In this straight-talk episode of The Ultimate Men’s Health Movement, Dr. Jack Rocco breaks down exactly how he evaluates and treats erectile dysfunction—from the first conversation to precision, personalized treatment. He covers testosterone’s role, why free T matters, how SHBG can muddy the picture, when and how to use PDE5 meds (Viagra, Cialis, Levitra), the power of compounding and sublingual dosing, brain-level helpers like apomorphine and oxytocin, office-tested Trimix autoinjectors for guaranteed rigidity and tailored duration, and regenerative options like the P-Shot (PRP) for tissue quality and venous leak. He also tackles the mental load on both partners and why the right plan often repairs confidence and connection—not just performance.The First Visit: What Dr. Jack AsksObtain vs. maintain: where does the problem startCan you complete the encounter; is your partner satisfiedContext: stress, sleep, meds, health conditions, relationship factorsTestosterone 101 (and why “average” isn’t optimal)Total vs. free testosterone and why free T drives functionSHBG can bind most T; high SHBG with “normal” total can still feel like low TWhen to look deeper: free T, SHBG, LH, FSH and how that guides therapyStep 1: Testosterone OptimizationGoal: wake up tissues, restore sensation and responsivenessTypical patient feedback: more fullness, better sensitivity, improved energy and moodStep 2: PDE5 Medications (Viagra, Cialis, Levitra)Onset and duration differences (single night vs. weekend coverage)Why compounding helps: precise micro-dosing, combo formulas, sublingual options for faster effectPersonalizing to minimize side effects and maximize reliabilityStep 3: Support for the “Big Head”Apomorphine for central arousal driveOxytocin for bonding, relaxation, and responsivenessCombining brain and body support to reduce pressure and improve experienceStep 4: Trimix Autoinjectors (reliability on demand)How autoinject pens work with tiny 30-gauge needlesDialing firmness and duration via Bimix/Trimix/Quadmix blendsOffice testing to set the right dose and remove uncertaintyEspecially helpful when neuro-signals are impaired (e.g., spinal cord injury)Step 5: Regenerative Medicine and Venous LeakP-Shot (PRP) basics: spin blood, concentrate plasma, bathe erectile tissuesGoals: tissue quality, responsiveness; potential help with venous leakWhen to add PRP to a planThe Relationship ResetThe performance spiral: why anxiety and avoidance compound the issueReplacing pressure with a plan restores confidence, intimacy, and ease for both partnersDon’t guess, assess: history, exam, and labs (total T, free T, SHBG) reveal the path.Start simple, personalize fast: many men improve with T optimization plus a tailored PDE5 approach.Reliability changes everything: Trimix autoinjectors provide guaranteed rigidity when needed.Regenerate strategically: PRP can support tissue health and address venous leak considerations.Confidence is contagious: solving performance often solves pressure and reconnects the relationship.Website: TheUltimateMensClinic.comLocation: New Bedford, Massachusetts (virtual options available)Erectile dysfunction, men’s health, testosterone, free T, SHBG, Viagra, Cialis, Levitra, Trimix, PRP, P-Shot, venous leak, performance anxiety, relationship healthKey Topics CoveredPractical TakeawaysConnect with Dr. Jack Rocco / Ultimate Men’s ClinicSuggested Tags

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