Ep 561: Restoring Sexual Vitality Over 50 with Dr. Anne Truong

Dr. Anne Truong is a board-certified physician with over 20 years of clinical experience and a trailblazer in the field of regenerative medicine and men’s sexual health. Known for her outside-the-box approach, she helps patients heal the cause of sexual dysfunction—not just mask the symptoms. Through her practice, Dr. Anne has helped countless individuals reclaim their vitality, confidence, and quality of life.

Her patients, lovingly called “Vitality Warriors,” trust her integrative, patient-centered methods that blend cutting-edge regenerative therapies with nutrition, hormone balancing, lifestyle support, and deep education.

💡 Key Takeaways:
✅ Sexual dysfunction is often a symptom, not the root issue
✅ Cardiovascular and metabolic health are foundational for sexual vitality
✅ Hormone replacement therapy is safe and transformative—when done correctly
✅ Women benefit tremendously from topical hormone therapy for vaginal health
✅ Testosterone is the most abundant hormone in women—it matters!
✅ Stress, diet, and sleep quality all impact libido and sexual performance
✅ Both men and women deserve to enjoy vibrant intimacy well beyond midlife

🔗 Connect with Dr. Anne Truong:
Website: https://truongrehab.com/

Instagram: @dranne_official

Get Hard System: click HERE

📺 Watch this episode to learn:
✨ How to take control of your sexual health
✨ What your libido is trying to tell you about your health
✨ Practical steps to improve intimacy, naturally and holistically

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Podcast Transcript

Chapters

00:00 Introduction to Sexual Health and Dysfunction
03:11 Personal Journey into Sexual Health
06:01 The Importance of Sleep and Hormones
08:51 Back to Basics: Diet, Exercise, and Stress
11:52 Understanding Testosterone and Its Effects
15:05 Cholesterol, Blood Sugar, and Cardiovascular Health
17:49 The Connection Between Blood Flow and Sexual Function
21:02 The Role of Diet in Managing Cholesterol
24:03 Understanding Erectile Dysfunction in Women
31:35 Addressing Women’s Health Concerns
40:16 Understanding Hormone Replacement Therapy
49:35 The Get Hard System for Sexual Health
54:04 Breaking the Taboo of Sexual Health Discussions

Jannine Krause (00:14)
Hey, health junkies, on this episode of the Health Fix Podcast, I’m interviewing Dr. Anne Truong. She is a board certified physician with over 20 years of clinical experience and she is an innovator. And in fact, she is definitely thinking outside the box when it comes to sexual health. Now, she is working with men and women of all ages.

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to help them restore their sexual health. And in particular today, we’re gonna be talking about erectile dysfunction. We’re gonna be talking about low libido. We’re gonna be talking about poor circulation as it relates to low libido and sexual dysfunction. And we’re really gonna dive into what erectile dysfunction is really a sign of. It’s a sign of something more serious going on that should be looked at and not something to be.

brushed aside and being like, you’re getting older, this is what happens, no way. This type of thing can be fixed and it can also turn around other things that could be going on with your health. So, Dr. Anne opens up lots of different doors here for folks to be thinking about their sexual health and how to improve it. Over 40, and we’re really at any age, because honestly, I’m seeing folks as young as mid to late 20s having trouble.

with erectile dysfunction. So let’s introduce you to Dr. Anne Chung and talk all about sexual health.

Jannine Krause (01:37)
Dr. Anne Trong, welcome to the Health Fix Podcast.

Anne Truong MD (01:41)
Thank you for having me here. I’m looking forward to our conversation today.

Jannine Krause (01:46)
man, this one’s been a long time coming since our first round didn’t go so well and my tech issues were horrendous. So it’s good to finally get you back and the topic of circulation to our sexual organs and sexual dysfunction is such a under talked about topic in terms of my, you know, the medical practice as is, but so many people are struggling and man, women, men doesn’t matter. are.

are hurting in this department, so I can’t wait to talk about your Get Hard system. But before we get there, we gotta kinda lay the foundation a little bit. a lot of folks are seeing the commercials online for the yellow pills and the blue pills, know, Viagra and Cialis, and even some of the like pumping tools to kinda help men out, but women don’t really have anything out there that’s like a hot thing other than different creams and circulation enhancement tools. So,

When you came to working and specializing in this particular practice, were you seeing just that in your regular practice? How did things kind of evolve for you to be like, I need to help folks in this department?

Anne Truong MD (02:47)
Well, know, it really, you know, for really selfish personal reasons because as I was entering, I started doing this around 2012. And at that time I was, I was like in my early mid forties and I was starting to see some changes myself. And so was my husband. My husband had heart disease.

is familial, so it’s in the genes and it’s in the family. He has high cholesterol, so he had heart disease and had to take five medication on top of having two stents in his heart. And that affected his sexual function as well. And then I myself was undergoing perimenopausal symptoms as well. So we were both kind of like, all right, we’re noticing a big change here compared to we were when we were.

in our 30s and the kids are just out of the house. They started to go to college. This is our second honeymoon here. you know, let’s enjoy it. And then we’re like, okay. Things are not working as well as they used to be. So, and that’s when, and I was already doing stem cell therapy and hormone replacement therapy. So that’s when I kind of dive into, okay, what’s going on here with sexual health.

