Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.
By far the most common cause of ED is vascular dysfunction. When the arteries that supply the penis with blood to achieve and maintain an erection are blocked or hardened, or the lining of these arteries are damaged, blood flow is reduced. Vascular dysfunction not only affects the small arteries of the penis, but the larger coronary arteries of the heart too. Astute doctors now recognize that ED may actually be an early warning sign of impending cardiovascular disease, showing up several years before a cardiovascular event like a heart attack or stroke.2 To maintain healthy vascular function, and in turn, normal erectile function, consider these supplements:
ED can be caused by a handful of things, but one thing’s for sure: You need a healthy supply of the neurotransmitter nitric oxide (NO) to get and maintain an erection. NO is produced in nerve tissue and helps jolt your Johnson by relaxing the smooth muscle so blood can fill the penis. After the initial release of NO, your body releases a cascade of chemicals—including more of the neurotransmitter—to help keep you hard and happy, according to a study in the Proceedings of the National Academy of Sciences.
If you want to go long enough to help your date reach the big O, reach for some oatmeal. The popular breakfast cereal is a good source of l-arginine, an amino acid commonly used to treat erectile dysfunction. Plus, whole grains like oatmeal also help lower cholesterol levels. Having high cholesterol can lead to atherosclerosis, a condition that clogs and narrows arteries, impairing blood flow. This could eventually lead to heart problems, but you’ll likely notice issues below the belt first. The arteries surrounding the genital area are narrower than coronary blood vessels, so they’re more susceptible to clots. Simply put, the better your cholesterol levels are, the better your erection will be, too.
There’s a reason chocolate became a gift given before amorous activity. Cacao increases levels of the mood-boosting hormone serotonin, which can lower stress levels, boosting desire and making it easier to reach orgasm. And that’s not all: Cocoa also increases blood flow through the arteries and relaxes blood vessels, sending blood to all the right regions, which can boost pleasure.
Cherries are rich in anthocyanins, plant chemicals which clean your arteries of plaque, keeping them open for business. That has a direct effect on blood flow below the belt. So make them a regular snack: One cup clocks in at fewer than 100 calories and boasts B vitamins, cancer-fighting flavonoids and three grams of fiber. For more essential fat-blasters for your kitchen, stock up on these 9 Best Flat-Belly Superfoods!

When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.

Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).

In a prospective human phase 1 open-label and single-arm study reported by Haahr et al. (27), 17 men with refractory post radical prostatectomy ED were given a single intracavernosal injection of autologous adipose-derived regenerative cells (ADRCs) freshly isolated after a liposuction. The procedures were well-tolerated and over a 6-month follow-up period, 8 of 17 men showed improvement of their erectile function.
ED is caused by vascular, hormonal, neurogenic, pharmacological, or psycho-genic factors. Performance anxiety where the person fears failing in a sexual scenario is a common psychogenic cause for ED.3 Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke or spinal cord injuries. Radical removal of the prostate (also called prostatectomy) is the cause of nerve-related ED as nerve injury is possible despite advances in surgical methods.4
And what about L-citrulline? Watermelon has the highest concentration in nature (particularly the white rind), followed by onions and garlic. Just one standard serving of yellow watermelon provides enough L-citrulline to boost sexual performance. My advice is that you might want to stick to watermelon and not onions and garlic to boost your nitric oxide production before going on a date!
There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.
 6. Have you suffered from testicular atrophy? 7. Have you suffered from erectile dysfunction? 8. Do you experience pain in your penis? 9. If so, describe the pain. 10. Is there any one incident which you feel might have acted as the trigger for this condition? 11. Has the rate of shrinkage increased or decreased over the years? 12. Do you drink? 13. Do you notice any worsening of symptoms as a result of drinking? 14. Do you smoke? 15.

Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
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