HealthyGamerGG - Why 40% Of Young Men Need Erectile Retraining

Episode Date: August 31, 2026

Talk to a HG Coach 1-on-1: https://bit.ly/46bIkdoDr. K's NEW Guide to Love, Sex, & Relationships is here! Order now: https://bit.ly/4dO3x0VDr. K's Guide to Mental Health: https://bit.ly/44z3SztHG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQIn this episode, Dr. K unpacks the highly requested, real-world science behind his "penile retraining regimen". Moving beyond common myths, he explains why testosterone is often a red herring for erectile issues, how the physical habits of masturbation "train" the body to struggle with real intimacy, and provides a breakdown of pelvic floor and mental exercises that can clinically treat erectile dysfunction (ED) and premature ejaculation without relying on medication. What to expect in this episode: The Testosterone Red Herring: Why a drop in testosterone isn't the primary driver of erectile issues, with clinical data showing that only about 5% of erectile dysfunction cases are actually caused by low testosterone. The Role of Obesity: How endocrine-active fat cells (adipocytes) actively convert testosterone into other hormones, making physical health and cardiovascular conditioning far more critical than artificial hormone boosters. Death Grip Syndrome: How years of masturbating with a tight, dry hand grip trains the penis to expect 100 to 130 PSI of pressure, making it physically impossible to stay aroused by a partner's body, which naturally only produces 5 to 30 PSI. "Don't Skip Dick Day" Exercises: A breakdown of a clinical trial where targeted pelvic floor exercises completely cured ED in 40% of men and significantly improved it in another 35%—a therapeutic impact directly comparable to Viagra. Separating Orgasm from Ejaculation: A lesson in the physiological mechanics of tantric sex, explaining how strengthening pelvic muscles allows men to control the urethral pathway to experience prolonged pleasure and delay ejaculation. The Theory-Crafting Hack: Why performing complex math or theory-crafting optimal video game rotations (like calculating warlock DPS meters in Molten Core) in your head during intercourse is a highly effective, clinical technique to slow down premature ejaculation. Redefining Normal Timing: Why the average sexual encounter lasts only 3 to 7 minutes, and why the ultimate goal should be managing performance anxiety and letting go of the shame that kills erections, rather than chasing unrealistic, hour-long standards Learn more about your ad choices. Visit megaphone.fm/adchoices

Two and five Canadians will hear the words you have cancer. That's why every step and dollar raised matters. On September 19th, join thousands in Toronto for the Princess Margaret Cancer Foundation Walk. Challenge yourself, friends, and family to walk 21 kilometers in support of life-saving research. Together, we can carry the fire and help create a world free from the fear of cancer. Register today at pmcfwalk.ca. Hear that? It's your money calling. It wants a promotion.

Elevate your savings with the Scotia high-interest savings account. Always earn high regular interest rates that grow the more you save and invest. Conditions apply. Visit scotiabank.com slash h-I-SA to learn more. Scotia Bank. You're richer than you think. Hey, chat. Welcome to the Healthy G-GER podcast. I'm Dr. Al-O Kanoja, but you can call me Dr. K. I'm a psychiatrist gamer and co-founder of healthy gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you.

So let's dive right in. All right, chat. Today, we are going to drop Dr. K's penile retraining regimen. Words that I never thought would come out of my mouth. But here we are. So I made a YouTube video about erectile dysfunction kind of blew up. And at the end, I made this joke about, oh yeah, yeah, like, you know, here's, you can sign up for Dr. K's only fans where you can get Dr. K's penile retraining regimen. So in order to help you all with this problem, I'd love to tell you all about a new guide we've made, which is Dr. K's guide to penile retraining. And I kind of said it as a joke, but everyone was like, hey, Dr. K, can you drop your penile

retraining regimen? And so the answer is yes. And we're going to be doing that today. A couple of quick disclaimers. So the stuff that I'm going to teach you guys today is stuff that I've sort of used clinically. So I've worked with people with pornography addiction who have had difficulty with preempties. immature ejaculation, erectile dysfunction, and pornography addiction. So I've used some of this stuff clinically.

