Sexual performance is extremely complex, with a myriad of confounding factors and processes.
Nevertheless, most people see a lack in performance and automatically chalk it up to some hormonal imbalance and immediately scour the face of A.I. to find the answer on how to set the balance right.
While it’s true that hormonal balance plays a key role in sexual performance, only focusing on this mechanism is a monstrous oversimplification. People using this myopic focus miss the bigger picture, namely, two key players to this complex topic: cardiovascular and neurological systems.
And if they are missing these systems, they are missing their common denominator: nitric oxide.
What Is Nitric Oxide and Why Does It Matter for Sexual Performance?
Nitric oxide (NO) is a gaseous signaling molecule that is produced with the help of L-arginine (arginine). Once synthesized, NO is responsible for relaxing vascular and cavernosal smooth muscle, increasing arterial inflow, and enabling erection (source). Without nitric oxide–mediated vasodilation, optimal blood flow simply does not occur, hindering performance.
Animal models suggest that NO works through more mechanisms than just interacting with blood vessels and stimulated tissues. One 2021 review in Biomolecules takes a deep look into these models and demonstrates that
NO interacts within the brain and limbic system to promote hormone release, sexual motivation, and performance.
Nitric oxide is not optional. It is foundational.
Does Arginine Supplementation Support Erectile Function?
If NO is foundational, arginine is non-negotiable.
Arginine is the direct substrate for nitric oxide production. If substrate availability drops, NO production can decline, hindering performance.
A 2017 study in Andrology strengthens this notion. When comparing arginine and L-citrulline (another NO precursor) concentrations in individuals experiencing various levels of sub-optimal erectile function and healthy controls, researchers reported lower levels of the NO precursors in those with arteriogenic complications and severe complications. These findings lead authors to conclude that a significant portion of those reporting sub-optimal erectile performance demonstrated significantly lower levels of arginine and L-citrulline.
Two years later, a systematic review and meta-analysis published in The Journal of Sexual Medicine evaluated 10 randomized controlled trials involving 540 men with mild to moderate erectile function complications.
Authors concluded that arginine supplementation at doses ranging from 1,500 to 5,000 mg significantly promoted erectile function and subjective experience scores compared to placebo. Notably, those with greater dosing schemes (5,000 mg) seemed to perform better.
More recently, a multicenter, double-blind, placebo-controlled trial investigated the effects of supplementing with 6 g/day of arginine for three months in men with vascular-related performance complications. After the trial, arginine was shown to promote blood flow measures and function scores.
Is Arginine Safe?
Generally, human trials report low adverse rates. A study using 6 g/day reported similar adverse events to the placebo, none of which were registered as clinically relevant.
Though not a recommended dose, an article from 2016 in the Journal of Nutrition suggests that healthy individuals can safely consume up to 30 g/day, citing this 2016 study. Again, not a recommended dose.
The Bottom Line: Nitric Oxide is a Modifiable Performance Lever
Sexual performance may be complicated, but it runs on Nitric Oxide.
Nitric Oxide needs arginine.
Not stimulants.
Not hormone manipulation.
Better Nitric Oxide production.
Nitric Oxide protection means sexual performance protection