her practice. Just a really fancy word for her love slave. But before we go, I want to also introduce another member of our team here, of our podcast. Hopefully you can see him, it's Bodie, our dog. So he'll be with us throughout this whole journey.

Anne: He's a Cavalier King Charles, and he's 10 years old and he's been in every part of our life. And I want to mention that the new show format we have actually decked out and checked out for you because we bought the Rode Castor Pro and a stream deck, and we want to present our best to you. It took us a week to learn how to operate this tech. We needed support of our techy guy Zeblon and Juergen to really help us through this journey. So this is our first show, so be patient with us. It's going to be raw, it's going to be authentic, but we want to deliver good content for you all.

Year of the Tiger

On that note a week ago was Chinese new year, the Year of the Tiger. And the Tigers' known for bravery, confidence, strength and strong willed, opinionated and stubborn. Our daughter, Kelsey was born in the Year of the Tiger and she certainly exemplify all that strength.

5 Common ED Mistakes – Episode Origins

Five Common Mistakes — The ED Dice
Photographer: Jonathan Petersson | Source: Unsplash

And also February is the heart health month. And on that note, I want to discuss about heart health and how it's related to ED and discuss about the common mistake that men make when they're facing with ED.

Bao: So on that note, I know that you wrote a book on the common mistakes, as you mentioned when facing ED. And I want to know, and I'm sure the audience wants to know why you did this.

Anne: Well, the reason why I did that was because I've treated over 7,000 men with ED and I see that by the time they'd come and see me, they already take ED medication, it's not been working. But they don't realize that some of the things that they are trying to do and the information they get on the internet is really harming them more than really helping them. And that it just delay them from getting solution to fix their ED. And we're going to talk about it more today.

Sexual Activity into your 70’s

And studies have shown that you can have good sexual activity all the way up to your '70s, to the day you die, if you know what to do to continue that. What are your thoughts?

Bao: Well, I mean I, for one, I definitely want to enjoy intimacy beyond my '70s going even the longer that into my grave. And honey, I know that you can appreciate that from a self-interest perspective. So I definitely want to enjoy the intimacy as long as I can live.

Anne: Well, and women should think about the same thing as well. In a future episode, we'll talk about changes in a woman for sexual health. One thing that will knock off confidence in a man in his sexual performance is that, and what I want to know, be interesting is that how many time a man cannot perform until it start affecting his confidence and start to become a performance anxiety. Is it one, is it 10 times or 20 times? I'd like to hear what your thoughts are. So please comment below to see how many times do you think it would take for a man to have performance anxiety. What are your thoughts?

Experiencing Performance Anxiety

Bao: Well, when it comes to performance anxiety, I believe that experiencing that once is enough. And I personally do not want to ever experience that. And thank God you're my doctor and you've definitely helped me with that. And thank you for that, by the way.

Anne: All right. Yeah. It's one of the best doctor you know, right?

Bao: The only doctor I know, and that's the only one that I trust, especially when it comes to sexual health, you do take good care of me. So what I want to ask you is, what is the mistake that men make when facing with ED?

Common Mistakes #1: Thinking that Medication is the Only Solution

Common Mistake: Medication is NOT the only solution
dicationPhotographer: Myriam Zilles | Source: Unsplash

Anne: Well, the number one mistake is that, number one, and I want to stress on that put that number one is, men think that ED medication is the only solution to take care of ed. In fact, ED medication, after you make your ED worse, because it doesn't address the root cause of the problem of ED.

ED happens because of poor blood flow down to the penis. And if you take ED medication, all it does is just relaxes the smooth muscle of the penis. And while it give you short term result in the long run, it actually, your root cause which is blood flow actually gets worse. But if you create a false sense of confidence sense that, hey, things are working.

And I equate that almost to taking pain medicine. When first noticed having back pain, because you become addicted to it. You become dependent upon it for performance.

It becomes a crutch and just swept away your confidence and spontaneity, and that you don't have any type of spontaneity when you take this ED medication at all. And that men that have chest pain, they can't take the ED medication as well. Again, it's the bandaid and it doesn't really solve your ED.

