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.

1. The First Visit: What Dr. Jack Asks

• Obtain vs. maintain: where does the problem start

• Can you complete the encounter; is your partner satisfied

• Context: stress, sleep, meds, health conditions, relationship factors

1. Testosterone 101 (and why “average” isn’t optimal)

• Total vs. free testosterone and why free T drives function

• SHBG can bind most T; high SHBG with “normal” total can still feel like low T

• When to look deeper: free T, SHBG, LH, FSH and how that guides therapy

1. Step 1: Testosterone Optimization

• Goal: wake up tissues, restore sensation and responsiveness

• Typical patient feedback: more fullness, better sensitivity, improved energy and mood

1. Step 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 effect

• Personalizing to minimize side effects and maximize reliability

1. Step 3: Support for the “Big Head”

• Apomorphine for central arousal drive

• Oxytocin for bonding, relaxation, and responsiveness

• Combining brain and body support to reduce pressure and improve experience

1. Step 4: Trimix Autoinjectors (reliability on demand)

• How autoinject pens work with tiny 30-gauge needles

• Dialing firmness and duration via Bimix/Trimix/Quadmix blends

• Office testing to set the right dose and remove uncertainty

• Especially helpful when neuro-signals are impaired (e.g., spinal cord injury)

1. Step 5: Regenerative Medicine and Venous Leak

• P-Shot (PRP) basics: spin blood, concentrate plasma, bathe erectile tissues

• Goals: tissue quality, responsiveness; potential help with venous leak

• When to add PRP to a plan

1. The Relationship Reset

• The performance spiral: why anxiety and avoidance compound the issue

• Replacing pressure with a plan restores confidence, intimacy, and ease for both partners

• Don’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.com
Location: 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 health

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