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Choosing the Right Supplement for Erectile Dysfunction

Updated: Sep 14, 2023

Introduction to Supplements for Erectile Dysfunction (ED)


Many men try supplements to treat ED, but their effectiveness can vary significantly between individuals. It’s essential to have realistic expectations and understand that supplements are only part of a comprehensive treatment plan for ED. In this post, we will discuss how to select and safely try supplements and provide an overview of popular options.





How Pick Supplements


There is a lot of trial and error in picking supplements. It's very difficult to know which one will help you because everyone is different, and the underlying causes of ED vary significantly from person to person. To minimize trial and error, consult with a physician specializing in Naturopathic, Functional, or Integrative Medicine. They can order tests to examine your vitamin, mineral, and hormonal levels, as well as metabolic function, to guide your supplement choices. It’s crucial to source supplements from reputable suppliers, as counterfeit and low-quality products are prevalent in the market. Generally, these doctors can also point you to sources of quality supplements.


How to Safely Implement the Trial and Error Approach


If you go with the trial-and-error approach, I suggest doing the following.


Before you start taking any supplement:


  1. Select one supplement to try out.

  2. Investigate any contra-indications for using the supplement and make sure those contra-indications do not apply to you.

  3. If you have pre-existing health conditions or are taking medications, consult your doctor to ensure they have no concerns about the supplement.

  4. It’s always a good idea to consult a doctor about your supplements, even if you do not have health problems or are on medication.

  5. Ensure you are taking the recommended dosage of the supplement. If you aren’t sure about the dosage, again consult a doctor.


Once you start taking the supplement:


  1. Take only the recommended dosage of the supplement.

  2. If you have a bad reaction to a supplement, stop taking it immediately and consult with a doctor.

  3. Try the supplement for 2 to 3 months and see if there is an improvement.

  4. If there is no noticeable improvement, you can stop taking the supplement.

  5. If there is an improvement, continue taking the supplement.

  6. Decide if you want to try another supplement and repeat the process.

  7. Over time you can take multiple supplements but add them one at a time to evaluate them.


Here is a list of supplements commonly used to treat ED. I intend to cover most of them in more detail in future posts. If you know of anything I missed, please contact me.



Supplements Overview


L-arginine: An amino acid that the body converts into nitric oxide, which can help to relax blood vessels and improve blood flow. Improved blood flow may contribute to better erections.


Warning! It has come to my attention that men over 45 should not use L-arginine or should use it very sparingly. I will cover this in more detail in a future post.


L-citrulline: Another amino acid that gets converted to L-arginine, which in turn becomes nitric oxide. It may help improve blood flow and erectile function.


L-carnitine: Some studies have suggested that L-carnitine may improve erectile function in some instances, particularly when combined with other supplements like L-arginine.


Propionyl-L-carnitine: Similar to L-carnitine, propionyl-L-carnitine has been studied for its potential to improve erectile function, particularly when combined with other treatments or supplements.


Horny goat weed: Contains a compound called icariin, which may inhibit PDE5, an enzyme responsible for reducing blood flow, potentially enhancing blood flow and erectile function.


Ginseng: A popular adaptogenic herb believed to have anti-inflammatory and antioxidant properties. Some studies suggest ginseng, particularly Korean red ginseng, may help improve erectile function.


Yohimbine: Derived from the bark of an African tree, yohimbine has been shown to improve erectile function by increasing blood flow and stimulating nerve impulses in the penis.


DHEA (Dehydroepiandrosterone): A hormone precursor that the body converts into testosterone and estrogen. Some studies suggest that DHEA supplementation may help improve erectile function in men with low testosterone levels.


Tongkat Ali: A Malaysian herb believed to boost testosterone levels and enhance libido, which may help improve erectile function.


Maca root: A Peruvian plant that may help improve libido and sexual function, though the exact mechanism is poorly understood.


Ashwagandha: An adaptogenic herb that may help reduce stress and anxiety, which can contribute to erectile dysfunction. Some studies suggest that it may also improve testosterone levels.


Magnesium: An essential mineral that may help improve blood flow and support healthy blood pressure levels, potentially contributing to better erectile function.


Zinc: An essential trace mineral that plays a role in testosterone production. Low zinc levels have been associated with erectile dysfunction, and supplementation may help improve sexual function in some cases.


Vitamin D: A fat-soluble vitamin that may help support testosterone levels and overall sexual health.


Warning! You should take Vitamin D with Vitamin K. Vitamin D alone can harden your arteries, and vitamin K will counter that effect. I suggest getting both combined into one supplement.


Ginkgo Biloba: A herb believed to increase blood flow, which may help improve erectile function. However, scientific evidence supporting its effectiveness for ED is limited.


Pycnogenol: Is derived from the bark of French maritime pine trees. This antioxidant is sometimes used for ED, often in combination with L-arginine, to improve blood flow.



Niacin (Vitamin B3): Niacin is used for ED due to its potential vasodilatory effects, which could help improve blood flow. However, more research is needed to confirm its effectiveness.


