you guys always want to know what is the
best supplement for erectile dysfunction
well I'm Dr Rena Malik urologist and
pelvic surgeon and if you're new here I
always bring evidence-based content
regarding Urologic Health every Monday
and Friday and today I'm going to be
sharing with you the newest data on a
supplement called L-Arginine and before
I dive into that I want to be sure that
you guys understand that supplements are
just that they supplement your health
they are not a substitute for taking
good care of your body meaning managing
your high blood pressure managing your
diabetes eating well and exercising
regularly these things are not going to
fix your sexual function unless those
things are optimized as well the number
one cause of erectile dysfunction in men
is vascular erectile dysfunction meaning
that it's usually due to things like
high blood pressure or diabetes that are
affecting the blood flow to the penis to
start off what is L-Arginine well it's
an amino acid meaning it's a building
block of protein and it usually gets
into your body through eating your food
the interesting thing about L-Arginine
is it is a substrate or building block
for nitric oxide and if you've seen some
of my videos before you'll know that
nitric oxide is essentially an ignition
for erections and so a lot of the
supplements and treatments that are out
there tend to focus on building
increasing nitric oxide and what it does
is it allows the smooth muscle in the
penis to relax so blood can fill in and
Gorge that erectile tissue to create the
erection if you're not really
understanding what I'm talking about
make sure you check out my master class
on male anatomy to learn a little bit
more about exactly what is down there as
well as my video on tadalafel versus
sildenafil where I talk about how
erections happen and in our bodies the
Arginine levels can go down due to a
number of factors including stress high
blood pressure diabetes chronic
illnesses all those things can affect
the levels of Arginine and in our
bloodstream which can then make it
harder to get erections in addition to
having reduced blood flow in 2019 a
group of Korean researchers did a
systematic review and meta-analysis on
the use of L-Arginine for men with mild
to moderate erectile dysfunction from
this they found 10 randomized controlled
trials people got L-Arginine anywhere
from 1.5 to 5 grams of L-Arginine and
compared it to a group of people who got
either a placebo or no treatment at all
and looked at their outcomes as far as
erectile function is concerned and what
they found was that overall L-Arginine
did significantly improve erectile
dysfunction compared to those who got
Placebo and specifically they even got
Improvement in domains such as overall
satisfaction intercourse satisfaction
and orgasmic function however this
meta-analysis only focused on men with
mild to moderate erectile dysfunction as
well as they could have gotten
citrulline which is a precursor of r
large need and often that is easier to
take than L-Arginine the reason being is
L-Arginine is very rapidly metabolized
by our bodies and so it needs to be
taken very frequently also a lot of the
trials that were included were short
duration meaning they were somewhere
between two to four weeks there was some
that were eight and a few that were 12
weeks but most of them were smaller
studies and they had different Doses and
different formulations in response to
that a new study just got published
where the authors wanted to look at
L-Arginine as a single compounding it
wasn't combined with anything it wasn't
citrulline and over the course of three
months as well as those with severe
erectile dysfunction meaning they were
probably not able to get erections that
were sufficient for penetrative
intercourse at all in this group they
randomized a hundred men to either
receive L-Arginine 6 grams a day for
three months or get a placebo so those
who were in the experimental group got
the L-Arginine three times a day two
grams each dose after meals also they
couldn't be taking any other medications
that could increase the blood flow or
nitric oxide levels so if they were on
other supplements or taking other
medications for erectile function they
were not included in this study and
interestingly most often these studies
they look at a specific validated
questionnaire called the international
index of erectile function and this has
been validated which means that many
populations have taken it and has been
correlated with their degree of erectile
dysfunction they also did a penile
Doppler ultrasound to look at the blood
flow in the penis itself and to see if
that truly changed with the
supplementation after three months they
found that 74 percent of men had
Improvement in their erectile function
the majority of them had some
improvement meaning they still had some
issues but they were significantly
easier to overcome and things like
sildenafil into Del Phillip would
probably help get them even stronger
erections 20 24 of men had no erectile
dysfunction after taking the supplement
for three months as far as safety in the
patients taking L-Arginine there was a
significant increase in cholesterol
specifically HDL so I know a lot of
people think supplements are very very
safe but some of them do require
monitoring in this day they also found
other side effects of heartburn itching
specifically scrotal itching and while
not in this study other groups have
found that when taking high doses of
L-Arginine people do get low blood
pressure and it's important to realize
that in this study they had a really
small number of patients only a hundred
patients and it wasn't really powered to
detect a difference meaning that when
they looked at this they didn't design
the study for a specific number in mind
saying that if we look at this number of
patients we'll see this percentage of a
difference in the two groups and while
there was Improvement were the men
themselves actually satisfied and that's
really what matters and that that's not
indicated they didn't actually test
patient satisfaction at the end of this
study lastly as Dr Geo mentioned in our
video about supplements he prefers to
give l-citrulline over L-Arginine
because L-Arginine is very quickly
metabolized by our body that's why they
have to take it three times a day
whereas l-citrulline tends to last a
little bit longer so as always I hope
you guys found this video interesting
and remember to take care of yourself
because you're worth it
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