Andrology-Open Access
Open Access

Abstract

Combining a Nitric Oxide Boosting Dietary Supplement with Sildenafil Improves Nighttime Erections more than Sildenafil alone

Judson Brandeis*, Elliot Justin and Aidan J Tu

Objective: This study investigated whether ingesting a NO-boosting dietary supplement with Sildenafil one hour before sleep can improve nighttime erectile function compared to Sildenafil alone, using the TechRing by FirmTech to measure penile pressure while sleeping.

Methods: Twenty-two men (mean age 55, mean SHIM score 18.1) participated in the study. Participants wore the FirmTech TechRing, a validated device that measures erectile firmness and duration, over four nights. Following a two-day washout period without ejaculation or ED-related medications/substances, participants recorded baseline erectile activity after ingesting 40 mg Sildenafil one hour before sleep for two nights, then ingested two tablets of a nitric oxide-boosting supplement (containing L-citrulline, red beet root extract, Panax ginseng, and Muira Puama) in addition to the 40 mg Sildenafil one hour before sleep for two subsequent nights. Erectile quality was quantified as the area under the curve per hour of sleep (AUC/hr).

Results: AUC/hr significantly increased from a mean of 87 (baseline) to 117 (with supplements) with a mean difference of 30 and a p-value of 0.00004 (t=5.219). The number of nightly erections showed a significant increase from 3.25 to 3.87 with a mean difference of 0.62 and a p-value of 0.034 (t=2.285). No significant side effects were reported.

Conclusion: The combination of Sildenafil and a NO-boosting dietary supplement increased the intensity, duration and number of nighttime erections compared to Sildenafil alone without side effects. This study supports the use of a dual-therapy approach to ED treatment that minimizes side effects from high PDE5i doses.

Published Date: 2026-02-19; Received Date: 2024-10-06