Erections

The ability to achieve and maintain erections when aroused is a common health issue for many males. While females don’t experience the phenomenon the same way, inadequate blood flow to female genitalia is also common, and sometimes related to the same phenomena.

There are many potential causes of erectile dysfunction, but they generally revolve around vasodilation—the widening of blood vessels, which allows them to accommodate more fluid, and thus allow the penis to become erect. Nitric oxide is a chemical messenger that tells blood vessels to dilate, and a breakdown in signaling is a common reason for erectile dysfunction 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 erectile dysfunction. Anything that leads to endothelial dysfunction, such as smoking, inactivity, and excessive eating, can increase the risk for erectile dysfunction as well.

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

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what supplements affect erections.

Grade	Level of Evidence [show legend]
	Robust research conducted with repeated double-blind clinical trials
	Multiple studies where at least two are double-blind and placebo controlled
	Single double-blind study or multiple cohort studies
	Uncontrolled or observational studies only

Level of Evidence ? The amount of high quality evidence. The more evidence, the more we can trust the results.	Supplement	Magnitude of effect ? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.	Consistency of research results ? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.	Notes
	Panax ginseng	Minor	Very High See all 4 studies	An improvement in erectile dysfunction is seen with 3g of Korean Red Ginseng (fermented panax ginseng, regular panax ginseng not as well tested) which is thought to be secondary to anti-fatigue effects and improved blood flow
	Yohimbine	Minor	- See study	Erections are increased following yohimbine ingestion which is thought to be a combination of alpha-2-adrenergic antagonism (enhancing relaxation of the penile tissue so engorgement of blood can ensure) and increasing blood pressure (which would increase the amount of force in an erection). However, may not be able to overcome organic erectile dysfunction associated with poor blood flow
	Coenzyme Q10	Minor	- See study	Increased erectile function has been noted with CoQ10, but this may be secondary to reductions in symptoms of Peyronie's Disease
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	Eurycoma Longifolia Jack
	Maca
	Tribulus terrestris
	Ashwagandha
	Butea superba
	Dehydroepiandrosterone
	Saffron
	Citrulline
	L-Carnitine
	Pycnogenol
	Curcumin
	Grape juice