Sperling Prostate Center

Can a Simple Dietary Supplement Help with Erections?

“Baking bread may seem like a very simple process. It’s a combination of only four simple ingredients: flour, water, yeast and salt. However, there’s a lot of science in how these four ingredients interact, and how varying them varies the bread’s characteristics.”[i]

You probably don’t think of a bread recipe as an erotic experience, but in some ways it’s analogous to the body’s formula for an erection. Both of them depend on the right chemistry.

Successful break-baking relies on chemical interactions. Wheat flour contains two proteins, glutenin and gliadin. When water is added to the flour to make dough, the proteins form a kind of elastic network that will trap gas. The starch in flour is made of up chains of sugar molecules. Yeast, a type of fungus, converts the sugar into carbon dioxide, a gas that becomes trapped in pockets throughout the dough, causing it rise. Salt slows this process down, allowing the dough to achieve proper elasticity. Too much or too little of the right ingredients could upset the outcome. You hope for a nice firm loaf, but instead you get an unappealing failure.

Achieving an erection relies on the body’s chemistry. One of the key ingredients is nitric oxide. Nitric oxide, which normally exists as a gas, is a neurotransmitter, or signaling molecule, especially in cardiovascular function. For an erection to occur, nerve messages from the brain trigger biochemical processes that lead to the release of nitric oxide. The tiny blood vessels in the penis’ spongy tissue are lined with special cells called endothelial cells. These particular cells produce nitric oxide which relaxes the blood vessel walls so they become more elastic. This allows more blood to flow into the penis, making it “rise,” similar to carbon dioxide filling the pockets in bread dough so it expands.

However, an imbalance in one’s biochemistry can cause an upset in the formula for an erection. The body naturally produces an amino acid (a building block of protein) called homocysteine as it breaks down dietary proteins. Homocysteine production is offset by vitamins B12, B6 and folate, which is a good thing. Too much homocysteine in the blood leads to a condition called hyperhomocysteinemia.
This can increase the risk of diseases like heart disease, atherosclerosis (hardening of the arteries), dementia, Alzheimer’s—and even erectile dysfunction (ED)! Demir, et al. (2006) write that abnormally high levels of homocysteine are “an important determinant in ED… [and] significantly related with arterial and probably endothelial dysfunction in patients with ED.”[ii]

Counteracting hyperhomocysteinemia

Hyperhomocysteinemia generally indicates a B vitamin deficiency, especially those identified above. Fortunately, taking a folic acid supplement can counteract this condition. In fact, a study of men who had ED and took folic acid for three months demonstrated improved erectile function.[iii] The researchers enrolled 50 married men (ages 30-60) who had ED, and 50 controls (same-aged men with no ED). All participants gave samples of peripheral blood (blood circulating in the body) and penile blood before and after the period of supplementation, as well as a battery of tests and questionnaires before and after. All ED patients demonstrated high homocysteine levels prior to the period of supplementation, compared with controls. After the three months, homocysteine blood levels (peripheral and penile) had dropped significantly, and all patients experienced lower degrees of ED than they had at baseline.

The authors claim that their study is “one of the first that evaluated the effect of folic acid supplementation” on men with high homocysteine blood levels, and showed a significant decrease on these levels. They recommend that ED patients who are taking PDE-5 inhibitors (e.g., Viagra, Cialis, Levitra) be prescribed folic acid supplementation at the same time.

Sound good? However, do not experiment on yourself! If you experience ED, and are using PDE-5 inhibitors, talk to your doctor about the merit of adding a daily folic acid supplement. If it helped 50 men in an interventional study, perhaps it can improve your own quality of life and sexual relationships—but please do so under a doctor’s supervision!

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] “The Chemistry of Break-Making.” https://www.compoundchem.com/2016/01/13/bread/
[ii] Demir T, Comlekçi A, Demir O, Gülcü A, Calýpkan S, Argun L, Seçil M, Yepil S, Esen A. Hyperhomocysteinemia: a novel risk factor for erectile dysfunction. Metabolism. 2006 Dec;55(12):1564-8.
[iii] Elshahid ARM, Shahein IM, Mohammed YF, Ismail NF, Zakarria HBAE, GamalEl Din SF. Folic acid supplementation improves erectile function in patients with idiopathic vasculogenic erectile dysfunction by lowering peripheral and penile homocysteine plasma levels: a case-control study. Andrology. 2020 Jan;8(1):148-153.


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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