Erectile dysfunction (ED) has been defined as the persistent inability to achieve or maintain penile erection sufficient for satisfactory sexual performance. Together with premature ejaculation, ED represents the most common among the symptoms of male sexual disorders.
The prevalence rates of ED are estimated to range from 1-10% in adults aged <40 years to 50–100% for men in their 70’s and 80’s. Current approaches to ED are primarily based on pharmacotherapy, with phosphodiesterase type 5 (PDE5) inhibitors representing a first-line treatment.
The use of plant-derived products to enhance male sexual performance has a long and continuous history. A number of plants have been used as male sexual performance enhancers in traditional systems of medicine in different countries and different cultures.
Many supplements have been advertised as a cure or remedy for ED. Some of the ones that had been studied and proved to have benefits in clinical trials will be discussed below.
Different studies, including 4 from Korea and 1 from Brazil, studied the effect of this supplement against placebo. The duration of the treatment ranged from 2 to 3 months and in 4 of the studies it was reported that ginseng had a significant difference in favor compared to placebo. They all reported improved sexual function in men with ED. There is also a cream preparation for premature ejaculation.
Arginine and Pycnogenol
While L-arginine alone may not treat your ED, the combination of L-arginine and an herbal supplement called pycnogenol may help. A study in the Journal of Sex and Marital Therapy found that L-arginine and pycnogenol supplements helped a significant number of men ages 25 to 45 with ED achieve normal erections. The treatment also didn’t cause side effects that occur with ED medication.
Evidence shows that taking high doses of arginine can improve erectile dysfunction by stimulating blood vessels to open wider for improved blood flow.
Pycnogenol is a trademark name for a supplement taken from the pine bark of a tree called the Pinus pinaster. Other ingredients may include extracts from peanut skin, grape seed and witch hazel bark.
Propionyl L-Carnitine, L-Arginine and Niacin
A study from the University of Rome, Italy which included 54 unselected male between the ages of 35-75, presenting to their ED clinic and naive to other treatments, evaluated the effects of a 3 month supplementation with propionyl-L-carnitine, L-arginine and niacin on their sexual performance. They found a significant improvement in the international index of erectile dysfunction, with an improved erection in 40% of cases and with a partial response occurring in up to 77% of the patients enrolled.
These findings indicate that the favorable cardiovascular effects of nutraceuticals might also reflect on male sexual function with possible implication in the treatment and prevention of ED.
Two studies including 202 men with ED using tribulus against placebo showed that the herbal preparation was superior to placebo in patients with ED with or without sexual desire disorders.
Lifestyle changes can also help improve ED. Some lifestyle changes that have shown evidence to improve this condition are:
Eating a balanced diet may help maintain sexual function and decrease your risk of ED.
A 2020 study found that men who more strictly followed a Mediterranean diet or alternative healthy eating index 2010 diet had a lower chance of developing ED. In particular, they consumed less red or processed meat and primarily ate:
Research from 2017 similarly found that eating more fruits, vegetables and flavonoids (compounds found in produce, coffee, and other foods) lowered the risk of ED in men ages 18 to 40. These foods are important for your overall health, so helping maintain or improve your sexual function as well is a win-win.
Research indicates that physical activity may help protect against and improve ED. It may be particularly effective if your ED is caused by obesity, inactivity or cardiovascular disease, among other conditions.
A 2018 research review found that moderate-to-intense aerobic exercise for 40 minutes a day, four times per week for 6 months helped reduce ED. This includes exercises like:
- Brisk walking.
Physical activity helps improve blood vessel health, lower stress and raise testosterone levels, which can all help with ED.
It’s important for your overall health to get enough sleep each night. Sleeping regularly may also improve your ED. A study from 2017 found that men working night shifts who reported worse sleep quality were at higher risk for ED.
A large 2015 study also indicated that people with a sleep disorder had a greater risk of developing ED. Other research has linked obstructive sleep apnea to an increased chance of ED.
Not getting enough sleep can lower your testosterone levels, which may contribute to ED. Sustained lack of sleep is also associated with conditions that are related to ED, like diabetes and high blood pressure.
According to a research review from 2020, ED was significantly more common in men who were overweight, had obesity or a larger waist circumference.
A small 2014 study indicated that gastric bypass surgery improved blood vessel health and ED among extremely obese men. A 2017 research review similarly found an improvement in ED after bariatric (weight loss) surgery.
If your weight is contributing to your ED, exercise and a balanced diet can help you lose weight and improve your ED.
Smoking is another behavior that likely contributes to ED. This may be caused in part by smoking damaging blood vessels, preventing enough blood from reaching the penis for an erection.
Smoking may also reduce the availability of nitric oxide in the body, which is needed to cause the involuntary muscle relaxation and increased blood flow that play a role in erections. According to a research review from 2015, more-frequent smoking was associated with an increased risk of developing ED as well as more-severe ED.
Some damage from smoking may not be reversible. Still, the review concluded that quitting smoking, especially for men under age 50, may help improve ED.
Stem Cell Therapy
Several studies have shown sustained effects at 1 year of follow up with stem cells. The studies reported improved penile hemodynamics, sexual desire, intercourse satisfaction and improved erectile function scores. Another important point is that no major adverse effects were described and stem cell therapy has shown efficacy in ED of different etiologies.The ZignaGenix medical team has vast experience, having treated hundreds of patients for over five years. Our medical team is on the cutting edge of the science in this space, which is vital because in an emerging field like stem cells, the science is changing every day. At our clinic we offer this therapy for patients with ED with a high successful rate.
Borrelli, F., Colalto, C., Delfino, D.V. et al. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. Drugs 78, 643–673 (2018). https://doi.org/10.1007/s40265-018-0897-3
Rhim HC, Kim MS, Park YJ, Choi WS, Park HK, Kim HG, Kim A, Paick SH. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med. 2019 Feb;16(2):223-234. doi: 10.1016/j.jsxm.2018.12.002. Erratum in: J Sex Med. 2020 Mar;17(3):560. PMID: 30770070.
D. Gianfrilli, et al. Propionyl-L-carnitine, L-arginine and niacin in sexual medicine: a nutraceutical approach to erectile dysfunction. Andrologia. Aug, 2011. doi: 10.1111/j.1439-0272.2011.01234.x