And my husband couldn’t take ED meds and I don’t want to go in that route. I’ve always been leaning toward more holistic natural pathways and treating the cause of the problem rather than the symptom of the problem. And ED or sexual dysfunction, it’s a symptom of some cause. And most of the time it’s cardiovascular along with hormones, hormones changes.

So I dive deep into sexual health and what the causes are. I took a lot of courses and collaborated with some mentors and with the background of acupuncture, stem cell therapy and doing prolotherapy as well as being an interventional pain management doctor. I kind of put everything that I know together along with the knowledge that I have and created a framework.

to look at restoring sexual function at its root cause. And the root cause is really cardiovascular system and then optimizing hormones again, decreasing stress, diet, exercise, and optimizing sleep. But it really goes down to the basics of optimizing cardiovascular health, which is circulation.

And that ties with everything. Almost every specialty have that common, right? Because every organ in our body and every cell in our body need to have good blood flow so it can get its oxygen and also take away the metabolite as well. yeah, so I dive deep into it really from a personal reason, but I found that I love it because

it’s such a, make such a impact on our patients live. Not only is it just, it’s not about sex. Trust me. It is not about sex. It’s really about, general health and restoring relationship again. I, I’ve been called, a marriage whisperer because I’ve saved a lot of marriages by addressing the sexual health, but it’s not about that.

It’s about reconnecting again. It’s about getting your self-confidence again and feeling like you’re alive again. And unfortunately, sexual dysfunction happened when you’re kind of like in a second phase of your life with the kids out of the house. But unfortunately, your hormone dip, this is around mid-40s, your hormone dips, and that’s when you start having cardiovascular risk factors, which we will talk more about that.

make you susceptible to having decreased blood flow, which then affect your heart and your sexual functioning organs as well. So my point is, when you’re in your 40s or so, start looking at these factors that may be contributing to your cardiovascular health. And it actually shows up as really decreased libido and sleep

disturbances.

Jannine Krause (07:02)
You know, that’s interesting you bring that up about the sleep disturbances because I feel like a lot of women and men too will start to notice like I can’t sleep through the night or I’m having trouble, you know, going to sleep or like I’m up at 4 a.m. and I can’t seem to get this change going and some people will have the sleep disturbances with sleep apnea. And so I’m guessing you’ve probably seen that huge correlation there.

Anne Truong MD (07:15)
Mmm.

Yes.

Yes, yes, absolutely. When sleep apnea decrease, men and women, it decreases hormone production. And for men, it decreases testosterone production because when you have sleep apnea, when untreated sleep apnea, this is untreated sleep apnea, you have less REM sleep or rapid eye movement. When you have less rapid eye movement, your testosterone aren’t being made well.

and that you tend to hang around more in the sympathetic nervous system rather than the parasympathetic nervous system and you become a little bit more stressed. So the stress and also not able to make testosterone will then lower libido but also affect your energy level. That’s why sleep disturbances is what we sometimes we attribute it to other causes. But when you’re in your

mid 40 this shows up at wake but your eye just opened at 330 in the morning like as if some you know is if the alarm went off yeah and 330 is the worst time to wake up because you got to get up to go back to work is no use going back to sleep I’ve been there I believe me at 330 morning my eyes will be open and then I’ve also and this is another thing is that you just have no libido

And for women, it may be subtle, but for men, it’s obvious and it shows up as like, you know, less morning wood than normal. And it may show up that it takes a little bit longer to get there. And sometimes, you know, he loses it. So it’s very subtle sign that you need to pay attention to. And because the reason why I say that is that if you start early, they’re dressing it early.

You’re going to make a whole big impact on restoration of performance.

Jannine Krause (09:13)
It’s huge to, you know, I can’t say enough about mentioning this to your doc because I think a lot of people are embarrassed, right? And same thing with like libido. A lot of women will now start to tell me more that I didn’t hear this 10 years ago. Not many people were talking, like that was, you know, we’d had to pull it out of them, right? But libido is such a factor.

And with libido, I think a lot of people have tried different things like Damiana and, you know, horny goat weed and even deer velvet antler and things and they’re like, I’m not getting results. What would you say to folks who have tried different things with the libido and nothing seems to be working?

Anne Truong MD (09:49)
Well, believe it or not, you gotta get back to the basics. Sometimes we chase shiny object, right? this work, this supplement. Get back to the basics. What are the basics? Diet, exercise, sleep, and stress reduction. All of those factors actually will lower your hormone and affect your blood flow, all right? So that’s what I call the basics, right?

Because what you eat is what your body is gonna feed your body. Every cell in your body is gonna absorb what you eat. And it’s like your car, it requires super unleaded gas, but then you’re giving it regular gas. What do you think is gonna happen? It’s not gonna function as well, right? It can throw drive, but it’s not gonna be in the optimal performance. So you’ve gotta give your body what…

what it needs, which is really, you know, what we call kind of the Mediterranean diet, a diet focusing on lean meat, such as chicken, fish, more vegetables, fruit. And what I tell my patient is, eat what the Earth gives you. Eat that the Earth grow for you. And don’t eat anything in a box or in a plastic bag. Simple as that. And it’s true.

