Increasing your testosterone levels and boosting nitric oxide are two of the best ways for men to have better sex. What are the best natural testosterone boosters and nitric oxide supplements? Read on to find out.
Last Updated: 04/13/2023
At men’s sexual health clinics, they’ll often use several strategies to improve sexual function. When you use a few different methods you can address different causes of low libido and erectile dysfunction such as low levels of testosterone, poor blood flow, and low nitric oxide. For example, men’s clinics might use simultaneously all or some of the following strategies to improve erectile function:
Nitric oxide boosters
Medications used to improve sexual function
Li-ESWT (acoustic soundwave therapy)
Lifestyle strategies like weight loss
Testosterone supplements and nitric oxide boosters are excellent ways to enhance the effects of Li-ESWT. That’s why Part 11 of our 90-Day Challenge shows men which natural testosterone and nitric oxide boosters may improve your outcome with acoustic soundwave therapy or medications that increase sexual function.
Our 90-Day Challenge encourages you to change one aspect of your lifestyle each week, to have the best sex of your life.
In this article, we’ll go over which supplements are backed up by science to naturally raise testosterone or nitric oxide.
If you’re wondering what does nitric oxide do, nitric oxide (NO) is nature’s libido enhancer, among many other benefits.
Pretty much every cell in the body makes nitric oxide, but it’s especially important in blood vessel health since it dilates the blood vessels, which improves blood flow to the penis. Given its blood-flow-boosting actions, nitric oxide is important for cardiovascular health, too.
Nitric oxide supplements contain precursors for NO, so that your body can make nitric oxide on its own. Dark green leafy vegetables also boost the production of nitric oxide in the body, but it’s difficult to eat enough of these vegetables to make beneficial amounts of nitric oxide.
People who want to raise nitric oxide levels use nitric oxide boosters such as L-citrulline, L-arginine, and beetroot. Each of these nitric oxide supplements has some scientific support for their ability to boost nitric oxide levels in humans and in some cases improve sexual function. Men with sexual decline often have low levels of L-citrulline and L-arginine.1
Researchers reviewed 10 randomized controlled trials of arginine and sexual function that included a total of 540 men.2 The researchers found that taking arginine supplements with doses ranging from 1,500 to 5,000 mg significantly improved sexual decline compared with the placebo or no treatment. Arginine supplements also led to improved satisfaction with sexual intercourse and orgasms.
One study found that a combination of L-arginine and tadalafil made Li-ESWT even more effective.3 Men received six weekly applications of Li-ESWT or Li-ESWT together with 2,500 mg of L-arginine and 5 mg tadalafil. The researchers measured the men’s progress at one, six, and 12 months after the last Li-ESWT application.
The study authors concluded that combining Li-ESWT with L-arginine and an ED pill increased the effectiveness of the Li-ESWT and made the benefits last longer.
However, some people can't convert L-arginine to nitric oxide. So you may want to use another amino acid known as L-citrulline together with L-arginine. L-Citrulline is converted into L-arginine in the body and is better absorbed.4
Scientists have investigated whether L-citrulline can improve erection hardness in men. In one of these studies, a single-blind trial, 24 men with an average age of 56.5 years took a placebo for one month and then 1.5 grams/day of L-citrulline for another month.4
When taking L-citrulline, half of the men experienced an improved erection hardness score. The men also had more sexual intercourse when they were taking the L-citrulline compared to the placebo.
The researchers concluded that although L-citrulline wasn’t as effective as phosphodiesterase type-5 enzyme inhibitor drugs, at least in the short term, it did have a beneficial effect on sexual function.
In another small study of 13 men, researchers studied the combination of L-citrulline with transresveratrol in men who were not getting any benefit out of taking ED pills on demand.5 While taking the L-citrulline and resveratrol, the men continued using the ED pills on demand.
The study was a randomized, double-blind, placebo-controlled crossover pilot study, which means that the men took a placebo for one month then for another month switched to L-citrulline 800 mg/day and transresveratrol 300 mg/day. The men continued to use the ED pills when they knew they were going to have sex.
Taking L-citrulline combined with transresveratrol led to a significant improvement in the men’s Sexual Health Inventory for Men score. There was also a small increase in the erection hardness score.
Beetroot juice is another nitric oxide booster.6 It’s a source of nitrate, which your body uses to make nitric oxide.
We haven’t been able to find any studies specifically investigating beetroot and sexual function, but because nitric oxide is involved in sexual health and beetroot increases levels of nitric oxide, it makes sense that it may benefit sexual function.
Working with your doctor to make sure your testosterone levels are normal is important to maintaining your sexual stamina. Testosterone is a hormone important for sex drive and libido. If your testosterone levels are low, you can either try testosterone replacement therapy or testosterone supplements.
Taking testosterone supplements is one way to boost testosterone levels naturally. You can use testosterone boosters together with other methods to support sexual function like Li-ESWT. Here are some supplements that may raise testosterone levels, according to science.
Zinc is a natural testosterone booster. Zinc kickstarts men’s testosterone production and a deficiency in this mineral spells trouble for men’s hormones.
A 1996 study observed that zinc and testosterone levels were closely tied together in young and old men.7 In the study, researchers fed young men a low-zinc diet so that the men became zinc deficient. After 20 weeks of a low-zinc diet, testosterone levels dropped by nearly 75%.
Researchers gave elderly men in the study zinc supplements and found that testosterone levels in these men nearly doubled.
Aim for about 11 mg of zinc per day. Over time, taking too much more than that can lead to lower immunity and imbalanced copper levels.
Another way to naturally boost testosterone and support sexual function is to make sure you’re getting enough vitamin D3. Some, but not all, studies show that there’s a relationship between vitamin D and testosterone. One study of 300 healthy men showed that the higher the blood concentration of vitamin D, the higher the testosterone level.8
In that same study, 41 men who had one testicle removed due to cancer, received an injection of a hormone meant to trigger testosterone production in the remaining testicle.8 The men with the lowest vitamin D levels produced less testosterone after the injection compared to men whose vitamin D levels were normal or high.
Vitamin D3 may also play a role in sexual function. One review of eight published studies including a total of 4,055 patients, found that in men with vitamin D deficiency, sexual function was significantly worse than in controls.9 This study also found that men with severe sexual decline have lower vitamin D levels compared to men with mild sexual decline.
One reason why vitamin D3 might improve sexual function is because it’s also good for cardio health.9 Men who have poor sexual function often have cardiovascular concerns.9
Scientists and doctors consider poor sexual function a red flag that something isn’t right with the heart or cardiovascular system. Vitamin D3 strengthens the blood vessel lining, supports a healthy inflammatory response, and has other benefits that promote heart health.9
Certain B vitamins like folate and vitamins B6 and B12 lower levels of an amino acid known as homocysteine. High levels of this amino acid have many bad effects on the body, including possibly lowering testosterone levels.10 Homocysteine is also linked to heart disease. 10
One review of published studies revealed that non-diabetic men with poor sexual function are more likely to have high homocysteine levels.11 Another study found that men undergoing sexual decline had lower levels of folic acid and vitamin B12 and higher homocysteine levels.12
B vitamins may support healthy sexual function in other ways besides lowering homocysteine. For example, niacin is known for its ability to maintain healthy cholesterol levels. In one study, a dose of 1,500 mg per day of niacin improved sexual function in 160 men who had high cholesterol and moderate to severe sexual decline.13
In men who had type 2 diabetes, the B vitamin folic acid taken daily combined with the drug tadalafil every other day led to significantly more improvement in sexual function compared to the drug alone.14
Research has shown that taking magnesium supplements increases free and total testosterone values in sedentary men and athletes.15 In addition, magnesium maximizes physical performance and muscle function during exercise.16
Magnesium also is involved in sexual health. For example, men with stage 3-4 chronic kidney disease (CKD) who also have low levels of magnesium are more likely to suffer from poor sexual function.17
Unfortunately, many men are deficient in magnesium and this spells trouble for sexual health. The National Health and Nutrition Examination Survey studied 1,096 men with sexual decline and 2,649 participants with healthy sexual function.18 Men who didn’t get enough magnesium in their diet, as well as other minerals like zinc and selenium, had an increased risk of sexual decline.
People who eat a diet high in processed foods and low in dark, green leafy vegetables are often deficient in magnesium. Certain medications like proton pump inhibitors can also cause a drop in magnesium levels.19
Dehydroepiandrosterone (DHEA) is a hormone and a precursor to testosterone.20 Its levels drop with age.