Some of it works. But then we're also doing a literature search on other things that we're going to include in today's video, which I think would be part of a penile retraining regimen. But just to be clear, this is not something that is a clinical protocol. It's never, there's never been an RCT of Dr. K's penile retraining regimen. There's a part of it that involves physical therapy exercises, which will explain to you all. If you'll have erectile dysfunction, please go see a licensed professional. And especially for the exercise portion, which is basically don't.

skip dick day we would strongly recommend that you see a physical therapist but we'll we'll explain the principles behind the the exercises and then on my only fans i have demonstrations of me walking through all of the exercises which um you know you can pay x amount of money for it's not a real thing first thing to understand if you want to take care of your dick chances are testosterone is a red herring so a lot of people have been freaked out about testosterone low testosterone levels so in about around the year 2000 testosterone levels used to be about 605 nanograms per deciliter for the average person. That has dropped in around 2016 to 411 nanograms per deciliter. So that is absolutely a big drop. But testosterone deficiency doesn't start

until about 300 nanograms per deciliter. So testosterone has dropped. A big part of that drop is obesity. As you become more obese, the amount of testosterone that you have floating through your system actually reduces. And a big reason for that that a lot of people don't realize is that fat tissue, adipocytes, adipose tissue, is not just energy storage. It's actually endocrinologically active. Fat cells will be involved in the conversion of testosterone to other things. Okay. So even though testosterone has dropped, most research suggests that only 5% of erectile dysfunction, that's the number that I kind of go with. It's 2 to 23%. But about 5% of erectile dysfunction is due to testosterone. So if you have erectile dysfunction, if you have difficulty as premature ejaculation

or inability to ejaculate, there's a good chance 95% of all ballpark don't need more testosterone. Okay. So what do y'all need to do? What is the penile retraining involved? So we're going to start with the first thing, which is cardiovascular health. So the penis is a cardiovascular organ. So sure, we need some amount of testosterone to activate the penis. But if we look at what an erection actually is, it is a discrepancy between the blood going into the penis. and the blood coming out of the penis. So we have arteries in the penis. We have veins in the penis.

And basically when we get erect, there's a mismatch between how much blood is going in. And then the penis swells with blood. And then less blood comes out. Okay. So the number one cause of erectile dysfunction is actually a lack of cardiovascular health. So anything that we do to improve our cardiovascular health will improve our erections. Aerobic exercise works great. I really like weight training.

Weight training of the quadriceps. So if you guys want to do sets of squats or lunges a couple times a week, that's really good because the quadriceps muscle is the largest signal for testosterone production in our body. And then, of course, squats are also really good for our general cardiovascular health. But basically, becoming physically active, doing some weight training is great for your to rehabilitate your penis into the glorious, magnificent member that it should be. Okay. Second thing we're going to talk about is penile retraining. So this is important to understand. Our physiology adapts to our circumstances.

Okay? If I live at a high altitude of the partial pressure of oxygen, if I live in like Colorado or something like that, let's say I live at a elevation of 2,000 meters, 6,000 feet. My body will detect that and it'll increase the production of red blood cells. Okay. So my body always adapts to my circumstances. So a big part of what I see with young men who struggle with premature ejaculation. and erectile dysfunction, general penis health. Okay.

And some, I've worked with people who struggle with both. Is we have to, the penis has been trained in a particular way. So a lot of people will blame pornography. I think that's a huge part of it. But if we look at simply the effect of pornography alone, pornography does not cause erectile dysfunction. What leads to an erectile dysfunction is pornography usage, which with certain mental changes, which we'll talk about.

And then physical changes, which is that most people who watch pornography, we're talking about, let's say, 13 or 14 year old boy who starts watching pornography, start. masturbating using dry hand, right? And then does that for, let's say, maybe 10 years before they have their first sexual intercourse, which means that the penis has been trained to respond to a particular stimulus. So a big part of penile retraining is to literally use a different stimulus. Okay. So this is where we get to death grip syndrome. So if we use a looser grip and lots of lubrication and we don't like tug one out over the course of 60 seconds, if we slow through the things down that retrains the penis, okay? So in this situation, their penis has gotten used to their

hand, right? And the, the vagina produces about, the vagina produces about five to 30 PSI of pressure. A hand grip is around 100 to 130 PSI of pressure. There's some weird conversion stuff there. But anyway, so we know that like the hand just has a far tighter grip than what the vagina is able to produce. And so part of the retraining involves using, a sustained level of stimulation that has more lubrication and a much less tight grip. Okay. Now, how long does this take? You know, I see progress in about 10 to 14 days.

