Can Nitric Oxide Effectively Treat Erectile Dysfunction?

Do you have frequent difficulty achieving or maintaining an erection that allows for enjoyable sex? This condition, known as erectile dysfunction (ED), is quite common in men and often linked to cardiovascular problems.

If you have managed to isolate the causes of your ED – something which isn’t always easy – and poor blood flow is a significant contributor, then you’re in luck. Numerous treatments are available, one of the most popular is a compound called nitric oxide.

Find out how NO can treat ED, what it is, and how it works.

What Is Nitric Oxide?

In chemical terms, nitric oxide (also known as nitrogen oxide and nitrogen monoxide) is a colorless gas represented by the formula NO. It also happens to be one of the principal oxides of nitrogen, an element that is absolutely crucial in the physiology of living beings.

As such, the role of nitric oxide in human biological processes has received a substantial amount of scientific interest. However, despite the many findings that have occurred, most people are still relatively ignorant of the vast importance nitric oxide has with regard to their health.

When it comes to biological functions, nitric oxide acts primarily as a gaseous signaling molecule [1]. It plays a role in a variety of processes and is one of the main biological messengers in vertebrates. However, nitric oxide’s most important function is its role as a signaling molecule in the cardiovascular system — its discovery received a Nobel prize in 1998.

Dr. Robert F. Furchgott, Louis J. Ignarro, and Ferid Murad made up the three-man team and not only uncovered NO’s complex role in the cardiovascular system but also made paradigm-shifting discoveries in the study of signaling molecules.

For instance, nitric oxide was thought to be an extremely unstable molecule and, therefore, not of major importance in mammals due to its elimination half-life of only 10 seconds. We now know that nitric oxide acts as a signal molecule in the nervous system, as a weapon against infections, as a regulator of blood pressure, and as the gatekeeper of blood flow to different organs.

The team’s discoveries also fundamentally altered what was known about signaling molecules — the transmission of a signal by a gaseous molecule produced in one cell could travel to another cell, penetrate its membrane, and then regulate its function, which was entirely unknown at the time.

Nitric Oxide In the Treatment of Erectile Dysfunction

Nitric oxide is produced mainly by three types of cells: nervous system, immune, and endothelial cells. The endothelial cells, located in the inner lining of the blood vessels, are the ones we’ll focus on [2].

Once created, nitric oxide diffuses into adjacent vascular smooth muscle cells and activates guanylyl cyclase, which then produces cyclic guanosine monophosphate (cGMP). The latter compound – cGMP – is what causes blood vessels to relax, allowing for increased blood flow, also known as vasodilation [3].

The ability to successfully deliver nutrients and oxygen through the blood is obviously of paramount importance. This, in turn, makes nitric oxide’s regulatory effect on blood flow a major cardiovascular function.

Erectile Dysfunction, Nitric Oxide, & Cardiovascular Health

Studies have found a significant comorbidity between poor cardiovascular health and erectile dysfunction. More studies are needed, but the medical community now generally agrees that an unhealthy lifestyle, hypertension, and poor blood flow are known contributors to erectile dysfunction.

How does this happen, though?

We know that drinking, smoking, genetic history, advanced age, obesity, and physical inactivity all reduce the ability of blood vessels to relax. Apart from causing consistently high blood pressure — a significant health concern — these “inelastic” blood vessels restrict the blood flow needed for an erection.

Erections are a complicated bodily response, and the inability to achieve one can be due to numerous interrelated factors. However, in cases that are due solely to cardiovascular-related reasons, the usual malfunction is simple to understand:

In order to achieve a proper erection, the corpus cavernosa — one of two columns of spongy tissue that runs through the shaft of the penis — must fill up with blood to become erect. However, an erection can’t happen if the inelastic blood vessels restrict the amount of blood available to enter the penis.

By increasing blood flow to the penis, nitric oxide can be effective in the treatment of blood-flow-related erectile dysfunction [4].

Nitric Oxide & Erectile Dysfunction Medications

PDE-5 inhibitors are the most common way to treat erectile dysfunction. They prevent the breakdown of nitric oxide in the body, but they must work with whatever level of nitric oxide is present in the system. In other words, they do not increase nitric oxide production.

Those who do not respond to PDE-5 inhibitors might need to switch to nitric oxide-producing methods.

Do not combine both nitrates and PDE-5 inhibitors, as this can lead to a dangerous drop in blood pressure.

For those suffering from ED, the previous findings raise one important question: how do I increase nitric oxide production in the body?

How to Increase Nitric Oxide Production

There are plenty of methods for raising your nitric oxide levels. However, before trying these, we recommend you purchase a simple nitric oxide test strip — available on Amazon or at your local pharmacy — in order to find out where your baseline level is at.

Once you have a baseline reading, you can try any or all of the following methods to increase NO levels naturally:

  1. Eat more leafy greens – Nitrate, an important precursor for the formation of nitric oxide, is often found in certain kinds of vegetables. Veggies high in nitrate include celery cress, chervil, lettuce, beetroot, spinach,  and arugula [5].
  2. Increase antioxidant intake – Because nitric oxide is an inherently unstable molecule and lasts only seconds, it must be constantly replenished. One way to increase its stability, however, is to consume antioxidants, molecules that neutralize free radicals. Important antioxidants include vitamin C, Vitamin E, Polyphenols, Glutathione.
  3. Consider nitric-oxide supplements – These supplements will not include nitric oxide but its precursors. Two of the most common are the aminoacids L-Arginine and L-Citrulline.
  4. Limit your use of mouthwash or switch brands – Believe it or not, it has been found that most mouthwash brands utilize ingredients that kill off certain types of “good” bacteria that contribute to the production of nitric oxide [6].
  5. Exercise – Nitric oxide production occurs mostly in the endothelial cells, which can be kept healthy and functional through regular exercise.

Conclusion: Nitric Oxide for ED

For many men, the efficacy of PDE-5 inhibitors can leave much to be desired. This can, of course, relate to the inability of PDE-5 inhibitors to treat the psychogenic causes of ED, but it also leaves something to be desired in terms of biological effectiveness.

For this reason, it’s important for men to be aware that other options, such as nitric oxide, are also available. Producing more nitric oxide will undoubtedly have a positive effect on blood flow and may just be enough to successfully treat your erectile dysfunction.


  1. Liu, H., Weng, L., & Yang, C. (2017). A review on nanomaterial-based electrochemical sensors for H2O2, H2S and NO inside cells or released by cells. Microchimica Acta, 184(5), 1267-1283.
  2. Bruckdorfer, R. (2005). The basics about nitric oxide. Molecular aspects of medicine, 26(1-2), 3-31.
  3. Lucas, K. A., Pitari, G. M., Kazerounian, S., Ruiz-Stewart, I., Park, J., Schulz, S., … & Waldman, S. A. (2000). Guanylyl cyclases and signaling by cyclic GMP. Pharmacological reviews, 52(3), 375-414.
  4. 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.
  5. Hord, N. G., Tang, Y., & Bryan, N. S. (2009). Food sources of nitrates and nitrites: the physiologic context for potential health benefits. The American journal of clinical nutrition, 90(1), 1-10.
  6. Govoni, M., Jansson, E. Å., Weitzberg, E., & Lundberg, J. O. (2008). The increase in plasma nitrite after a dietary nitrate load is markedly attenuated by an antibacterial mouthwash. Nitric oxide, 19(4), 333-337.






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