Written by Amanda Williams, MPH
You often hear men say, “If I could only have the stamina of when I was a twenty year old”. Well, the great news is that there are so many alternatives to prescriptions and medications available to support your libido and enhance your overall sexual performance the natural way. Nowadays, we are bombarded by commercials on pharmaceutical agents that are prescribed to men with erectile dysfunction. These medications can have multiple unwanted side effects (have you listened to a TV commercial promoting a product for erectile dysfunction lately?) and are not always an option for men with certain health conditions. So let’s look at a few key nutrients that may help support overall sexual health and libido.
L-Arginine and Nitric Oxide
Let’s start with the basics, like the amazing amino acid L-arginine, which allows for the release of nitric oxide in the body. Nitric oxide (NO) is a vasodilator, naturally occurring in the body that requires arginine for its release. L-Arginine is the only substrate in the biosynthesis of NO, which plays critical roles in diverse physiological processes in the human body including neurotransmission, vasorelaxation, cytotoxicity and immunity. L-Arginine is engaged in several metabolic pathways within the human body. It is an essential component of the urea cycle, the only pathway in mammals that allows the elimination of toxic ammonia from the body.
Herbal Support for a Healthy Libido
There are many herbs that can play a supportive role in enhancing sexual performance that have been extensively studied for their multiple health benefits.
In late 2008, investigators at Massachusetts General Hospital conducted a double-blind, randomized, parallel-group study of two different doses of Maca Root for the treatment of sexual dysfunction related to the use of the selective-serotonin reuptake inhibitor (SSRI) class of modern antidepressant drugs. Researchers found that after giving Maca Root extract to both men and women on a daily basis, participants experienced a significant improvement in a standardized score of sexual function, while subjects taking a placebo did not.
Muira puma extract, commonly called the “Viagra of the Amazon”, is another great herb for overall male sexual support, as it has been shown to have adrenal adaptogen-like properties to help support stress, as well as being a well-known aphrodisiac. 
Horny goat weed, also known as Icariin, is a powerful extract that has been studied for its ability to mimic testosterone. Icariin may further support the ability to maintain an erection by blocking phosphodiesterase-5 (PDE5)—the enzyme responsible for causing erections to subside. This extract has been shown to also enhance the release of nitric oxide and optimize the vasodilatory action of obtaining an erection.
Shown to support male hormonal balance, libido and performance, Long Jack Extract is also known as Tongkat Ali and Eurycoma longifolia. This Southeast Asian botanical is used traditionally to enhance energy levels, endurance and stamina.
According to Memorial Sloane Kettering Cancer Center, Tribulus Terrestris extract is a perennial herb that grows in the subtropical regions of eastern and western Asia, southern Europe, and Africa. It is used in traditional Chinese and Indian medicine systems for chest pain, heart-related problems, dizziness, skin and eye disorders, to expel kidney stones, and as a diuretic. A recent pilot study evaluating Tribulus in men with partial androgen deficiency showed significant differences in testosterone levels and erectile function.
There are a wide array of nutrients that may help to support a healthy libido and enhance sexual performance. It is important to recognize that hormone levels can and will change as we age. This is why I always encourage men (and women!) to get their hormone levels tested with their doctor. Feeling youthful and vivacious is the key to a long life. Do not let low hormone levels get you down and out of the game, when there really are so many wonderful nutrients that are available to support your needs.
 Mayo Clinic Drugs and Supplements, www.mayoclinic.org/drugs-supplements/arginine
 Dording CM, Fisher L, Papakostas G, et al. A double-blind, randomized, pilot dose-finding study of Maca root (L. Meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008;14(3):182-91
 Plato AL, Detanico BC, Link VM, et al. Anti-stress effects of the “tonic”Ptychopetalum olacoides (Marapuama) in mice. Phtyomedicine. 2010 Mar;17(3-4):248-53
 Zhang ZB, Yang QT. The testosterone mimetic properties of icariin. Asian J Androl. 2006 Sep;8(5):601-5
 Dell’Agli M, Galli GV, Dal Cero E, et al. Potent inhibition of human phosphodiesterase-5 by icariin derivatives. J Nat Prod. 2008 Sep;71(9):1513-7
 Xu HB, Huang ZQ. Icariin enhances endothelial nitric-oxide synthase expression on human endothelial cells in vitro. Vascul Pharmacol. 2007 Jul;47(1):18-24
 Kotirum, Surachai et al. Efficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: Systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine , Volume 23 , Issue 5 , 693 – 698
 Memorial Sloane Kettering Cancer Center. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/tribulus-terrestris
Amanda Williams, MPH
Director of Nutrition– Boca Raton, Florida, 561.367.8646
Amanda Williams holds a doctorate in medicine from Xavier University in Aruba, a Masters degree in Public Health from Nova Southeastern University, and a Bachelor’s degree in biology from St. Mary’s College Orchard Lake. Amanda has spent the last ten years focused on nutrition and wellness. Her background in disease state management allows for a unique nutritional approach to many of the most common health concerns. She has successfully completed training as an instructor in Diabetes Self-Management through Stanford University. To stay on top of the wellness world, she continues to obtain medical education credits through the American Academy of Anti-Aging. Listen to Amanda LIVE on InVite® Health Radio at www.invite.nyc! Email Amanda Williams: AWilliams@invitehealth.com