Sometimes it takes a little bit longer and let's understand why. If you stop masturbating, about 50% of people will have a nocturnal emission within about seven days. So there's something in the body that like has somewhere around a week to two week cycle to readjust to things. So there are other cases of this. So if you look at like when you start losing muscle mass, so if you stop lifting weights for about 10 days,

that's when you really start to lose muscle mass. So there's something about this like one to two week period that a lot of mechanisms in our body kind of recalibrate over that amount of time. So if we're talking about this penile retraining, one of the things that we want to do is stop using pornography. We'll get to that in a second. Use a loose grip, lots of lube, and go slow. The other ultimate penile retraining, I just got to be honest with y'all, is intercourse.

Okay. So if we're talking about retraining a part of our body, giving it an alternative, like, goes a long way. Right. So it's kind of hard, and no pun intended, to, you know, stroke with less pressure, a fifth of the pressure that you're usually doing or a third of the pressure that you're usually doing, a way more loob. And it's just going to kind of feel unsatisfying, which is why we recommend the body system. Okay. Yeah. So the other thing about penile retraining that I've found working with people is that intercourse is like a really great way to retrain.

Now, this becomes part of a problem because, you know, you can get premature ejaculation. We have difficulty finishing. We can have erectile dysfunction. But this is one of those things that's like, if you guys are sitting there and your reaction is like, but Dr. Kay, I can't get laid. That's the problem. You're saying that in order to retrain my penis, I need intercourse. Like, that's so hard.

And I understand that. Right. And that's why we make things like Dr. K's guide to love sex and relationships. I understand that this is challenging. And so we've spent hundreds of hours trying to figure out how to help y'all engage in healthy relationships. But this is where, like, as a doctor, I got to just be honest with y'all for a second, right? So when it comes to the human body, there are certain ways to do things. So if you want to be physically healthy, changing your diet and changing your exercise regimen are critical parts of that. So if you want to retrain your penis, a huge part of doing that is engaging in sexual intercourse.

And this is where, like, I know you guys want an answer to do it at home, which is what we're going to give you all today. But, like, this would be incomplete without that element. And this is where, like, I feel like my role here is not to help you guys just solve this problem within these four walls. Right. It's to help you actually engage in the healthiest and funnest solutions out there. Okay. So check out the guide. If you guys need help with that, we'll get to the rest of the regimen.

Okay. Cardiovascular health, loose grip, lots of loop. Give it about two weeks. Next thing we're going to talk about is the actual physical therapy regimen. Okay. So this is a really cool randomized controlled trial that taught pelvic floor exercises to men with erectile dysfunction. Found some really awesome stuff. The first thing is about 75% of men, 40% of people had complete resolution of their erectile dysfunction.

35% of people had improvement in their erectile dysfunction. And the level of improvement is comparable to Viagra. Okay. So this is what's really cool. We don't need Viagra. We can actually train ourselves. We can do don't skip dick day. They're dick day exercises that you can do that will strengthen your penis and strengthen your erections. Okay. Here's a summary of these exercises. In this protocol, these were taught by a physical therapist. So if you guys are really interested in learning these, I think that's the best way to do them. But we can go over some of the basic principles today. And I'm going to teach you guys this stuff. Okay. Once again, demonstrations are available on OnlyFans when I'm modeling everything. Okay. So, three parts of the pelvic floor that we're going to sort of teach y'all, okay? The first is if you tighten down there, you'll notice that there are three distinct areas of tightening, okay? The first is sometimes I play games on the internet and we will have something known as a butt clenching moment. But clenching moment is contraction of the anal sphincter, okay? And this is what's really cool is the study that was using these pelvic floor exercises actually measured digital anal pressure.

