Erections

The ability to achieve and maintain erections when aroused is a common health issue for many men.^[1] While women don’t experience the phenomenon in the same way, inadequate blood flow to female genitalia is also common — and sometimes related to the same phenomena.

Aging is the biggest risk factor for ED, but there are a host of other contributing factors,^[2] such as diabetes, vascular disease, low testosterone,^[3] and hypothyroidism.^[4]

The potential causes of ED generally revolve around vasodilation — the widening of blood vessels — which allows the penis to accommodate more fluid, thus allowing it to become erect. Nitric oxide is a chemical messenger that tells blood vessels to dilate; a breakdown in signaling is a common reason for ED and high blood pressure.

Nitric oxide precursors and substances that lead to greater nitric oxide synthesis are commonly found in drugs and supplements aiming to improve erections. Sex hormones are involved in nitric oxide synthesis, and men with low testosterone are more likely to have ED. Anything that leads to dysfunction in the walls of the blood vessels, such as smoking, inactivity, and excessive body fat, can increase ED risk as well.

Sometimes ED isn’t a breakdown in vasodilation or a hormonal problem but secondary to psychological issues of anxiety and anhedonia — a diminished ability to feel pleasure. In this case, while some libido-enhancing supplements may be useful, the answer may not be found in supplements or dietary modification.