Do Any Supplements Actually Work for Male Sexual Performance? | A Pharmacist’s Review

By Dr. Casey Greene, PharmD, IFMCP

 

If you’re a guy then you’ve no doubt seen countless advertisements for various men’s sexual performance or ED “miracle pills”. You’ve also probably gathered that most of these simply don’t work, especially when compared to proven prescription options like Viagra or Cialis. 

That brings me to the next question…

Why not just use the prescription options like Viagra, Cialis, or compounded injectable trimix?

I’ve worked with 10s of thousands of guys using those successfully in my years as a pharmacist. In their own right they’re miracle drugs for many guys, at least for artificially enhancing blood flow very briefly (not for the root plumbing causes). 

 

Why Would Guys Want a Supplement for Sexual Performance?

What about guys that want a natural option without a doctor’s visit or prescription?

What about guys that want to naturally enhance baseline function without drug dependency?

What about guys that want to address the root causes of their ED?

 

Do Any Supplements Actually Work?

Most of them? No. A rare few? Yes. 

Do these rare few work well enough for your case? That depends on many factors, but they’ll likely help. 

In fact, there are easy to use test strips you can place under your tongue briefly before taking these supplements to test your pre-levels related to blood flow. Then you test your levels again 90 minutes later using a fresh strip to see your increase. No doctor or lab required. 

Plus, luckily with this type of supplement you can see the results yourself in real time, or not. This means there’s no guessing whether it works or not. 

Most supplements claiming male sexual performance and blood flow lean on the ingredients with some study evidence, but they don’t accurately use the studied ingredients, combinations, or doses, or they would require massive amounts beyond what’s in the supplement. 

The supplements I’ve seen the best results and rave reviews in include nitrates…

But not just any nitrates. It needs to be particular nitrates and in particular doses, like those used in the studies that showed the best results. 

Nitrates work by increasing nitric oxide (NO) levels, which is essential for optimal blood flow. As we age nitric oxide production generally decreases, but often does so much faster with typically poor diet and lifestyle habits. 

Nitric oxide (NO) is so important to health, blood flow (and by extension erectile function), that its discovery in 1998 led to the Nobel Peace Prize in Medicine. Nitric oxide itself is a gas though, so we have to take other chemicals or precursors to effectively increase levels. While many supplements claim to increase nitric oxide levels, very few do it effectively. 

Notably, nitrates are used in many powerful medications used for more dire heart conditions. These are often made so powerful that they can’t be combined with other ED meds like PDE5 inhibitors (ex: Viagra, Cialis). This is because of the risk of dangerously low blood pressure. 

The best supplements, however, use a very effective mixture and strength of nitrates (ideally based on real studies and evidence), but without the risk levels of these nitrate medications. You also want the nitrate mixture tightly standardized so every dose is accurate and predictable. Most of the time this is only done in pharmaceuticals, but it can be done at this level of precision in supplements too. This makes them safer and more effective for everyday use for sexual performance support. 

What Nitrates & Other Ingredients Are Shown to Work?

Most of the nitrate mixtures shown to work in studies use some combination of potassium nitrate + natural plant sources of nitrates like arugula and hesperidin, and typically with around 500mg of combined nitrates per dose. This means that extracts from these plant sources need to be extremely precise and predictable to meet dosing requirements. Quality is key!

Some other ingredients are key to maximize the nitrate conversion process into nitric oxide gas as well. Remember it’s nitric oxide gas in the blood vessels that actually causes and maintains vasodilation, and therefore erectile performance. 

 

Other key ingredients:

• Vitamin C: Synergizes with nitrates by accelerating the conversion of nitrates into NO

• Potassium: Enhances NO activity and counterbalances sodium to maintain optimal blood pressure and blood flow

• Magnesium: The primary relaxatory electrolyte involved in relaxing blood vessels and most commonly deficient mineral electrolyte

• Thiamine: Supports energy production involved in relaxing blood vessels and other heart and blood vessel functions around blood sugar

• Activated Folate: Supports BH4 production critical to NO conversion

• Activated B12: Lowers toxic homocysteine levels and supports healthy red blood cells and energy and oxygenation processes in tissues

 

How Should I Take Nitrates for Sexual Performance?

The most ideal way is daily. This is because optimizing your nitric oxide pathway supports overall cardiovascular health to provide many benefits. This supports maintenance of optimal heart and vascular health, as well as blood flow to the brain to maintain optimal mental performance. This maintains optimal daily sexual function as well. 