And I still don't know what the digital measurement is because sometimes in medicine, digital means finger. So literally, like, when we do digital rectal exams to evaluate for, like, you know, prostate cancer, a digital rectal exam doesn't mean using computer. It means using a, this is a digit, using a finger. So I don't know in this trial if they were inserting fingers into butts. So the first area is the anus, okay? second area of the pelvic floor that we want to focus on is the part that makes your penis go up. So when you have an erection, right, you know, you can like pull that muscle and make it floppy.

Like when you want your penis to stand at attention, you're like, attention. That muscle is also kind of part of, I guess technically I don't know if it's part of the pelvic floor. But it's kind of, you know, at the top of the penis. So these are two muscles. And then in between these, you have your perinium. And the perineum is kind of like literally like the pelvic floor that you kind of pull up. Okay, so if we look at this regimen, what we're going to see is like in a standing position with your feet apart, tighten your pelvic floor muscles, as if you were trying to stop the flow of urine and wind escaping. If you look in the mirror, I would recommend, you should be able to see the base of your penis move nearer to your abdomen, right?

That's your, that's the flip up. Try, so this is really important. Try to avoid holding your breath, pulling in your abdomen or tensing your buttocks. So this is important. We don't want to tense the gluteal muscles. We actually don't want to do butt clenching. What we want to do is raise that pelvic floor, that perennial area, and breathing can be really good, right? So breathing will like relax all of the other muscles that you're not focusing on.

So in a sitting position, you can basically do the same. Perform three maximal contractions and sitting every in the morning and evening. You can lay down while do it. You can walk while doing it. After you avoided your urine, try tightening your pelvic floor muscles. During sexual activity, try tightening your pelvic floor muscles. to achieve and maintain penile rigidity during sexual activity. Slow thrusting movements generate higher pressures inside the penis.

Pressure inside the penis is what maintains the erection. To delay ejaculation, we can try tightening our pelvic floor muscles. This is the, from the paper, this is the regimen that they used. Once again, you can find a physical therapist if you guys want training and stuff. And that, by the way, is not a meme, right? So getting trained in this stuff just like you would train with a personal trainer, it goes a long way. But let's talk a moment about premature ejaculation. So one of the interesting things about Thon3,

sex that people don't realize is in the West, we use the word coming, right? But coming actually has two pieces. There's orgasm and there's ejaculation. And we assume that these two things come together, but they don't. Simple example of this, we talked about nocturnal emissions. So 50% of people who abstain from sexual intercourse post-puberty adults, adult men, will have a nocturnal emission within a week. So this is a case of an ejaculation without an orgasm.

Now, if we look at tantric sex, what tantric sex is all about is, I mean, that's not what it's all about. There's a real spirituality to it. But the technique that gets popularized in the West is a prolonged orgasm without ejaculation. And here's the key thing to understand. And if you guys have ever had this experience, you kind of know. There's a lot of people don't understand. Orgasm ends with ejaculation. So if you really look at it, you start to have your orgasm before you nut, right? Like, think about it for a second. And when you finish nutting, your orgasm is definitely over. So orgasm starts. Then you start ejaculating. When ejaculation, is over orgasm ends. And this is what all the gooners, we've done a video about this,

and what edging and all this kind of stuff is about, right? As people have started, people have sort of rediscovered this a little bit, that if you play around with the gray zone of orgasm and ejaculation, you can really do some weird stuff. So the yogis who are really good at this kind of stuff, and they used it for spiritual purposes, which is a conversation for a different day. This is the fundamental technique. So the yoga asan, the posture that we use, basically strengthens the pelvic floor. And as you guys know, the muscle, you know, the muscle that top muscle, the one that causes the penis to go like this, that is the muscle that holds in urine. And what happens in the anatomy of the penis is the urethra is the pipe that,

you know, there's only one hole in the penis through which urine and semen come out of. And so the seminal vesicles is, semen comes in through the seminal vesicles and you have your urethra, they connect it at some point. So the muscle that actually stops the flow of one, stops the flow of the other. And so the key thing about premature ejaculation is if you strengthen those muscles, and the reason that, if you guys remember that worksheet, the reason they have X number of seconds is because if you lift that muscle, what you'll find is that that muscle gets exhausted very easily, right? You can do reps, but holding it becomes very difficult. So as you strengthen your pelvic floor, your ability to hold gets way better. Okay? And that will help you

with premature ejaculation. So it'll help you with erectile dysfunction because we're increasing the the pelvic pressure on the penis, we're doing a cardiovascular kind of thing. Pelvic floor will also help us stay erect. We want to do slow thrusts. That's really important, okay, because it increases the internal pressure of the penis and will help you maintain erection. So this is an important part. This is don't skip dick day.

Okay. Next thing that we're going to talk about is premature ejaculation and erectile dysfunction from a mental and sexual standpoint. Another thing to understand is if you're someone who's nutting too quickly, a big part of how quickly you orgasm is your mental state. So we know that if you're depressed, like it's hard to achieve orgasm. You know that if you're stressed, it's hard to achieve orgasm. So one technique that's kind of interesting.

So if you sort of think about, you know, the sexual act, in your mind, you're horny. And with your body, you're having sex. And when you're horny in your mind and you're having sex in your body, that's when you nut. And as we know, like, there are certain things that are hot, right? So this is what we tend to find with people who use pornography a lot is that they will require more hardcore pornography in order to get hard, get excited, and finish. So what we see is that the mental component, and what is hardcore pornography, it's not just physical stimuli, right? So there is an element of maybe bouncy, jiggly, or wetter, whatever, but there's a mental

component of it. There's some amount of, like, you know, like if we look at like, why is step sibling porn so searched for because the physical act, you can't see the genes of the people involved, Right. So that's a mental thing. And it's one of the most searched for categories. So a big part of premature ejaculation is what is in your head. So this is where some techniques that work really, really, really well, I'm going to be honest with you all doing math in your head. So if you feel like you're going to finish and you're not ready to finish, do math in your head. Another thing that I've heard works incredibly well is theory crafting for whatever video game you're playing. Like think Excel spreadsheet, DPS meters, figuring out optimal rotations for warlock. DPS and MoltenCore. You are going to DPS very, very slowly. Like all these kinds of things. If you do some kind of mentally distracting activity in your head while you maintain the physical rhythm, and remember, we want to go slow, that's going to work great.

And by slowly, I mean, slow. On the flip side, if you're struggling with erectile dysfunction, remember, erectile dysfunction is the inability to maintain an erection for the duration of the act. So the more mentally you can get into it, the better off you will be, right? And this is where we're not, yeah, the better off you will be. So the more mentally aroused you are, which is why people will try to engage in like fetishes and stuff like that. We've got a whole video about how to have those conversations in Dr. K's Guide to Love,

sex and relationships. But the mental component is really important as well. And you can titrate that up or titrate that down. Last thing is a simple bit of advice about premature ejaculation or not even premature ejaculation. is just ejaculating first. So one of the things that a lot of men struggle with is that they're like, they'll ejaculate before their partner. And this is like a problem, right?

Because you like want to give her the D or him for a long period of time. You don't want things to be over super quickly. And just a quick bit of research about that. The average sex act lasts between three and seven minutes, totally normal. 50% of women, if you ask them, prefer sex to be over after 15 minutes. So 15 minutes is kind of the upper limit. They're kind of done. So one of the key things is we want to shoot for ideally 15 minutes, but sometimes when you're having sex and you're aroused and it's been a couple of days, you finish quickly.

And this isn't necessarily a bad thing. So I think this is one of those things where, you know, letting your partner know that, hey, like, this was just too amazing and you're, you know, I'm sure. Well, I'm trying to debate about whether I should. If you guys, I guess we can make this if you guys want. But, you know, letting your partner know how gratifying the experience was for you, right? I'm not going to actually model that dialogue in this video right here. But like just letting your partner know, like, I couldn't hold back. Like, this was too good.

You know, the PSI of the genital organ was amazing. Don't say that. That's, I'm sure you guys can read between the lines there, right? You're too tight. And letting your partner know that you thoroughly enjoyed the experience is really, really, really good. So like, that's one thing. Don't worry so much about premature ejaculation. If it happens, it happens.