Don’t wait with natural solutions until it’s too late

But the worst thing is that you don't find out about it until just a couple years later. And that's when you're like, oh my God, this doesn't work, where do I go from here? A man's erection is a marvel of biological engineering, because it takes six systems to work together from your brain all the way down to your penis. And it has to work together in coordination and imbalance to create an erection.

Know that ED causes 90% of physical meaning medical condition causing that. And 10% are psychological and you can actually restore blood flow with RD by just changing your diet, to eat a diet like the Mediterranean diet and doing high intensity exercises about 180 minute a week and sleep just simple sleeping of seven hours can go a long way.

Being nervous is a natural thing sometimes

Bao: Well, I just want to say that right now, I'm very nervous actually. This is my first podcast ever with Dr. Ann and looking in the camera and talking. But it actually, it's not too bad. It's not too bad, but I can comment on the ED medication in that I had ED in the past and I was on medication.

And what I've noticed is that being on medication, you lose the spontaneity as well as the confidence and really have to plan out the intimacy. And I know that with my darling wife here, that used to disturb her a lot, and that's why we began this journey with her being the sexual dysfunction physician. She eliminated that variable. I mean, how did you find that, honey? In terms of now we can be more spontaneous without the medication?

Overcoming a Lack of Spontaneity

Anne: Well, certainly, you kind of break into your routine, you are hot and heavy, you're ready to go. And then you have to take the medication, you got to wait for at least 15, 20 minutes and that you have to wash what you eat because eating a fatty meal can decrease the potency of the medication. And in the long run, it just doesn't do you any good at all. And it's like taking pain medicine, till we realized that we need to treat the cause of the problem early. And that's exactly what we did with spontaneity is critical in a relationship.

Bao: And I think spontaneity also improves intimacy too where, going back to what I said, you agree with me on this is that you don't want to plan things out. You lose that spontaneity and it just doesn't work that way.

#2: It’s Not Just Older Men

older men are not the only ones affected by erectile dysfunction
Photographer: Shane Rounce | Source: Unsplash

So moving on now, what is mistake number two that men with ED make?

Anne: Well, mistake number two is that men think that ED only occurs in older men. That is not true at all, in fact, men 20 to 40 years old, 25% of them actually have ED. You can actually still have ED while you have an erection, because ED is defined as inability for a man to have enjoyable sex and with penetration.

So ED can range from a longer to take aroused, to have an erection or a partial erection, or you have an erection and you lose it down to, all the way to the severe range, which is no erection at all. And the interesting thing is that the younger that you have ED, it is easier to reverse the symptom than [inaudible 00:10:49] can have longer improvement.

So my point is that if you're young, you can still have ED.

And if you have it, don't go for that pill. Look for long term solution that can reverse while you have ed in the first place.

Bao: So let me clarify, you can have an erection, but still have ED condition. I thought that ED means that you have no erection at all. I mean, I don't understand that.

Anne: Right. And that's what a lot of men think as well. In fact, a study shows that 67% of men do not even realize they have ED because they still have an erection though, because an erection is created by blood flow. And just imagine in your penis, there are two pipes that are open, like this big, when you're younger. And as you get older with a certain medical condition, the pipe becomes smaller. And because of a little plaque that gets deposited that impact the flow.

About Blood Flow

And so when you have less flow, you can still get some input of blood into the penis, but it's just not as much. So therefore that's why it takes longer, or that you have a partial erection. It's kind of like turning on the faucet, you're not turning it on full, you just turn it on partial. You still get the water influx coming in, but it's not as much. So you think about a blood flow in that sense, if you're not having a firm erection like you used to have, then you shouldn't certainly think that I may have ED. And there's a questionnaire that we have that you can take to determine whether you have ED or not, and arrange it from mild, moderate to severe.

Bao: So it's almost like having weak water pressure in the pipes. You're not getting a strong pressure with the water flowing out. Interesting.

Common Mistakes #3: Hoping the ED Will Go Away

common mistakes include using online tools only
Photographer: Nick Fewings | Source: Unsplashhoping the e

Bao: Okay. All right. What is mistake number three that men make with ED? Men have ED?

Anne: Well, mistake number three, is that hoping that ED will go away. ED, in fact, at least 30 million men in the U.S, and there are at least new cases of ED of 600,000 new cases a year. Bao: Wow.

