Nitric Oxide and Its Role in Erectile Dysfunction

Man eating healthy trying to increase nitric oxide in body

Several potential issues can cause or worsen erectile dysfunction. Many of these are discussed on our website. However, some are less discussed yet worthy of mention and attention; one such potential cause is a deficiency in nitric oxide. Nitric oxide, or NO, is a gas molecule that most cells in the body produce. It is an integral part of how our body functions and plays a role in activating the enzymes in blood vessels that, among other things, help make a normal erection. As we age, however, the body produces less nitric oxide (which is the case for many essential bodily functions).

While the prevalence of erectile dysfunction continues to be researched, studies have shown that about 20% of the United States male population and 50% of those aged 40 to 70 years may suffer from moderate ED. Greater than 60% of men over 70 may suffer as well. This data is from the early 2000s, and the obesity epidemic, for example, has significantly worsened so those prevalence figures may be even higher.

How Does Nitric Oxide Help?

Simply put, nitric oxide is critical to creating erections. Nitric oxide is released by cells in the corpora cavernosa of the penis, activating a pathway for various proteins and compounds to affect the muscles required to get an erection. NO is naturally catalyzed by the enzyme NO synthase from L‐arginine and L‐citrulline.

Why Nitric Oxide Matters in Medical ED Treatment

The advent of ED medication marketed very heavily over the past few decades, has completely changed the paradigm for men suffering from ED. NO is also crucial in the workings of ED medications like sildenafil, generic Viagra, and tadalafil, generic Cialis. These are collectively known as phosphodiesterase type 5 (PDE‐5) inhibitors. These drugs work by slowing the breakdown of cGMP (a calcium channel regulator activated by a chemical pathway with NO as a foundation) in the body. However, if there’s insufficient nitric oxide in the first place, the drugs are less able to do their jobs.

Natural Ways Our Body Produces Nitric Oxide

The amount of nitric oxide produced naturally in our bodies is reflective of our overall health. Healthy bodies typically have healthy amounts of nitric oxide for their age, while those of us suffering from lifestyle shortfalls, poor diet, and a lack of exercise often do not produce enough. There are several ways that patients can increase nitric oxide production and reduce the likelihood of continued erectile dysfunction. These include:

Eating healthier: We always suggest our patients prioritize a nutritious diet, which includes complex carbohydrates, healthy, unsaturated fats, like fatty fish, olive oil, and avocado, while avoiding empty carbs like sugars and white grains, and saturated fats, like those found in highly processed foods. You can’t go wrong eating vegetables, fruits, and lean meats while avoiding fried and decidedly less healthy foods.

Exercise: Exercise is critical to the proper functioning of every cell in our body. Not only does it improve our physical health but also our psychological health, which can play a part in preventing erectile dysfunction. Exercise should consist of cardiovascular activity and strength training and be performed daily under your physician’s guidance.

Vitamin D is also critical to cellular health and nitric oxide production. The best way to get this vitamin is by exposing unprotected skin to the sun but be mindful of the potential for skin cancer with unprotected sun exposure. Work with your dermatologist or primary care physician to develop a healthy exposure balance. Patients with chronic vitamin D deficiencies will likely be given vitamin D supplements after a quick blood test.

The above can help you lose weight and improve your health, leading to better blood flow, higher nitric oxide production, and a lower risk of erectile dysfunction. As mentioned above, nitric oxide production generally declines as we age, and for some, there’s simply no way to boost production.

How to Measure Nitric Oxide

We will work with you to measure nitric oxide in your body. Breath analysis, urinalysis, and pH testing can all easily measure nitric oxide levels noninvasively. Each method has its pros and cons.

Do Supplements for Nitric Oxide Work?

Supplementing for nitric oxide should be discussed with your urologist. Supplements introduce the building blocks of nitrous oxide into the body, not nitric oxide itself, and your body must still convert those building blocks into the gas. Once again, no supplementation can compensate if the body is not healthy and primed for nitric oxide production. That said, seeing a men’s health specialist is the best way to understand what is behind any issues associated with erectile function and the best treatment options to correct them.

We look forward to seeing you in our office and discussing the myriad of erectile dysfunction treatments we provide, including medical therapy like Viagra and Cialis, injections for moderate erectile dysfunction, and in cases of severe impotence, penile implants that are not only safe but very effective and long-lasting.


  1. Burnett AL. The role of nitric oxide in erectile dysfunction: implications for medical therapy. J Clin Hypertens (Greenwich). 2006 Dec;8(12 Suppl 4):53-62. doi: 10.1111/j.1524-6175.2006.06026.x. PMID: 17170606; PMCID: PMC8109295.