It’s always called the caveman diet because in those days, you know, you have to eat what the earth give you but that’s what our Body is made from right? We are made from the earth We are in one with this earth and if we’re eating something that is made in a factory like a cracker, you know, the earth didn’t grow a cracker for you or you know a Cookie earth didn’t grow that for you. So

That’s something to consider. then exercise like 30 minutes every other day, as simple as just walking outside, connect with nature outside because that will also decrease your stress level as well too. And I recommend just walking outside without headphones and listen to the nature sounds, smell, the smell of nature. That really does a great job in.

calming down your stress system, calming down the sympathetic nervous system as well. And just 30 minutes every day or every other day. And then sleep. Can’t stress enough how important sleep is. There’s a reason why we have to sleep. When we sleep, our body heals physically and mentally. So we have to heal up here, but we also have to heal physically as well. That’s our reset period. And if…

you’re not getting adequate sleep, then your body’s not gonna be able to heal. recommendation is seven to eight hours of sleep a night. And then the last part is stress reduction. That’s why I recommend exercising out in nature, doing meditation and simple things with, know, hanging out with people that you care about and, you know, laugh.

and doing things that you love. As simple as that, and you know what? It doesn’t cost you anything. You pay for your food anyway, right? You can walk outside, you don’t have to join a gym, sleep, stress reduction, doesn’t cost anything versus chasing after some supplement that you think is gonna solve your problem. So believe it or not, diet, exercise, stress reduction, and sleep optimization will improve testosterone, improve…

Jannine Krause (12:43)
Thank

Anne Truong MD (13:01)
all hormones, really. But what it also does is also improve cardiovascular health or increase blood flow. And therefore, it improves sexual function, but also heart functioning. And it really functioning for the lungs, the kidney, everywhere else. And also control insulin resistance, which is a risk factor for

diabetes type two. So it really solve a lot of adult onset, acquire chronic condition such as high blood pressure, diabetes, high cholesterol. Those are the triad that we acquire as we get older, which set us up for heart disease, which then lead to sexual dysfunction.

and which then lead to heart attacks or even strokes later on in life.

Jannine Krause (13:52)
And you know a lot of those things like you mentioned it’s not uncommon for me to see the beginnings of cardio metabolic issues in folks You know like you had mentioned the blood sugar also, you know cardiovascular cholesterol kind of stuff going up also having different types of blood pressure issues now a lot of people You know, maybe doing all the basics right and they’re like, hey, I’m not seeing change here What would you say to someone who’s perhaps taking testosterone?

they’re incredibly fit. I’m gonna preface because you kind of already knew this this question a little bit because I talked about my my police officers and firefighters in my practice who a lot of them are very fit they’re taking testosterone they are working on you know their diets and they’re not seeing changes with the libido and not seeing changes with

erectile, you know, quality, let’s put it that way, how long they can last, you know, things of that nature. What would you say to someone that might be in that category where they’re kind of, the basics are down, they went to try to optimize with testosterone and they’re still not having issues, or still having issues, sorry.

Anne Truong MD (14:56)
Yeah, still having issues and I see that more common than not. And I would tell you, sometimes I’ll see a man who’ll come in physically fit, muscular, had an eight pack, not a six pack, but an eight pack and looked like a vision of health. But you know, and he’s on testosterone, but when I do his blood work, he is not a vision of health. So it meant if you are on testosterone, make sure that you get your blood work checked at least

Jannine Krause (15:05)
you

Anne Truong MD (15:22)
once a year or twice a year, because when you’re on testosterone, a lot of clinic will give you a high dose of testosterone thinking that high testosterone is better, not necessarily. Testosterone is determined genetically. What amount of testosterone that is your sweet spot is determined by your genes. So there was a study that came out two years ago that shows that the testosterone receptor or this little

whole keyhole that is in every cell of your body is different in every man and woman that is determined by genetically. So what that ultimately means is that a man, his sweet spot where he feels great could be the ranges from 300 to 900. He will feel great at 500, not necessarily 900. And another man could feel great at 900.

And so there’s a different sweet spot for everyone. Not necessarily high is better. That’s number one. All right. And then number two is that the higher you crank up testosterone, there’s a chance it will be converted to estrogen. Estrogen is the metabolite of testosterone. So your body like to be in balance. If you give it too much or something, it’s going to try to get rid of it and try to convert it to something else. Now,

a caveat testosterone in a man is actually help with his libido. So sexual drive is also for testosterone, but also estrogen to estrogen. So some hormone clinic will automatically give you an estrogen blocker like anesthrazole.

thinking, I’m gonna crank them up high, I’m gonna give them estrogen. Not necessarily. I will let my men have been estrogen level about 50 or 60, even though the recommended is like less than 30. But nothing that’s not necessarily you need to put that on. But I see a lot of hormone clinic automatically put a guy on and nesters are which an estrogen blocker. So follow your blood work. And then also testosterone also can be converted

to DHT, dihydrotestosterone, and that’s an inflammatory component of testosterone, which then will irritate the prostate, will make the prostate enlarge, as well as contributing to hair loss. So when you’re on testosterone, need to check the estrogen, you need to check the dihydrotestosterone or DHT. You also need to check

What is your free testosterone versus your total testosterone as well? So that’s number one. So if you’re on testosterone, cranking up high doesn’t necessarily mean that you’re better. these men must maybe feel that because maybe their estradiol, their estrogen is being suppressed, all right? Or that they’re so high, the body is converting it to other forms. All right, so.