Anne: And this is just an underestimate. This study was done in 2009. And I assume that it's a higher number at this point. And the reason why it's so common is that, in order for an erection to happen it has to start from the brain, going down to the penis. And the brain is the larger sexual organ in our body.

And there are six system that is involved, involve the brain and then processing of the emotion that you have. And then the hormone that is released from the brain and then the nerve, the nerve from the brain going all the way down to your spinal cord nerve, and then affecting the blood vessels.

Balancing 6 systems

Anne: And then the penis muscle itself. The penis muscle is a smooth muscle and it's controlled by the autonomic nervous system of sympathetic and the parasympathetic. What's interesting is that these six system that I mentioned have to work in balance and in synergistically. And therefore, if you have many steps in the system, there are many chances of having a problem.

ED is actually a warning sign of potential heart disease.

In seven to 10 years, a third of men actually go on to have heart disease. And that we know that the number one killer of men in middle age is heart attack. The reason why this happens because the penis is small and the blood vessel that go to the penis is the smallest in the body. It's about one millimeter and that the blood vessels affected first and then the next blood vessel is two millimeter or three millimeter. And that involve the heart, the heart's about two to three millimeter.

First warning signs

And the penis shows the first warning sign and then if you don't do something about it, it'll progress to affecting the heart and the arteries of your extremity, a condition called peripheral vascular disease. And also ED can cause anxiety and depression and frustration and therefore relationship will suffer.

Bao: Well, I always thought that ED was just caused by the penis itself, because that to me is just another, what men describe as another brain that we have, but it's really interesting how you've described it, that there's different systems that it can affect ED. So I find that very interesting.

Involving all senses

Anne: Yeah. And that's what I want to point out that it really starts in here. And that's why, your processing of your senses, visual, the smell, the taste, the sound it can cause arousal and ED medication actually does not help you with arousal at all. All it does it just relaxes the muscle of the penis. So you can circumvent that by working on the largest sexual organ, which is your brain and using your senses.

Bao: That makes a lot of sense. That's how you fixed me. So going on, moving on.

#4: Using Online Dispensaries for ED Meds

Common mistakes number four is using online tools only
Photographer: Maya Maceka | Source: Unsplash

What is mistake number four that men with ED make?

Anne: Right. Mistake number four is, men going on online dispensary to order ED medication. Now, we've stressed earlier that ED medication does not treat the underlying cause of why you have ED, which is poor blood flow.

If you do that, it's as if you have chest pain and then you go online to order medication for your chest pain would do that? No. Why would you do the same thing for your ED? Now, taken that when you have ED, it's a private matter, it's a lot of emotion that goes into that, and you certainly don't want to discuss it with maybe your doctor or even your spouse and that's why you want to go online because it's more discreet.

Take advantage of your doctor’s expertise

But just know, it's almost the same thing as getting a medication for chest pain online. You really need to be evaluated by a sexual medicine doctor who can really look at you comprehensively, your history, doing a good physical exam on you, look at all the medication that you have, checking out your heart, your glands, such as your thyroid and your hormones, looking at your pulse and doing a prostate exam, as well as a thorough exam on the penis.

And doing a questionnaire to evaluate if you have ED and how severe it is also doing a questionnaire like they're called ADAM questionnaire, to look at your testosterone hormone level and doing comprehensive lab testing that look at all the intricacy from your brain all the way down to the penis and evaluating the sick system that I talk about, from the brain all the way down to the penis.

Lifestyle matters

And also looking at your lifestyle, what are you doing? Are you smoking? Are you sleeping? What diet are you taking? Exercise and other toxic behavior that may contribute as well.

Bao: Now I know that patients who we've spoken to, I've talked to that have contacted us initially have gone through the online dispensary with medication. And it only works for a while. And the common theme is they let me know that they're not speaking to a medical doctor, they're not getting the personal attention or even the expertise to fix their issue, their condition and these places, all they want is, to prescribe a medication which we all know, now you all know, that it really is bad for you if you have ED. So definitely the common theme is to see a medical doctor, whether in person or just have a conversation. So any thoughts on that?

Anne: Well, sometime it's just easier just to go online and seeing somebody online to give you a medication, seeing somebody that really examine you and look at you thoroughly, for least an hour, really goes a long way in addressing the source of your problems. I'm always addressing that approach at this time.

Common Mistakes #5: Ignoring Lifestyle

Common mistakes number four is to ignore lifestyle issues
Photographer: S Migaj | Source: Unsplash

Bao: Okay. What is mistake number five that men with ED make? Anne: Well, mistake number five is ignoring simple things such as lifestyle factor that really can affect your ED. Do you know that certain medication that you take over the counter can affect your erection? Such as medication antidepressant, antihistamine, anti ulcer medicine, ibuprofen, high blood pressure medicine, pain medication, and of course, recreational drug.

But simple things such as diet, like eating a lot of sugars or processed food can affect your performance and smoking, stress, prolonged stress and drinking excessively of alcohol. And I mean, five to 10, had alcohol a day. In fact, you're allowed two drinks a day or two beers a day or two glasses of wine a day. And you should be okay. Even not having sex frequently, if you don't have sex, it's like the penis, you use it or you lose it.

Use it or lose it

The penis muscle can actually atrophy if you don't use it. Like your bicep, you don't go to the gym, it is going to start getting smaller or atrophy and the same thing with the penis. You don't use it, it gets smaller, it gets scarred down. And then when you actually try to use it, it's not going to be as good as it used to be, right? So why are you surprised if you haven't used it and then you try to use it and it's not as good as it used to be. So I would recommend at least three times a week for sexual activity.

The role of sleep

Sleep, not getting enough sleep, it can contribute to your erection capacity as well.

Bao: Now I have a better picture of that because, I consider myself an athlete. I exercise every day, I play tennis at the college level and I've experienced ED. Also, I don't smoke, but I'd never realized that sleep deprivation and ulcer can lead to ED of which I admit, I had that. And I'm sure a lot of you out there in audience have had some of these symptoms, maybe not all, but some of these symptoms. And I just find it interesting that overall, that can itself affect ED, correct?

Anne: Right. Absolutely. You can actually be in good health and have ED. I've seen many patient in the '30s and not overweight, exercises, they're muscular, but they come in and they have ED. And a lot of that due to probably sleep and prolonged stress and probably not eating the best diet they could eat, a low, very low carb like keto diet, sometime it's not the best either. It should be a balanced diet and I recommend the Mediterranean diet.

Options to treat ED

So on that note, I want to stress that there are many other options to treat ED without medication or surgery. And the main thing that the treatment should be geared towards increasing blood flow to the penis, and also changing your mindset. Like I said, the brain is the largest sexual organ, but to increase blood flow, there is a procedure called platelet rich plasma, where I get blood from your own blood and treat that in the penis to restore blood flow.

Shock wave therapy

And there's also another modality called shock wave therapy. What you use sound wave and deliver that energy to the penis muscle, to restore blood flow, as well as hormone replacement therapy. And for men, a testosterone level decreases after the age of 35 and tell men just a 10% decrease they can see a change in their erectile capacity. And simple things like I talk about earlier. Lifestyle changes such as diet, exercise, sleep, and also there is peptides like PT-141, which stimulate the nerve in the penis for an erection. But the bottom line is there are many other options out there to treat ED. Get the right treatment, as soon as you realize that you have ED.

Finding the right treatment

Bao: Well, I think you hit it on the note is that you have to get the right treatment and also to be treated by a credentialed experienced physician to fix the ED. And, I've had my ED fixed and by Dr. Truong here, Dr. Ann, and I just want to mention that initially I was hesitant in doing it because with the PRP shot entails injecting PRP into the penis, and I was a little bit apprehensive, but I went through with it and she literally forced me to do it. And I did it. And I'm so glad to this day that I did it because it fixed my ED, I can be spontaneous. And I'm sure the audience out there, you would want to be spontaneous and really have someone with credibility to fix your ED.

Common Mistakes — In Conclusion

Anne: Well, with that we will conclude our show with Bodie here. And if would like to get a copy of this ebook, where I go into a more detail, the five common mistake men face when they have ED, go to our website, sexualhealthformenpodcast.com to download the ebook. And I appreciate you being with us for our first show, and we will see you next time. Bye-bye.

Bao: So feel free to laugh at us. It's our first show and we really enjoy being with you today. And I leave you with a thought, use it or lose it. Thank you.

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