“Dr. Bob welcomes your questions about sexuality and will strive to answer them with the most up to date available medical/scientific information. Wherever possible, the scientific source(s) of the information is provided for your information. Answers to your individual questions represent generally accepted current conventional psychological and health science theory and practice but they are not intended to propose diagnoses or specific treatments. In all cases consultation with a medical or other health services provider is highly recommended.”

Q.  What is the difference between “supporting healthy erectile function” and “treating erectile dysfunction”?

A. US government and state laws restrict the way that professions and commerce may use certain terms including the term treatment.  For instance, anyone who holds a doctorate degree from an institution granted the right to award it can lawfully use the title “doctor.”  However, this does not entitle anyone to practice medical treatment or prescribe treatment medications without a valid license.  The treatment of any medical condition including prescribing medication is reserved by law to medicine.  On the other hand, a psychologist can employ non-medical means to treat emotional and behavioral disorders.

Erectile function is not a medical condition so anyone who claims a safe method to improve it can legally claim to “support” it.  On the other hand, erectile dysfunction (ED) was considered a psychological disorder long before it became a medical condition.  As a result, a licensed or certified psychologist can treat it with psychological techniques, and a physician can treat it as a medical disorder with prescription medications or other medical or surgical means.

While the law has an interest in safety and claims of efficacy (truth in advertising), it often allows the market to determine exactly how effective anything is that is said to “support healthy sexual function.”  It is assumed that if it is found by consumers to do that, then they will most likely continue to use it whereas it fails to satisfy “support” claims, they may soon discount its use.  That’s how “free markets” should work.

Since the 1980s, L-arginine, as used in conventional medicine, has been scientifically proven to be an effective treatment for a host of medical disorders including:

• Hypertension,⁽¹⁾
• coronary heart disease (CHD),⁽²⁾
• elevated serum LDL cholesterol (hyperlipidemia),⁽³⁾
• erectile dysfunction (ED),⁽⁴⁾
• Type II diabetes,⁽⁵⁾ and
• kidney disease,⁽⁶⁾ and
• preeclampsia ⁽⁷⁾ to name just a few.

… as reported in conventional medical publications (See below).  However, the typical consumer supplementation of L-arginine is not considered treatment under medical supervision and therefore it can only be claimed to “support healthy erectile function.”

In any case federal authorities do not now recognize L-arginine dietary supplement products to be a valid medical treatment for ED and therefore, allegations of its effectiveness notwithstanding, labels for the product can only legally state that it “supports healthy erectile function” even were it recommended by your physician.

[(1) See:  N. Gokce (2004). Supplement: Arginine Metabolism: Enzymology, Nutrition, and Clinical Significance: L-Arginine and Hypertension.   Journal of Nutrition, 134, 2807S-2811S (October 2004).]

[(2) See: Adams, M. R., McCredie, R., Jessup, W., Robinson, J., Sullivan, D., & D. S. Celermajer (1997). Oral L-arginine improves endothelium-dependent dilatation and reduces monocyte adhesion to endothelial cells in young men with coronary artery disease.  Atherosclerosis, 129, 261-269.]

[(3) See:  Clarkson, P., Adams, M. R., Powe, A. J., Donald, A. E., McCredie, R., Robinson, J., McCarthy, S. N., Keech, A., Celermajer, D. S., & J. E. Deanfield (1996).  Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults.  Journal of Clinical Investigation, 97, 1989–1994.]

[(4) See:  Zorgniotti, A. W., & E. F. Lizza (1994). Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction,” International Journal of Impotence Research, 6, 33-35.]

[(5) See:  Lucotti, P., Setola, E., Monti, L. D., Galluccio, E., Costa, S., Sandoli, E. P., Fermo, I., Rabaiotti, G., Gatti, R., & P. Piatti (2006).  Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin-resistant type 2 diabetic patients. American Journal of Physiology:  Endocrinology & Metabolism, 291, E906-12.]

[(6) See:  Tarumoto, T., Imagawa, S., Kobayashi, M., Hirayama, A., Ozawa, K., & T. Nagasawa (2007). L-arginine administration reverses anemia associated with renal disease.  International Journal of Hematology, 86, 126-129.]

[(7) See:  Rytlewski, K., Olszanecki, R., Korbut, R., & Z. Zdebski (2005).  Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia.  European Journal of Clinical Investigation, 35, 32-7.]

“Dr. Bob welcomes your questions about sexuality and will strive to answer them with the most up to date available medical/scientific information.  Wherever possible, the scientific source(s) of the information is provided for your information.  Answers to your individual questions represent generally accepted current conventional psychological and health science theory and practice but they are not intended to propose diagnoses or specific treatments.  In all cases consultation with a medical or other health services provider is highly recommended.”

Q.  Can I improve my sex life through nutritional support?  What if it’s ok already?

A. If you are reasonably healthy, and as good as your sex life may already be, it can usually be made better yet by the proper kind of nutrition.

There are two ways to do that:  First, a nutrition plan that has the right balance of “greens and beans” as noted in my book, Great Food, Great Sex (Ballentine, 2006), does just that:  The recipes in that book aim to supply adequate amounts of foods rich in L-arginine, as well as antioxidant foods.  The foods rich in L-arginine fuel sexual vitality by supplying that all important nitric oxide (NO) needed in sexual arousal and performance vitality.  We call these foods, “beans,” but it is really about proteins including meat proteins.  However, we emphasize very moderate consumption of red meats due, in part, to the high levels of sodium they contain.

The foods called “greens” supply the antioxidants that protect your blood vessels from free radical damage.  Free radicals work in at least two ways:  First, they corrode the endothelium, the cell layer in your blood vessels that chemically extract NO from L-arginine.  Second, free radicals in blood cause fat cells to become rancid and so macrophages (immune system cells) gobble them up while trying to rid them from your blood stream.  In the process, they turn into the “puff-cells” that form the atherosclerotic plaque in blood vessel walls:  Atherosclerosis also damages the endothelium and there you have it—double whammy!

Second, supplementing your diet with L-arginine can also increase sexual vitality:  When you consume L-arginine about half the amount consumed becomes available to the endothelium.  Dietary supplementation of L-arginine adds to that available from food-borne L-arginine.

Caveat:  Most folks tolerate L-arginine quite well—either food-borne or as a dietary supplement—and they largely benefit from its consumption.  L-arginine is, after all, one of the components that make up protein.  It is found in varying quantity in many of our most common foods.  But a high L-arginine diet is not for everyone:  Individuals with active herpes, or those with certain forms of cancer (breast cancer in women) are cautioned to keep L-arginine consumption to a minimum.  A list of contraindications can be found in my book, The Arginine Solution (Warner Books, 1999).