Causes of erectile dysfunction may be psychological and physiological factors (neurogenic, vascular, endocrine causes). It may also be a side effect of drugs and a symptom of health complications such as diabetes.

Penile erection occurs as a result of increased blood inflow to the penis, engorgement with blood, and decreased outflow of blood from the penis. Primarily, this process is mediated by nitric oxide, which is a neurotransmitter and vasodilator. Nitric oxide is synthesized from L-arginine.  

Several researches on the efficacy of L-arginine and nitric oxide on penile erection, fixing erectile dysfunction, have reported positive effects of both chemicals in stimulating and maintaining erection. For example, a study reported that 80 % of men (out of 40, age group 25 – 45) with erectile dysfunction treated with L-arginine (dosage: 1.7 g/ day) and Pycnogenol, an extract from French maritime pine bark (Pinus pinaster), (dosage: 80 mg/day) recovered from their erectile dysfunction after one month of treatment. Pycnogenol, also an antioxidant, stimulates synthesis of nitric oxide from L-arginine. The researchers reported that there was no side effect associated with the supplements.

In another double-blind, placebo-controlled, clinical research on the effect and safety of the combination of 6 g of L-arginine glutamate and 6 mg of yohimbine hydrochloride with that of 6 mg of yohimbine hydrochloride alone and that of placebo alone, for the treatment of erectile dysfunction (ED), it was reported that combined oral administration of the L-arginine glutamate ( 6 g) and yohimbine (6 mg) was effective in improving erectile function in patients with mild to moderate erectile dysfunction (ED).

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