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Men's Health

Nutrition and Supplements for Erectile Dysfunction (ED)

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Erectile dysfunction (ED) affects up to 30–40% of men over 40,

and is strongly linked to vascular health, nitric oxide (NO) bioavailability,

and metabolic factors (Burnett & Musicki, 2005).

 

Lifestyle optimization—including diet, exercise, and weight management—remains first-line therapy, but several nutrients and supplements have supporting evidence.

 

1. L-Arginine and L-Citrulline

  • Precursors to nitric oxide, promoting vasodilation.

  • Evidence:

    • Oral L-arginine (5 g/day) improved ED in men with low baseline NO (Chen et al., 1999).

    • L-citrulline (1.5 g/day) also improved erection hardness and is sometimes better tolerated, as it bypasses first-pass metabolism (Cormio et al., 2011).

  • Works best when combined with pycnogenol or PDE-5 inhibitors.

 

2. Panax Ginseng (Korean Red Ginseng)

  • Enhances NO synthesis and may improve penile blood flow.

  • Meta-analyses show modest but consistent improvement in International Index of Erectile Function (IIEF) scores with 600–1,000 mg 3x daily (Jang et al., 2008; Borrelli et al., 2018).

 

3. Pycnogenol (Pine Bark Extract)

  • Potent antioxidant that boosts NO production.

  • Evidence: Combination of L-arginine (1.7 g) + Pycnogenol (40–120 mg/day) significantly restored erectile function in up to 92% of men after 3 months (Stanislavov & Nikolova, 2003).

 

4. Zinc

  • Essential for testosterone synthesis and sperm health.

  • Deficiency is linked to hypogonadism and impaired sexual function.

  • Supplementation improves testosterone and libido in deficient men (Fallah et al., 2018).

  • Note: Supplement only if deficient; excess zinc can impair copper balance.

 

5. Vitamin D

  • Supports endothelial function and testosterone production. Endothelial cells create the inner lining of blood vessels, and affect blood flow. 

  • Low vitamin D strongly correlates with ED severity (Farag et al., 2016). Supplementation improves endothelial health.

 

6. Omega-3 Fatty Acids

  • Are Anti-inflammatory, improves endothelial and vascular function.

  • Shown to improve endothelial dysfunction, a key contributor to ED (Mozaffarian & Wu, 2011).

 

7. Mediterranean Diet & Lifestyle

  • Mediterranean diet (rich in fruits, vegetables, whole grains, olive oil, fish, and nuts) is associated with improved erectile function and reduced ED incidence (Esposito et al., 2006).

  • Mechanism: Improves endothelial function (skin cells along inside of blood vessels), insulin sensitivity, and weight control.

 

 

Supplements with Caution or Limited Evidence

  • Yohimbine: Can improve ED but has significant side effects (anxiety, hypertension).

  • Maca root: Some small studies suggest libido enhancement, but less robust for ED.

  • Tribulus terrestris: Popular, but human data are inconsistent.

 

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Most evidence-supported supplements:

  • L-arginine / L-citrulline (nitric oxide boost)

  • Panax ginseng (herbal NO enhancer)

  • Pycnogenol + arginine (synergistic effect)

  • Zinc and Vitamin D (if deficient)

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Dietary approach: A Mediterranean diet, omega-3s, exercise, and weight loss are strongly linked to improved erectile function.

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Supplements should be used as adjuncts to lifestyle optimization and medical evaluation, especially since ED can signal underlying cardiovascular disease. Speak to your doctor. 

 

 

 

 

References

  1. Borrelli, F., Ernst, E., & Vincenzo, D. S. (2018). Ginseng for erectile dysfunction: A systematic review and meta-analysis. British Journal of Clinical Pharmacology, 84(12), 2686–2696. https://doi.org/10.1111/bcp.13717

  2. Burnett, A. L., & Musicki, B. (2005). The nitric oxide pathway in erectile function and dysfunction. Journal of Urology, 173(1), 23–26. https://doi.org/10.1097/01.ju.0000143689.14364.dc

  3. Chen, J., Wollman, Y., Chernichovsky, T., Iaina, A., Sofer, M., & Matzkin, H. (1999). Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: A randomized, double-blind, placebo-controlled study. BJU International, 83(3), 269–273. https://doi.org/10.1046/j.1464-410x.1999.00944.x

  4. Cormio, L., De Siati, M., Lorusso, F., Selvaggio, O., Sanguedolce, F., Bufo, P., … Carrieri, G. (2011). Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology, 77(1), 119–122. https://doi.org/10.1016/j.urology.2010.08.028

  5. Esposito, K., Giugliano, F., Maiorino, M. I., Giugliano, D. (2006). Dietary factors, Mediterranean diet and erectile dysfunction. Journal of Sexual Medicine, 3(6), 1116–1122. https://doi.org/10.1111/j.1743-6109.2006.00321.x

  6. Fallah, A., Mohammad-Hasani, A., & Colagar, A. H. (2018). Zinc is an essential element for male fertility: A review of Zn roles in men's health, germination, sperm quality, and fertilization. Journal of Reproduction & Infertility, 19(2), 69–81.

  7. Farag, Y. M. K., Guallar, E., Zhao, D., Kalyani, R. R., Blaha, M. J., Feldman, D. I., … Michos, E. D. (2016). Vitamin D deficiency is independently associated with greater prevalence of erectile dysfunction: The National Health and Nutrition Examination Survey (NHANES). Atherosclerosis, 252, 61–67. https://doi.org/10.1016/j.atherosclerosis.2016.07.919

  8. Jang, D. J., Lee, M. S., Shin, B. C., Lee, Y. C., & Ernst, E. (2008). Red ginseng for treating erectile dysfunction: A systematic review. British Journal of Clinical Pharmacology, 66(4), 444–450. https://doi.org/10.1111/j.1365-2125.2008.03236.x

  9. Mozaffarian, D., & Wu, J. H. Y. (2011). Omega-3 fatty acids and cardiovascular disease: Effects on risk factors, molecular pathways, and clinical events. Journal of the American College of Cardiology, 58(20), 2047–2067. https://doi.org/10.1016/j.jacc.2011.06.063

  10. Stanislavov, R., & Nikolova, V. (2003). Treatment of erectile dysfunction with pycnogenol and L-arginine. Journal of Sex & Marital Therapy, 29(3), 207–213. https://doi.org/10.1080/713847170

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