Coenzyme Q10 (CoQ10): Some studies have suggested that CoQ10 supplementation may improve erectile function in men with certain cardiovascular risk factors.


Muira Puama: Also known as “potency wood,” this Brazilian plant has been used traditionally to treat sexual dysfunction. It is believed to help improve libido and erectile function by increasing blood flow to the pelvic region. However, scientific evidence supporting its efficacy for erectile dysfunction is limited, and more research is needed to confirm its effectiveness.


References on Each Supplement


If you want to dig into scientific studies on supplements, here is a list of studies to get you started. It’s important to remember that studies are not “proof.” They are evidence, and not all studies are done well. It’s important to review as many quality studies as possible. Scientific literature reviews are often a good overview of studies on a particular subject.


L-arginine:

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: results of a double-blind, randomized, placebo-controlled study. BJU International, 83(3), 269-273.


L-citrulline:

Cormio, L., De Siati, M., Lorusso, F., Selvaggio, O., Mirabella, L., Sanguedolce, F., & Carrieri, G. (2011). Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology, 77(1), 119-122.


Horny goat weed (Icariin):

Shindel, A. W., Xin, Z. C., Lin, G., Fandel, T. M., Huang, Y. C., Banie, L., … & Lue, T. F. (2010). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The journal of sexual medicine, 7(4), 1518-1528.


Ginseng (Korean red ginseng):

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.


Yohimbine:

Ernst, E., & Pittler, M. H. (1998). Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. The Journal of Urology, 159(2), 433-436.


DHEA:

Reiter, W. J., Pycha, A., Schatzl, G., Pokorny, A., Gruber, D. M., Huber, J. C., & Marberger, M. (1999). Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study. Urology, 53(3), 590-594.


Tongkat Ali:

Tambi, M. I., Imran, M. K., & Henkel, R. R. (2012). Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia, 44, 226-230.


Maca root:

Zenico, T., Cicero, A. F. G., Valmorri, L., Mercuriali, M., & Bercovich, E. (2009). Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. Andrologia, 41(2), 95-99.


Ashwagandha:

Ambiye, V. R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M., & Dongre, A. (2013). Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study. Evidence-Based Complementary and Alternative Medicine, 2013.


Magnesium:

Cinar, V., Polat, Y., Baltaci, A. K., & Mogulkoc, R. (2011). Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biological trace element research, 140(1), 18-23.


Zinc:

Sørensen, M. B., Bergdahl, I. A., Hjollund, N. H., Bonde, J. P., Stoltenberg, M., & Ernst, E. (2002). Zinc, magnesium and calcium in human seminal fluid: relations to other semen parameters and fertility. Molecular human reproduction, 8(10), 958-964.


Vitamin D:

Farrokhyar, F., Tabasinejad, R., Dao, D., Peterson, D., Ayeni, O. R., Hadioonzadeh, R., & Bhandari, M. (2014). Prevalence of vitamin D inadequacy in athletes: a systematic-review and meta-analysis. Sports medicine, 45(3), 365-378.


Ginkgo Biloba:

Cohen, A. J., & Bartlik, B. (1998). Ginkgo biloba for antidepressant-induced sexual dysfunction. Journal of Sex & Marital Therapy, 24(2), 139-143.


L-Carnitine:

Cavallini, G., Caracciolo, S., Vitali, G., Modenini, F., & Biagiotti, G. (2004). Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology, 63(4), 641-646.


Pycnogenol:

Stanislavov, R., & Nikolova, V. (2003). Treatment of erectile dysfunction with pycnogenol and L-arginine. Journal of Sex & Marital Therapy, 29(3), 207-213.


Propionyl-L-carnitine:

Gentile, V., Antonini, G., Antonella, B., Mariotti, G., Ignarro, L. J., & Salvatore, G. (2004). Effect of propionyl-L-carnitine, L-arginine and nicotinic acid on the efficacy of vardenafil in the treatment of erectile dysfunction in diabetes. Current Medical Research and Opinion, 20(9), 1377-1384.


Niacin (Vitamin B3):

Ng, C. F., Lee, C. P., Ho, A. L., & Lee, V. W. (2011). Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia. The Journal of sexual medicine, 8(10), 2883-2893.


Coenzyme Q10 (CoQ10):

Safarinejad, M. R. (2012). The effect of coenzyme Q₁₀ supplementation on partner pregnancy rate in infertile men with idiopathic oligoasthenoteratozoospermia: an open-label prospective study. International urology and nephrology, 44(3), 689-700. (While this study does not directly address erectile dysfunction, it does investigate the potential impact of CoQ10 on male fertility.)

Muira Puama:



Conclusion on Supplements


Working with a doctor knowledgeable about supplements and men’s health is highly recommended. Always research each supplement, check for contraindications, and ensure you use quality supplements. Remember that supplements are likely to be just part of the solution for ED, as part of a more comprehensive treatment plan.


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