Doing hormone replacement therapy is a balance and they need to know that everyone has a different sweet spot. So that’s what I would recommend. And also, you know, when I see the men that I see that come in with an APAC, well, I do their blood work and they have high cholesterol. Their cholesterol is like 280. Their LDL is like, you know, 200 and their blood sugar is high. So what physically shows does not necessarily mean

what is on the inside. And so what is their cholesterol level? What is their blood sugar level as well? That’s why blood work is very essential to that. so looking at the cholesterol level, looking at the blood sugar level as well. And then the next part is stress, because when you have high stress, that can also deplete your testosterone.

level as well too. And so unless you lower the stress and you keep cranking up the testosterone, the testosterone is not going to be utilized efficiently in your body. And we see that a lot. So oftentimes I have these men take ashwagandha and cortisol support supplement to lower that cortisol stress.

And sometimes even lowering the testosterone level will actually help with their libido and also making sure that they have a higher estrogen level as well too. Oftentimes less is better. I’ve treated over thousands of men on hormones. I can tell you probably I have a handful of guys that need an estrogen blocker, but

99.9 % of them do not need it. If you will not need it. Guys, you listening to that you will and women too, if you optimize your diet and your exercise. So if you can literally increase your testosterone level 30 % by eating the Mediterranean diet. That in itself. Yeah. Yeah. We have seen men literally increase it within

Jannine Krause (20:18)
Yeah.

Anne Truong MD (20:22)
30, it’s almost 40 % by just dropping bread, dropping pastries on a daily basis.

Jannine Krause (20:30)
That’s so incredible to hear, because here’s the thing, I think so many people are kind of in the supersized, you know me, society where little testosterone is good and more must be better. And I hear this from guys all the time, they’re like, well doc, I think I need more. And I’m like, no, so it’s good to hear you kind of being on the same lines as me is less is more, less is more in the individuality component here is so huge.

Anne Truong MD (20:53)
Very, very much. When you’re treating symptoms, you’re not treating levels. If a person feels better, and I see this from just treating thousands of men, some men, like my husband, he’s happy on around 600 testosterone level, whether it ranges from 300 to 900. If I crank him up to 900, he actually feels worse. He actually feels worse. So there is a level that when you…

just have to find that and then believe it or not, believe it or not, when we get him to that level, his cholesterol is also improved as well. So do you know that testosterone can also improve cholesterol and blood sugar as well? Metabolizing cholesterol and blood sugar and that when you have low testosterone, you tend to have a little higher testosterone and blood sugar. But when you get testosterone to an optimal level, that gets control much, much better.

Jannine Krause (21:48)
know, cholesterol, hot topic, right? Do we use statins? Do we use herbs? Do we use diet, exercise? A lot of folks are starting to say diet and exercise don’t work as much for the cholesterol. I would love to hear what you’re doing on your end. You know, I know you just said the basics with the Mediterranean diet. What else do you do for folks with cholesterol that are a little bit higher and you know they need to do something to help adjust?

Anne Truong MD (22:11)
Right,

right, right. know, cholesterol that, know, cholesterol, is it not genetic? There are some genetic conditions that predispose you to get cholesterol 500, 600 and higher. So that you definitely need medication for. But most of the time cholesterol is acquired. It is acquired because you don’t have high cholesterol when you’re younger. You get high cholesterol from

from your diet and it only your liver and your liver is where the cholesterol is being produced. And it takes about three months for to edit, to have any changes in your cholesterol level, and, blood work. So it really reflects what you’ve been eating with the next last three, three to four months. All right. And, so that’s, that’s number one. And then number two is that there’s a debate or red meat or lean meat. Right.

And I think that that’s really individualized. I’ve seen some of my patients that are on the keto diet and they eat more red meat and the cholesterol is fine. I’ve seen some patients that is on the keto, they eat more red meat and the cholesterol is high. And so, and that’s where I was saying that there’s a genetic component and you’ve got to treat the patient, not the numbers. And so you got to treat, okay, this,

if they’re high and you know what their diet is about, then you can kind of tweak it a little bit. So I’m not a purist and I’ll no red me or anything. I just like, let’s try the Mediterranean diet and see where you’re at and see what the numbers show. that, it’s individualized and also sleep. Also, if you don’t sleep well, it will also affect your cholesterol level as well.

high cortisol or high stress, increased cortisol from your adrenal. And when your cortisol is high, then you will have insulin resistance. When you have insulin resistance, you’ll have high blood sugar. All right? And then that, then we also have high cholesterol. Now, why do we care about high sugar and high cholesterol? Why do we care? Why do we talk about that all the time, right? It’s because

Jannine Krause (23:56)
Bye.

Anne Truong MD (24:24)
When you have high cholesterol, your blood becomes more viscous. Your blood becomes, it has, I mean, literally, we draw our blood, can tell which Hachamori has high cholesterol because the blood is less red and it looks a little creamy. It looks a little creamy even, and it looks like it has some fatty in it. It’s a different color, all right?

Jannine Krause (24:42)
Mm-hmm.

Anne Truong MD (24:48)
And so it makes your blood more viscous, more thick. And so imagine your blood vessels like a pipe like this. It’s like a pipe and your blood flows in the pipe, right? Well, when you have high cholesterol, those cholesterol components kind of stick together, become like a glob and stick to the blood vessels, all right? And then it start collecting blood sugar or the sugar to it. And it create a call, a plaque.

