NO and ED: An Intimate Look at Nitric Oxide’s Impact on Male Sexual Health

Valentine’s Day may be an unwelcome holiday for men affected by Erectile Dysfunction (ED), as it potentially brings up difficult feelings about their condition. As a Pharmacist treating patients suffering from ED and other sexual health issues for many years, I’ve witnessed the painful effects that ED can create in men’s lives — from shattered self-esteem to broken relationships.

Part 2 of a 2 part sexual health series. For part 1, click here

By Greg McKettrick

Erectile Dysfunction — defined as an inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse — can be caused by numerous factors including aging, prostate cancer treatments, obesity, lifestyle choices (smoking, alcohol consumption), and chronic diseases like diabetes. ED is also considered a general marker for cardiovascular disease. In the U.S., it affects 20% of all adult males, 30%–50% of men aged 40–70 years, and more than 60% of men older than 70 years.

Fortunately, there’s an effective way to address ED, by supporting healthy male sexual function in a way that drugs often can’t. That way is Nitric Oxide (NO) — more specifically, achieving and maintaining adequate levels of NO in the body.

In this second part of a two-part series, we’ll look at Nitric Oxide’s specific impacts on male sexual function and intimacy. (For part one’s discussion on female sexual health and NO, go here.)

Why is Nitric Oxide So Important in Addressing ED?

Nitric Oxide is a natural vasodilator and unconventional neurotransmitter that plays a vital role in the body’s circulation of blood and oxygen. As blood moves throughout the body, providing oxygen and nutrients, NO helps the blood vessels relax. When relaxed, blood vessels widen and allow for more blood to flow throughout the body. For patients with ED, adequate blood flow to the sexual organs is critical for starting and maintaining an erection.

Although the body naturally produces Nitric Oxide, by age 40, NO production functions at just 50% and continues decreasing thereafter. Age, environment, stress, and pharmaceuticals can impact a person’s ability to make their own Nitric Oxide.

How Nitric Oxide Impacts Male Sexual Function

Nitric Oxide plays a critical part in the physiological mechanisms that enable healthy sexual function in both males and females. Here are some of the ways NO is involved in male sexual function specifically:

  • NO is critical to causing and maintaining an erection. Nitric Oxide acts as a neurotransmitter of non-adrenergic, non-cholinergic (NANC) inhibitory nerves which innervates smooth muscles, including the penile corpus cavernosum. Meaning, it plays a crucial role in the initiation and maintenance of intracavernous pressure and penile erection.

  • NO activates a critical component of penile engorgement. NO activates soluble guanylcyclase to increase cyclic guanosine monophosphate (cGMP). cGMP regulates activity of calcium channels as well as intracellular contractile proteins that relax smooth muscles of the penile corpus cavernosum, thus allowing engorgement of the tissue.

  • NO explains why ED medications don’t work half the time. Phosphodiesterase (PDE5) inhibitors (like the little blue pill and its cousins) prolong the action of cGMP, thus prolonging erections and increasing sexual satisfaction. However, they don’t cause erections. For this to occur, sufficient NO must be present. This is precisely the reason PDE5 inhibitor medications are ineffective in about 50% of patients.
  • Alcohol and smoking inhibit NO, leading to ED. Acetaldehyde, a principal metabolite of ethanol, may contribute to ED by decreasing the production of NO and increasing superoxide production. Smoking can also lead to a deficiency of NO, and thus lead to erectile dysfunction.

  • NO supplementation can help ED. In men who are deficient in NO and experience some degree of ED, supplementation with a dietary form of Nitric Oxide can increase blood flow to an adequate level, and thus assist the restoration of sexual function.

How to Effectively Boost Nitric Oxide Levels in Addressing ED 

For all the reasons above, I consider Nitric Oxide support to be the first step on a journey to healthy sexual function — and Berkeley Life makes it easy for my patients, of all ages,  to incorporate it into a healthy regimen.

Natural, dietary nitrates such as beet root and leafy greens are proven to boost the body’s production of Nitric Oxide. Although NO levels can be improved through a nitrate-rich diet, modern eating habits make a simple supplementation program like Berkeley Life’s a more efficient and effective solution. Their proprietary formulation provides an infusion of dietary nitrates, and the once-a-day supplement can conveniently boost systemic levels of Nitric Oxide for 6–8 hours. I like to pair this supplement with the Berkeley Life Test Strip, which provides a non-invasive tool to assess improved NO levels from home.

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