Taking a DHEA supplement may boost levels of testosterone. In one study of eight middle-aged men and eight young controls, 50 mg/day of DHEA taken one night before a high-intensity interval training exercise led to an increase in free testosterone in middle-aged sedentary men.21.
While that was a small study, one review of 42 published studies established that DHEA significantly raised testosterone levels in both men and women.22 Doses above 50 mg worked best. Working with your doctor to get your DHEA levels tested before you start taking supplements is the best way to make sure you’re taking the right dose.
Saw palmetto stops the breakdown of testosterone into its byproduct, dihydrotestosterone. By stopping testosterone breakdown, saw palmetto maintains healthy levels and boosts libido.23 By triggering testosterone production, it can reduce symptoms of andropause, a condition males go through as they get older, where testosterone levels drop.23
Ashwagandha, also known as Withania somnifera, is an herb used to promote stamina, enhance muscle strength and endurance, and improve overall health.
In one randomized, double-blind, placebo-controlled study of 43 overweight aging men who had mild fatigue, the men took either ashwagandha extract or a placebo. The men taking the ashwagandha had a 14.7% greater increase in testosterone compared to the placebo.24
As a natural stress reliever, ashwagandha can regulate levels of the stress hormone cortisol.25
High levels of this hormone aren’t good for sexual health, because cortisol narrows penile blood vessels. Higher cortisol levels are linked to worse sexual function.26
Fenugreek (Trigonella foenum-graecum) is an herb that resembles clover. It grows in southern Europe, Western Asia, and the Mediterranean. Fenugreek is a libido booster for men that can maintain healthy testosterone levels.27
In one double-blind, randomized, placebo-controlled study, 60 healthy males between 25 and 52 received 600 mg of a specialized fenugreek extract called Testofen or a placebo for six weeks.27 Fenugreek improved libido, sexual arousal, and orgasm. It also increased muscle strength, energy, and well-being.
Another randomized, double-blind, placebo-controlled trial studied 120 healthy men between 43 and 70 years old.28 It investigated the effects of 600 mg of Testofen fenugreek extract over 12 weeks. Fenugreek improved the Aging Male Symptom questionnaire score and sexual function, including frequency of sexual activity. Fenugreek also boosted total serum testosterone and free testosterone compared to placebo.
Some research indicates that fenugreek can increase free testosterone levels up to 46% in most men taking it, while at the same time improving libido.29
Tribulus terrestris is a plant-derived libido enhancer and may act as a herbal testosterone booster. There’s some research showing this botanical can raise testosterone levels.
In a study of 70 aging men suffering from testosterone deficiency and poor sexual function, half of the men received 250 mg Tribulus terrestris three times per day for three months while the other half received a placebo.30 In the men taking Tribulus terrestris, total testosterone levels increased and they experienced a significant improvement in sexual function.
In men who received 770 mg/day of Tribulus terrestris for six weeks or a placebo, the Tribulus group did not experience improved exercise performance but did have increased testosterone levels.31
A trial of 172 men taking either Tribulus terrestris or a placebo didn’t actually report on testosterone levels, but found that men in the Tribulus group had significantly improved sexual function including increased satisfaction with sex, orgasms, and sexual desire.32
Some scientists have suggested that the reason why Tribulus improves sexual function in many men may not be because it raises testosterone, but rather because it acts as a natural nitric oxide booster.33
However, Tribulus terrestris hasn’t increased testosterone or improved sexual stamina in all studies. In one trial of 30 men with poor sexual function, the researchers gave half of the men Tribulus terrestris and half the placebo.34 The researchers found that Tribulus terrestris was not more effective than the placebo in improving sexual function or increasing total testosterone levels.
Sometimes it takes two or three different approaches that work together to restore your sexual stamina. Testosterone supplements or nitric oxide supplements work well with other methods to boost sexual function.
Just be sure to ask your doctor to make sure the supplement or supplements you’re going to take aren’t contraindicated with any medications you’re using. Consider booking an appointment with a functional medicine provider or men’s health clinic, since they are usually the most knowledgeable about dietary supplements.
Week 9: How Much Porn Is Too Much?
Week 10: How Often Can You Use a Penile Pump?