A plaque is like a cholesterol glob and sugar glob. And what happened is that it’s thick to the size of the blood vessel. And over time, it will build up and build up and build up. And then so what’s gonna happen is it’s gonna get bigger and bigger. It’s gonna block the blood flow going through the blood vessels. That’s really the etiology of a heart attack. That’s really the etiology of ED.

it decreased blood flow because of blockage and the blockage is due to the cholesterol and the glob, which then collect the blood sugar to it. And blood sugar itself, high blood sugar itself is caused damage to the blood vessel lining called the endothelium. The endothelium is this lining that protect your blood vessels

from all the toxin leaking into yourself. And to high blood sugar will kind of tend to erode that endothelial lining, which then allows for more toxin to leak into your cells, which then will cause cellular dysfunction, which then will cause like mitochondria, ATP disruption. And you see it as…

disease, know, cardiovascular disease. You can even see it as cancer because that will also affect the DNA as well too. So believe it or not, a lot of cancer is diet-induced, diet-related. We know that smoking, you know, can cause lung cancer by the same mechanism as well. So that’s why blood sugar and cholesterol is pivotal.

to blood flow and that’s what I’m trying to explain them to because sometimes people are like, I don’t care, what does that mean? But if they know what that means to their health and ultimately what is the consequence? The consequences that you’re not getting enough blood flow to the organ and the organs that are dying. So ED, erectile dysfunction, women have erectile dysfunction also. It means that the sexual organ

Jannine Krause (27:20)
Yes, let’s talk about that.

Anne Truong MD (27:23)
It’s not getting the blood flow and it’s slowly dying. Like a male penis is dying. So the woman, the woman, the the woman organ of a penis is the clitoris. Right. And so it’s slowly dying. It’s like having a heart attack. There’s no different. A heart attack is just, you’re not getting enough blood for the heart to pump. That’s why you get the heart attack and it start to have scar tissue. but for, I want to say this for your women listeners is that

Your clitoris is the only organ made for pleasure. has no other function other than giving you pleasure. Versus a man, his penis is for three functions, is for erection, but it’s also a way for him to urinate, but it’s also a way for him to ejaculate. So there’s three mechanisms, functions. But for women, it is your only organ that’s for pure

pleasure and that’s kind of like your mini penis but believe it or not it’s just not that knob that you see it’s actually goes back further it’s actually four inches it’s actually four inches it kind of goes in and kind of spread out along the labia menorah as well so most women don’t realize that it’s like i have an organ just purely for pleasure well there’s a reason why right

because it’s that way you can have the pleasure organ versus the man. has to do a lot more work. There’s a different physiology there as well, but women also have erectile dysfunction because as they get older and their hormone drop, their clitoris and their labia, I don’t know, you know this, atrophy, it becomes smaller.

And women, when they’re in menopause and they don’t have hormone replacement therapy, the labia will actually shrink until a point where you don’t have any. It kind of revert back to pre-puberty girls. I don’t know, look at girls before puberty, they do not have a labia at all. Yeah, yeah, it actually revert back to that stage.

Jannine Krause (29:30)
Yeah.

Anne Truong MD (29:36)
I advise women at least to look at yourself down there like once a month and see what a mirror and see what changes there are down there. Sometimes it’s good to kind of know your body and be attuned to what’s going on.

Jannine Krause (29:51)
100 % 100 % I’m glad you bring that up because so many women unfortunately end up to me and they’re talking about even the tissue sticking together You know, it’s been so atrophied and and I just had a patient the other day with clitoral adhesions and I’m like, ⁓

Anne Truong MD (30:05)
Yes.

Jannine Krause (30:07)
What, you know, so if those kinds of things are happening, obviously it is absolutely crucial for us to keep working on circulation in that area. Now, what kind of things can someone do? Say someone’s a little bit afraid still of the bioidentical hormone.

replacement therapy and they’re a little bit like, I don’t know if I want to do that or maybe they have cancer history and they’re just freaked out. What kind of things can we do that are non hormonal that you see to be effective? Kind of like some of the hyaluronic creams, like what else would you think? What do you use?

Anne Truong MD (30:35)
yeah, right.

There are some products out there that, well, first of all, before I say that, that research has shown that hormone with bioidentical hormone replacement therapy is perfectly safe for women. It does not cause breast cancer, especially topical hormone replacement therapy. Follow closely with the doctor being managed. For women,

All they needed topical estrogen and some estrogen down there, topical and then progesterone capsule at night. And they’ll feel great. And multiple research studies have shown it does not contribute to breast cancer. The study that was done about 20 years ago actually was using synthetic.

synthetic estrogen and progesterone. So I want to kind of set that record straight and that no women should be concerned about hormone replacement. In fact, we treat women that are post breast cancer on hormone replacement therapy right now. And they’re doing fantastic. All right. And they need it the most actually.

So, but for women that may not want to do on hormones, and they shouldn’t be, but I understand, is that you can use hyaluronid acid as the lubricant. You can also use coconut oil ⁓ as well as a lubricant, which works really well. Olive oil, ⁓ it can be a lubricant.

Jannine Krause (31:59)
Mm-hmm.

Thank

Anne Truong MD (32:09)
And you mentioned one of your patients had clitoral adhesion. In fact, using DHEA, which is a natural, non-hormonal, but it’s really DHEA, kind of like the, how you call the mother of all the hormones. It’s the first component of all the hormones. And I oftentimes prescribe just DHEA alone down in…

a topical in the labia area for decreased lubrication or vaginal dryness down there and it works great as well. And sometimes it will also increase a little bit testosterone because DHEA also make testosterone. So you can kind of follow up with the blood work and see. So those are simple things like DHEA, hyaluronic acid. And I can’t tell you how much stress.

uh, uh, will, will help with, uh, with, uh, lubrication as well too, you know, uh, because, and I just did episode in my, uh, podcast about when is the best time, uh, uh, to have, uh, sex. Believe it or not, the best time is usually in the morning when your hormones are high, you, you, you rested already and it’s not at night.

