If you’ve ever researched ED treatments, you’ve likely come across nitric oxide — a naturally occurring gas that boosts blood flow, supports your immune system, and helps you get hard.
But are the supposed health benefits pseudoscience or actual science? What does the research indicate about using nitric oxide to treat erectile dysfunction? That's what this article aims to find out.
What is nitric oxide?
In simple terms, nitric oxide is a gas naturally produced by your body — but its role in the body is way more complex. Nitric oxide production is essential for a huge range of bodily functions, including:
- Relaxing your blood vessels. Nitric oxide is a vasodilator, meaning it dilates the walls of your blood vessels. This can help lower blood pressure and improve circulation, allowing blood to get where it’s needed (file this fact away for further down when we get into the nitty gritty of nitric oxide and ED).
- Enhancing overall blood flow throughout your vascular system. This is the network that delivers oxygen and nutrients to your organs and removes waste from your blood. Pretty important stuff for keeping your heart healthy and your circulation efficient.
- Enabling your cells to communicate with each other throughout your cardiovascular, nervous, and immune systems. This helps your body regulate certain functions including digestion and memory.
- Regulating hormone release, which is important for a host of functions including reproduction, metabolism, and stress response.
- Supporting your immune system so it can fight off bacteria, viruses, and parasites.
How nitric oxide impacts your sexual health
As part of its very important role in distributing blood around your body, nitric oxide is an essential part of your sexual function.
In men, it plays a crucial role in achieving (and maintaining) an erection. Nitric oxide is released in the blood vessels of your penis when you’re sexually aroused, relaxing the blood vessel walls and encouraging blood flow towards your erectile tissue.
When the tissue becomes filled with blood, it makes your penis feel engorged, leading to a hard-on.
Your body needs to have enough nitric oxide to sustain erections. If it doesn’t, you could experience ED — i.e. having trouble getting and staying hard.
Research shows that certain conditions that inhibit your body’s ability to synthesise nitric oxide could actually contribute to ED [1]. Some of these include obesity and hormonal imbalances.
Getting older and leading a sedentary lifestyle can also lead to nitric oxide deficiency [2].
Nitric oxide is also involved in women’s sexual function, namely by boosting blood flow to the sexual organs to increase arousal and sensitivity.
Can nitric oxide help treat erectile dysfunction?
Given how crucial it is in the body, including its ability to help you get hard, there are lots of nitric oxide supplements on the market.
The two most common are L-arginine and L-citrulline, amino acids found naturally in a bunch of foods that get converted to nitric oxide in the body.
Both are popular among those looking to treat conditions like erectile dysfunction or impotence.
But what does the research say? Is there any evidence that taking nitric oxide supplements really works for treating ED?
So far, there’s a bit of evidence indicating that nitric oxide can improve erectile dysfunction.
One 2014 study looked at L-arginine and L-citrulline supplementation and found that they could help enhance nitric oxide bioavailability in rabbits and mice. While it didn’t assess erectile function specifically, it did conclude that supplementation significantly boosted overall blood flow [3].
Another from 2020 also demonstrated the positive effects of L-arginine supplements when taken with ED medication. The researchers found that a combination of the two was the most effective method for addressing ED compared to taking each one alone [4].
A 2015 literature review found that several studies have supported the idea that nitric oxide supplementations could improve ED in some cases.
One study showed that orally administered L-arginine supplements could help with mild to moderate ED and another found that L-citrulline produced harder erections among mild erectile dysfunction cases [5].
However, many of the studies mentioned in the review had only been performed on animals and the evidence on humans was thus far mostly unclear.
Plus, the studies that have been done on human patients have been fairly small, indicating potential but not definitive proof that nitric oxide supplementation could assist with ED.
Some experts also argue that nitric oxide won’t work if ED is severe — a point that’s backed up by the fact that most of the research has indicated better results in mild to moderate cases [2].
So, if you choose to take nitric oxide for erectile dysfunction, be aware that it may or may not have an effect. It absolutely could do the trick, however being aware of its limitations can help manage your expectations when taking it.
It’s also worth mentioning that nitric oxide isn’t entirely risk-free. Supplementation can come with side effects, such as nausea, vomiting, headache and heart palpitations.
Plus, it could worsen some health conditions or interact badly with particular medications. That’s why it’s recommended that it be taken under a doctor’s supervision [6].
Alternative (and proven) ED treatments
If you’re still on the fence about nitric oxide, there are several alternative solutions that could improve your sexual function. Here are a few to consider.
Get the basics right
By that, we mean focusing on diet and exercise.
As far as what you eat goes, there’s research indicating that a diet rich in fruit, veggies, whole grains and fish, and low in refined grains, red meat and processed meat, could reduce the risk of ED [7].
Not only is exercise a great mood-booster and an excellent way to keep your body fit, but it may also assist in addressing ED.
A study by Harvard found that walking for just 30 minutes each day is connected to a 41% lower chance of developing erectile dysfunction. Additional research showed that moderate exercise (like swimming or cycling) helped restore sexual function in obese men [7].
So, it stands to reason that moving your body could both prevent ED and possibly even treat it.
Axe the smokes
Smoking isn’t great for your health, including when it comes to achieving and maintaining an erection.
Research has found a pretty strong correlation between smoking and ED, with one study finding that smokers are at a much higher risk of developing ED — likely because it depletes your nitric oxide levels, which we know is vital for erections.
The study also found that some men who quit smoking were able to improve their erectile function [8].
Lose weight
There’s also a known link between obesity and ED, with a lot of evidence indicating that being significantly overweight raises your chances of experiencing erectile dysfunction [9].
But losing weight could have a dramatic effect on your sexual function, with a 2005 study finding that 31% of participants were able to regain their erections by losing weight and implementing lifestyle changes like improved diet and regular exercise [10].
Addressing underlying issues
ED can be caused by a whole range of factors, including physical ones. In fact, it is linked to a number of conditions [11].
If there’s a medical reason behind your erectile dysfunction, chat to your doctor about addressing it. You may just find that treating the underlying condition could help restore your erectile function.
Try counselling
Some of the psychological factors behind ED include stress, depression, generalised anxiety, performance anxiety, and relationship issues. In this instance, counselling may be a more viable way to treat the problem, either solo or with your significant other.
Several psychologists and therapists specialise in treating sexual dysfunction, including ED.
Consider surgical options
Surgical options like penile implants and vascular surgery don’t come cheap, but they may be more effective if you’re experiencing severe erectile dysfunction and other treatments aren’t doing much to help.
The former are either malleable or inflatable rods that get inserted into your penis so you can manually create an erection, while the latter corrects a blockage or repairs a leakage that has stopped blood from getting to your penis.
Give medical ED treatments a go
You could also try Pilot’s ED treatment, a clinically proven option that delivers pretty impressive results. In fact, more than 90% of men have found success with Pilot’s ED treatments.
You can choose between a daily medication or an on-demand treatment depending on your needs, plus your subscription comes with unlimited follow-ups with a Pilot practitioner and discreet delivery across Australia.
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