Supplementing Nitric Oxide – A Natural Therapy for Erectile Dysfunction?

Man holding nitric oxide supplements in both hands

As we age, there is an inevitable decline in the ability to achieve an erection. This is simply because erectile function depends on blood flow to the penis, and as a man ages, the circulatory system becomes less efficient. This is also why we can’t perform in sports or endurance in our later years the same way we did in our teens, 20s, or 30s.

Dr. Engel Seminar PromoWith that said, some men begin to lose their erectile function earlier, and we see patients as young as 30 or 40 who have concerns about their ability to achieve and maintain an erection during sex. At this point, there is a continuum of care that almost every ED patient will follow. This begins with an evaluation of the root cause of the problem, and the answer may include any combination of psychological therapy (for a small number of patients), lifestyle change, and ED medications like Sildenafil and Tadalafil. If these options fail, we move on to injection therapy or a penile implant for severe cases of ED.

One less known cause of loss of erectile function is nitric oxide. The body produces this compound naturally, but its levels drop as we age. Poor nitric oxide production can also be caused by other factors, including hormonal imbalances and obesity, to name a few. A sedentary lifestyle can also reduce the body’s ability to create and distribute nitric oxide.

What’s Unique About Nitric Oxide?

Nitric oxide is responsible for the relaxation of the muscle cells in the walls of our blood vessels. When nitric oxide in the blood is at proper levels, our blood vessels can open or dilate to improve blood flow. This is systemic, meaning nitric oxide has effects throughout the body, so patients with proper concentrations tend to feel better and enjoy better sexual function versus those with deficiencies.

It stands to reason, therefore, that patients with compromised blood flow, either due to age-related degeneration of the arterial walls or a buildup of plaque within the artery, known as atherosclerosis, would benefit from a higher concentration of nitric oxide. Interestingly, we cannot bottle or manufacture nitric oxide itself, and instead, we rely on supplements that represent the building blocks of nitric oxide, including L-citrulline and L-arginine. When taken as a supplement, these building blocks may help stimulate the body into producing more nitric oxide and ultimately Improve sexual health.

Does Nitric Oxide Make an Appreciable Difference?

Depending on the root cause of the erectile dysfunction, nitric oxide may be helpful for some, while there may be little benefit for others. Nitric oxide will not be effective in patients with severe erectile dysfunction. These men may require injections or implants. For those whose erectile dysfunction is caused by performance anxiety or a lack of desire, talk therapy is often the best solution. Regardless of the cause, all men suffering from ED should still see their urologist to understand precisely what might be behind their inability to achieve erections.

Adjunctive Lifestyle Change

While taking supplements is helpful if you have low nitric oxide levels, it is by no means the only thing you can do to give yourself the best chance to restore a healthy sex life. Instead, you must look at the treatment of erectile dysfunction holistically. If you are generally unhealthy or have cardiovascular or metabolic issues that may limit blood flow around the body – for example, atherosclerosis or diabetes, or if you smoke – supplementation may not be the best and first course of action. Instead, improving your lifestyle to the degree that you give nitric oxide the best chance to work is a good first step. From there, a combination of therapies, including ED medication, may be a good option. Ultimately, visiting a qualified urologist is the best way to understand what’s right for you.

Differentiating Nitric Oxide From Nitrates

If you’ve ever taken a questionnaire for your suitability for ED meds, you’ve likely been asked whether you currently take nitrates. Nitrates are medications prescribed to later-stage cardiovascular patients and are sometimes taken recreationally to improve sexual function and last longer. These medications are distinct from the supplements intended to promote nitric oxide production and should not be confused with one another. If you have been prescribed nitrates or take nitrates, disclose this to your urologist, as it may change the course of your ED treatment.

The Bottom Line

Erectile dysfunction, to some degree, is a natural part of the aging process, but we do not need to stand by as it takes hold. However, supplements like nitric oxide are rarely the magic bullet. Instead, ED must be treated in many ways along a progression of modalities to ensure the best possible outcomes for each patient. Visit us for a consultation or purchase ED medications to learn more.


Urologic Surgeons of Washington is a proud member of Privia Medical Group. The best doctors in our community have joined together to form Privia Medical Group (PMG), a multi-specialty, high-performance medical group that puts patients first. Our physicians are united by the mission of providing better, more coordinated care for their patients.

Urology Urgent Care

Urologic Urgent Care

Every patient that would otherwise have gone to a generic urgent care for their urologic can now be seen at a specialist-level urologic urgent care with same-day appointments.

Online Appointments Learn More
ED Medications

Discreet & Convenient ED Medication Online

Take advantage of exceptional prices on generic ED medication while avoiding the pharmacy and anonymous websites. Available for same-day pick-up.

(202) 223-1024 Learn More