Jannine Krause (33:25)
Yeah.

Anne Truong MD (33:26)
It’s not so much at night because at night your hormones is at its lowest level. You’re tired, you’re distracted, versus in the morning. so, you know, I take that into account, but yeah, for women, I’m very passionate that, you know, women, do not have to suffer with vaginal dryness, do not have to suffer with chronic UTI.

when you’re in menopause, do not have to suffer with pain, with intercourse, it’s all reversible. right? Those are the most common things. You do not have to suffer with hair falling out or rashes or itchiness that you normally don’t have, that you do have. And insomnia, you cannot tolerate waking up at three or four o’clock in the morning.

That’s a sign that you have low progesterone. So women have three major hormones, testosterone, estrogen, and progesterone. And believe it or not, out of all those hormones, the one that is the most is actually testosterone for a woman. So you would think, yes, men have a lot higher testosterone level than their estrogen, but…

For women, testosterone level, it’s about 10 % of a man, but it’s still higher compared to the other two. So progesterone, when it decreases, it’s the first one that decreases, when it decreases, it will affect your sleep. So that’s why the first signs of perimenopausal is sleep disruption. And then the next hormone that goes is testosterone. Then that testosterone help with, it will affect your libido.

Jannine Krause (34:51)
home.

Anne Truong MD (35:04)
affected with the vaginal dryness as well as muscle gain. ⁓ Yeah, weight gain. Weight gain. I mean, weight gain. So more fat acquisition and you don’t develop as much muscle mass. So you become kind of flabby. You’re kind of menopausal flabbiness and that weight gain. You start having the tired…

Jannine Krause (35:11)
Muffin loss.

Mm-hmm.

Anne Truong MD (35:28)
down here that you normally don’t have. you sit down, you have that tire. I have that tire. so that’s what you notice. And then the estrogen is what is the component that causes hot flashes, night sweats. And then also you find that your foggy brain, your foggy brain, because you’re not getting enough blood flow.

Jannine Krause (35:30)
Thank

Anne Truong MD (35:49)
to your brain sometimes that you tend to forget words and I have all those symptoms when I was around maybe 51 and it all went away within a couple weeks after having been on hormone replacement therapy. So all those symptoms that I mentioned are reversible. You don’t have to live with it. I can’t tell you how many women in their 70s are diagnosed with dementia.

when it’s really they need to be on a bioidentical hormone to optimize their blood flow to the brain. And how often did you hear women being, oh, I’m on a sleeping pill, I’m on a depression pill, and then I’m on a medication to help me remember stuff, ADHD, because I have such a foggy brain. Right? Yeah. Those are the symptoms that actually correlate with

hormone replacement therapy. I can’t tell you how many times I would treat a patient on a hormone replacement therapy and we’d get them off of their depression medicine, their anxiety medicine, their sleeping medication, and even their blood pressure medication and cholesterol medication as well.

Jannine Krause (37:02)
Yeah, yeah, it’s quite impressive how someone can turn around. Now, interesting you mentioned, you know, 70 year old women. One of the big misconceptions I think that’s out there and help me to see how you see it as well. A lot of women will be told that say they had menopause, they went through it early, maybe they were like 45 and now they’re coming to a doc at 60. They’ve been told they’re out of that range to be able to support their hormones. Help us with that.

that answer that a lot of people are hearing there.

Anne Truong MD (37:31)
Yeah,

and I think that is really more of a personal preference. Yes, there were some studies that said if you’re over 65, it might not be as beneficial. I think I don’t agree with that. I tend to look at quality of life measure for a woman. That’s important. And we know that that

know, hormone replacement therapy that doesn’t cause all these bad, you know, all the cancers that we’re all concerned about. So it’s really quality of life. And starting a hormone replacement therapy, you can feel better within like five days, five days. In fact, I just started a friend of mine on hormone replacement therapy about a week ago and she already called me up and said, I feel so much better. My hair is not falling out. I’m sleeping better. I don’t have foggy brain anymore. My energy is so much better.

And that was just with topical testosterone and estradiol and progesterone capsule. That was it. So I would treat any woman that has symptoms that interrupt her quality of life at this point. And of course you have to be followed. You have to make sure you follow up with your mammogram and your…

Pap smear and women if you have a hysterectomy doesn’t matter how old you are You’re gonna be in your 30s have a hysterectomy and you can actually undergo Menopause early even though you don’t have your ovaries you may still have your ovaries But you it can still for some reason if you don’t have a uterus that the ovaries just don’t function as well and releasing Hormones because I have seen the past week

I’ve seen women in the late 30s had a hysterectomy and they’re now in full-blown menopause. Alrighty.

Jannine Krause (39:14)
Yeah.

Yeah, 100%. I see the same. see the same. You know, all of us seeing this can’t be denied. So this is just huge for folks to listen to this, you know, and really share these podcasts with their friends. Now, of course, you have your podcast. I want to talk about that in a second, but we got to get them to under to hear a little bit about your get hard system over at Toronto rehab as well and kind of give us a good sense of like where folks can find you, what you’re up to specifically. And it sounds like men and women not

just men, however you have a specific program for the men. Tell us about that and then tell us about your podcast.

Anne Truong MD (39:50)
Yeah, so our podcast is called Sexual Health for Men podcast. It’s on every podcast platform, Apple, Spotify, even on Amazon as well. And on YouTube, we also have a YouTube channel called Trong Rehabilitation Center. We’re big on YouTube and we talk about sexual health. I talk about more men’s sexual health.

Because I feel that if we start with men, women will follow as well too. Because I feel that men need to do a little bit more work than women. Because treating women, it’s actually easy. It’s actually really easy with the topical hormone and the capsule. You’re done. You’re ready. But for men, they need to do a little bit more work as in the hormones as well as the diet and the exercise.

Jannine Krause (40:19)
Thank you.

Anne Truong MD (40:40)
Because for men, in order for their penis to work for a fully functional erection, they have to increase their blood flow to the penis 40 times more than baseline. So that’s a lot to ask for an organ to function. So they need to do a little bit more work. So sorry, men, you do have to do more work to get it functioning. Just one thing that women don’t have to worry a lot about, right? So that’s…

That’s why I created the podcast, but also I’ve lived through it and I have a husband that undergone it. He no longer has issues because, you know, we have treated it. So the Get Hard system is really a system that look at treating the root cause of erectile dysfunction, even sexual dysfunction. This is not just for men, it’s also for women as well too. And so it starts with the brain.

Because the brain is your largest sexual organ. This is for men and women. Largest sexual organ. It is not the organ below the belt. Because if you… Because the brain is where sexual arousal happens. Because that’s where you have sensory input from your five senses. That’s what your eyes see, what you smell, what you taste, what you hear, what you touch.

And then I may even add the sixth one, which is your imagination, what you imagine as well too. So that gets processed and it goes to the mid part of your brain where you’re mixing with your emotion, your amygdala, your emotion, what your emotional state you’re in. But if you’re in a distressed state, you’re in a depressed state, it’s going to get dampened down. That signal going to get dampened down, right? And then that will then go to

the hypothalamus where the hormones is released. The hormones get the release and that start the chain of nerve signals that send the nerve signal to the nerve in the back of your brain here, the parasympathetic nervous system. So it starts in the brain and then emotion and then hormone, then nerve, and then it goes to, from there it goes to your heart.

your heart start pumping more and when it start pumping faster, it brings more blood flow to the blood vessel. The blood vessel start to expand so you can get more blood flow. So that’s the blood vessel is the fifth system. And then the fourth system is the muscle, which more blood will flow down to the sexual organ and the sexual organ engorges. So all the six systems of the brain,

the emotion, hormone, the hormone, the nerve, and the blood vessels and the muscle all had to work together synchronously to create the sexual response. And we don’t appreciate it because for us, when you’re younger, it will take a couple of minutes to get there, right? But when you get older,

takes a little bit more time and maybe it doesn’t work as well. So at our Get Heart system, we address those six system and what is going on with a person. So we address that with diet. First we do blood work to see what’s going on and then we look at your diet, your exercise, your sleep regimen, what’s your stress level. And we not only,

restore sexual function with hormones and hormone replacement therapy, stem cell therapy, and using technology to help with increasing blood flow. I do a Doppler ultrasound to assess for blood flow down in the penis to measure the quantity of blood that is impaired or not. And then we optimize, and once we,

we do the treatment to kind of boost the blood flow. The man has to continue with optimizing his diet, following the Mediterranean diet and exercise and meditation. So we address all the six system so that way it can be restored for function again. Because something that’s important as your sexual function, it requires…

like all those systems to coincide together and if one system is not working well, it’s not gonna have the result that you want. That’s why sexual dysfunction or ED is very common in men. It’s 50 % of men over 50 will have it and 60 % of men at 60 will have it and 70 % when you’re 70.

Man, if you’re 50 years old, half your friends that are a guy are having issues. And I assume that’s even more now because that was a study that was done in 1994, a 31 year old study. And that was not accounting for COVID, not accounting for vape and porn. And that’s like another discussion, right? But all of that is very common now. And we’re seeing now men in their 20s.

are having ED. And when men in their 20s having ED, it’s really more the lifestyle factors and stress and psychological factors that are creating the issue rather than a physical factor. you know, truly men over 45, the physical factor play a role, but men that are younger, it’s really lifestyle factors and

and psychological stress that’s affecting their function.

Jannine Krause (46:06)
Makes sense, makes sense. Yeah, I’m seeing younger and younger folks, especially in the fire and police services, our emergency responders are struggling and stress lifestyle, like you said.

Anne Truong MD (46:17)
Yeah, yeah, and we talked about that and I call that the Alpha Man syndrome. and that is because, know, at most, you know, the Alpha Man, you know, he he, you he looks he may look great, but he has the sense of, I can do everything myself. I can fix this myself. I’ll figure it out. But he’s not discussing it with his doctor. He’s not discussing it with his wife or his his partner.

And he tried to medicate himself. And oftentimes, unfortunately, he tried to sometimes cover it up and maybe in denial or maybe resort to more alcohol as well. But believe it or not, alcohol will actually affect your erection. Yeah. One drink will help you relax, you know, more than two drinks.

will actually impair your erection function. So it’s almost like kind of like doing things that make your condition worse and then you try to drink more, you know? So it’s actually a worsening way to cope. You the way to start with this guys, you know, your firefighter, EMT, so forth, is just, you know, get your blood work done. Be honest with yourself. If you’re starting to find out that you’re not functioning as well as you used to.

Go get your blood work done. Your insurance covers it. Get your hormone done. Get your blood sugar. Get your cholesterol checked. Get your kidney checked. Get your liver checked. It’s all done. That can all be found out by a blood panel. And get your hormones level checked. And see a doctor about it. And there’s nothing wrong with that. You are not less of a man if you have ED. In fact, we expect all men.

to have ED sometime in their life. It’s like gray hair. You’re going to get it, but you don’t have to live with it. So my message is that if you have ED guys, you don’t have to live with it. There are natural alternatives by treating the root cause of the problem. I’m a big proponent of you don’t know what you don’t know, but when you do know, then you can prevent it. So my mission on our podcast is to educate men and women on what

they can do to optimize and restore their sexual function. Because once you know what you can avoid and what you can do to optimize your condition, you will do it, right? Kind like how we brush our teeth. We’re told you brush your teeth and floss your teeth so that way you can have healthy teeth for the rest of your life and prevent cavities.

But no one talk about it for sexual health, Janine, right? Now, sexual health is such a taboo topic. You can’t talk about it on the internet. I mean, I’m in Facebook jail, I’m in Google jail because I talk about sexual health. You’re really more preventative, sexual health, but it’s so taboo. It’s a shameful state. It’s not something you’re not talk about, but it’s something that’s pivotal.

for us as human being, right? If it weren’t for sexual health, we wouldn’t be here, right? ⁓ And it’s the most primal part of our brain that drives a lot of what we do. If you think about a lot of what we do as human being is driven by sexual desire and driven by sexual behavior. So I, my,

Jannine Krause (49:19)
It’s true.

Anne Truong MD (49:37)
would like for us to talk about sexual health like like how now we’re now talking about mental health and and not not make it shameful, not make it taboo to talk about it and that to say, hey, you know, I have I have ED or women, you know, I have vaginal dryness, or I have sexual, it’s called female sexual dysfunction. There’s nothing wrong with that.

Jannine Krause (49:43)
Right.

Anne Truong MD (50:03)
All right. It’s like, you know, I have depression, have anxiety, nothing wrong with that. And it’s just part of living. But I’m hoping that what our channel and our podcast that we’re able to spread the message of there are things that you can do now to prevent or if you do have issues, there are things that you can do to restore again.

Jannine Krause (50:25)
So important, so important. And I think you’re absolutely right on that in terms of we need to talk about the preventative. But we also, like you said, you were the recipe, or recipe, that’s a whole nother website I had at times. You are the relationship whisperer, marriage whisperer, whatever you wanna call it. Because I think a lot of people don’t realize how important this connection is to each other. And in a time when I see people sitting out eating dinner and looking at their phones while sitting out together, I’m like,

If we’re out to dinner doing that, what is happening at home is my question.

Anne Truong MD (50:54)
Hahaha.

Yeah,

yeah, yeah. So, it’s, yeah, well, you know, sometimes you got to get back to basics. And I tell you, I just went on a wedding destination trip in Bermuda for four days. I didn’t use my phone for four days. And it was a very, very good feeling. And I didn’t need it to use my phone. I used my phone to take pictures. That was about it. But I was not on the Internet.

I was not on my laptop and you know what? Nothing falls apart. Everything was fine when we came back.

Jannine Krause (51:29)
It’s so true, it’s so true. gosh, Dr. Anne, I’m so glad that you’re helping folks to reconnect. I’m glad you’re speaking out about all of these things and I’m also glad to hear that you are, you know, I always like to hear open-minded folks when it comes to looking at hormones and kind of thinking outside the box. It is so refreshing to hear, yeah.

Anne Truong MD (51:48)
Absolutely. And I think that as a clinician, we really need to spread that word because there’s so many, you know, misconception about hormone replacement therapy. And it’s actually very affordable. You know, it’s very affordable. like cost of going out to dinner once a month. But people say, well, it’s not covered by money. Sure, it’s not gonna pay for it. But it’s like $30, $40 a month.

Now it is for your health and you know, it’s like you probably pay for it more not for going out to dinner. And but it’s like if you don’t own your health, who who would be so I’m I’m on hormone replacement therapy. So am I. So is my husband as well. And now, you know, a lot of my friends. So, you know, I hope that, you know, your viewers will listen to this and will feel empowered that they’re all alternatives and they don’t have to live.

with those symptoms that we talked about.

Jannine Krause (52:42)
absolutely agree. absolutely agree. So folks, head over to Trunk Rehab. So this is T-R-U-O-N-G-R-E-H-A-B dot com. And then for Apple and Spotify and all of those, what is the name of your podcast? I apologize, it’s not right here and I don’t want to stick some of my brain.

Anne Truong MD (52:57)
That’s

okay. So the podcast is sexual health for men podcast. Yeah. That’s your health for men. podcast. You just type that in and it will come up. It will mean the world to me. If you guys listen and give it a review and we would love to have more reviews on our channel, as well too. And, like I said, our mission is to empower education and knowledge for men and women to.

Jannine Krause (53:01)
Okay. Okay.

Anne Truong MD (53:24)
continue to have sexual longevity.

Jannine Krause (53:26)
Huge, huge. Thank you so much, Dr. Anne, for coming on. I sincerely appreciate it.

Anne Truong MD (53:30)
Well, thank you so much for having me here.