Here's the really important thing. See, when you get upset about premature ejaculation and then you start to feel self-conscious and kind of stuff, that's what really kills it. So one of the interesting things, I have this theory that ejaculate actually alters the intensity of female orgasm. Now, I looked for research to support this, couldn't find this. The best that I could find is that there is evidence that ejaculate in the vagina does have some impact. We just don't know what it is. People look for things like antidepressant properties. We haven't been able to really do that. But you can detect elements of the ejaculate within the

bloodstream of the woman after the ejaculation. So this is one of those things where like after the ejaculation, even if you prematurely ejaculate, you got to just make sure you finish the job for your partner, right? Men, woman, doesn't matter. And so something that's really interesting that I've kind of stumbled into with some of the people that I've worked with is that this pattern can actually, like, if you kind of ride the pattern out, it can actually end up really well. Because sure, you're ejaculating first, but then over time, your partner is also having a good experience, right? And then it's kind of like this association starts to form. And I've actually seen this pattern where the male partner ejaculating is highly arousing because of almost a Pavlovian response and can induce a greater orgasm

for the woman. Now, one of the things that I don't know is what's the mechanism of that? Is that Pavlovian? Is there literally a physiologic mechanism of semen and the vagina that does it? My point is like, as a psychiatrist, when someone comes to me with premature ejaculation, we should try to stop the premature ejaculation. Sure, we want to make things last between seven, 15 or more minutes. Totally fine. Let's do the quadriceps, lunges, squats, cardiovascular health, maybe some Viagra, do the mental stuff. Like, we want to do those things. But a big part of what I've learned as a psychiatrist is to like roll with the punches. Right. So if this is a problem that you struggle with, then it's not the end of the world. And you can end up having a gratifying

sexual experience even if you finish before your partner does, which is incredibly common. Okay. We don't want to leave them hanging. Right. So we don't want to like roll over and fall asleep. That's a big no-no. Over time, what I tend to see with people who follow these kinds of trajectories is that things move in the right direction. So this is another big part of the penile retraining is the time frame. So on the one hand, there's some evidence that about 10 to 14 days is what it takes to get started. But if we look at the pelvic floor exercises, these are measuring outcomes at six months. And so just because you're in a situation of erectile dysfunction or premature ejaculation with a partner today, doesn't mean that you can't fix it over a longer period of time, right?

And that's what's really scary about this is everyone is like, this happened once. How do I fix it tomorrow? Or how do I fix it next weekend? You may not be able to retrain your body that quickly from this weekend to next weekend because you've been using a certain amount of PSI on your penis for 15 years. That retraining may take months. And that's usually what sustained physiologic change.

When we're really looking at improvements in cardiovascular health, sure, we see things within two weeks of exercise. but exercise for a workout for six months and you'll see a big difference and the penis is no different. So then what we want is we want a way to deal with that shame. We want a way to satisfy our partner while we are retraining. So if you want more of this perspective of just thinking about yourself as a man in a different way, we've got a deep dive into healthy masculinity that I strongly recommend you check out. So I wanted to let you all know we're starting a new group.

We're starting a men's group. That's a workout group where we're going to go ahead and do penile retraining using a buddy. And so if you have difficulty applying a minimal pressure with the right amount of lube, you can pair up with someone through our new app that we're launching and find a nice buddy and you guys can kind of do it together. Okay. But also a good reason why we can use the body system to figure this out, right? Let's test your digital anal pressure.

Okay? I do you, you do me, use the body system working out. Don't skip penis day. Okay? I don't know. But anyway, they did that measurement. Thanks for joining us today. We're here to help you understand your mind and live a better life.

If you enjoy the conversation, be sure to subscribe. Until next time, take care of yourselves and each other. Two and five Canadians will hear the words, you have cancer. That's why every step and dollar raised matters. On September 19th, join thousands in Toronto for the Princess Margaret Cancer Foundation walk. Challenge yourself, friends, and family to walk 21 kilometers in support of life-saving research. Together, we can carry the fire and help create a world free from the fear of cancer. Register today at pmcf walk.ca.ca.