Some men will use nitrate supplements only as needed though. This is ideally 90 minutes before sexual activity for peak blood levels, but 45-60 minutes can still provide substantial benefit. Taken daily though you don’t need to worry about timing and get more comprehensive and long-term health benefits. 

Our top vetted and recommended nitrate formula for men is Pharmacist Formulations Nitric Oxide Complex. Not only is this formula vetted by our best clinical pharmacists based on evidence and studies on male blood flow, but it’s also our most popular product. Thousands of men have repeatedly voted Nitric Oxide Complex as their favorite product with repeat purchases. 

Other nitrate supplements often use other plant sources like beets. While beets are generally very healthy, concentrated extracts can have amounts of oxalates. This can put some guys at increased risk of kidney stones. 

For this reason, our Nitric Oxide Complex formula sources its nitrates from arugula and several other oxalate-free sources. This maximizes your blood blow benefits while adding no other risks. Nitric Oxide repeatedly remains not only our #1 men’s health supplement, but the #1 supplement in our entire product line…because it works!

Nitric Oxide Complex is our #1 pharmacist recommended male sexual performance supplement for daily or as needed use and quick results.

This section refers to what will restore and maintain long-term male sexual health and is almost always ignored by most doctors. Most solutions go straight to medications like Viagra, Cialis, or trimix injectables. These solutions are great for an immediate, short-term fix, but what about your baseline function if these meds aren’t around? 

Well, it’s more possible to restore and maintain baseline function than you might think…

But it does take at least a few months of these solutions to begin getting results, so you’ll need a little discipline and patience. You’ll be glad you did though for the entire remainder of your life. 

What is the primary cause for declining blood flow and sexual performance as men age?

Luckily for you it’s not simply getting old…

It’s what we do every day as we get older. This means you can do something about it. 

 

Insulin Resistance

The primary reason is chronically high blood sugar and how it damages blood vessels over time. Chronically high blood sugar causes your body to become resistant to insulin over time, which leaves damaging excess sugar in your blood vessels. 

While blood sugar is necessary for energy in normal amounts, excesses lead to significant problems with cholesterol and blood lipids, oxidation, inflammation, and damage to blood vessels. This all leads to stiffened blood vessels that don’t “perform” as we’d like and leave date night very disappointing to say the least. 

This is very similar to how high blood sugar damages tissues and organs in diabetics. Ever heard how diabetics can go blind, lose toes, go numb and have chronic nerve pain? This is from tissue damage from chronically high blood sugar levels. 

Even if you’re not diabetic don’t think you’ve escaped this problem. Many studies estimate 70-80% of Americans to have some level of insulin resistance from chronically high blood sugar. This is a result of the Standard American Diet (aka SAD). The way our industrialized food system is setup promotes this type of diet and problem. 

How do you know if you have insulin resistance likely contributing to ED?

Have you steadily gained weight over the decades? Weight that is increasingly stubborn to get rid of?

That’s the primary sign of insulin resistance, and insulin resistance is the #1 medical reason for obesity with aging. 

 

So how can you address insulin resistance to improve blood flow and sexual performance?

• Eat an anti-inflammatory diet such as the Mediterranean Diet
• Exercise at least 150 minutes a week (put sugar to productive use)
• Do resistance exercise (make your muscles suck up the excess blood sugar instead of fat cells)
• Take supplements that support optimal blood sugar control such as our Weight Loss Super Duo:
• Carb Metabolic Gummies -  Studied to lower blood sugar 42% post meal (the “Carb Hack”) despite eating carbs
• Metabolic Foundation - Combines berberine + alpha lipoic acid to provide study proven blood sugar support
• Minimize stress - High stress increases cortisol and blood sugar levels
• Maximize sleep - More sleep optimizes blood sugar control, weight, & sexual function

 

Maximize Testosterone Levels

I don’t need to tell you that having optimal testosterone levels is key to men’s health. It optimizes blood flow and sexual performance via the NO pathway, improves blood sugar control, supports muscle mass and metabolism, speeds recovery, and supports better mood, drive, and focus. 

Want proof that testosterone is critical for blood flow and erectile function? Ask any guy that’s ever stopped testosterone replacement therapy cold turkey…their natural testosterone levels are offline and things downstairs simply don’t work for some time…until restored. 

There are 3 primary ways to increase testosterone levels:

• Natural methods
• Prescription methods to support natural (internally produced) testosterone
• Testosterone replacement therapy (Rx)

This topic is far too in-depth for this article, but lucky for you our expert team has written an entire book on the topic. This book will revolutionize your ability to increase your testosterone levels. Many guys can get their total testosterone levels to a robust 800+, even if in their 60s. You can click the link below to get it for free: