Sexual Health for Men
About this protocol
Where to start
Start with L-citrulline. The strongest evidence in the natural supplement category for erectile function. Take 3-6 g daily; effects build over 4-8 weeks. Particularly effective when paired with proper hydration and cardio.
Add panax ginseng (Korean red ginseng). The second-most-evidenced compound. Works through dopaminergic and direct nitric-oxide-modulating mechanisms.
Add zinc if your dietary intake is low or your serum testosterone is borderline. Don''t mega-dose — 15-30 mg is sufficient for most men.
Add maca if libido (desire) rather than function (erection) is your primary concern. Trial evidence is specifically for sexual desire, not erection mechanics.
Tongkat ali is the most speculative — small trials show benefit on testosterone and sexual function but the literature needs replication. Worth a 12-week structured trial.
If you have new-onset erectile dysfunction — see a urologist or your primary care doctor. ED can be an early sign of cardiovascular disease, diabetes, or low testosterone, and these are all addressable when caught early. Don''t self-supplement past a workup.
5 nutrients
Start here
Strongest evidence — the foundation of the stack.
L-Citrulline
3-6 g daily, on an empty stomach (or 1-2 hours before activity for acute use)L-citrulline is converted to L-arginine in the kidneys, where it serves as a substrate for nitric oxide synthesis — the same mechanism PDE5 inhibitors target indirectly. Citrulline has better bioavailability than arginine itself. Trials in mild-to-moderate erectile dysfunction show improvements in hardness scores over 4-8 weeks. Pure L-citrulline is more cost-effective than citrulline malate for this use case.[1, 2, 3]
Panax Ginseng (Korean Red)
900 mg standardized extract three times dailyKorean red ginseng has the second-strongest evidence base in the natural sexual-health category. Multiple randomized trials show improvements in erectile function scores, libido, and sexual satisfaction over 8-12 weeks. Mechanism involves nitric-oxide modulation plus dopaminergic effects. Choose a standardized extract.[4, 5, 6]
Add if needed
Add these only if the foundation isn't enough.
Zinc
15-30 mg elemental, with breakfastZinc is required for testosterone synthesis. Severe zinc deficiency demonstrably suppresses testosterone in human studies. In replete men, additional supplementation does not raise testosterone further — this is a deficiency-correction nutrient. Picolinate and bisglycinate forms are well-absorbed. Do not exceed 40 mg/day for extended periods.[7, 8, 9]
Maca (Lepidium meyenii)
1.5-3 g powder daily, with breakfastMaca has small but consistent trial evidence for improving sexual desire and libido — distinct from erection mechanics, which is the citrulline + ginseng wheelhouse. Effect is independent of testosterone levels (maca does not raise testosterone). Useful when desire rather than function is the primary concern.[10, 11, 12]
Experimental
Emerging evidence — try last, only if curious.
Tongkat Ali (Eurycoma longifolia)
200-400 mg standardized extract dailyTongkat ali has emerging trial evidence for improvements in testosterone levels, sexual function, and stress markers — particularly in men with low-normal baseline testosterone. The literature is dominated by smaller Southeast Asian trials and needs broader replication. Treat as the most speculative item — worth a 12-week structured trial with measurable endpoints.[13, 14, 15]
Warnings
Lifestyle improvements
Cardiovascular health is sexual health
Erectile function is downstream of vascular health. The same factors that damage arteries — high blood pressure, high LDL/ApoB, smoking, diabetes, sedentary lifestyle — damage the smaller arteries of the penis first. ED is often an early warning sign of cardiovascular disease. Address the upstream causes; everything downstream improves.
Cardio + strength
30-45 minutes of zone 2 cardio 3-4× per week plus 2-3 strength sessions has effect sizes on erectile function comparable to many supplements. The combination matters more than either alone.
Sleep 7-9 hours
Testosterone is produced primarily during REM sleep. Chronic short sleep (under 6 hours) suppresses testosterone by 10-15% within a single week. Sleep is the highest-leverage hormonal lever available.
Body composition matters
Excess adipose tissue increases aromatase activity (testosterone → estrogen conversion). Losing 5-10% body weight in overweight men reliably raises testosterone and improves erectile function.
Limit alcohol
Acute alcohol is a vasodilator but chronic moderate-to-heavy alcohol use suppresses testosterone and damages vascular function. 1-2 drinks max, not daily.
Manage chronic stress
Cortisol and testosterone share precursor pathways and are inversely correlated. Chronic work, financial, or relationship stress directly suppresses sexual function. Address the source.
Psychological factors
Anxiety, depression, relationship dynamics, and pornography habituation can produce or amplify functional symptoms. A urologist + therapist combination has better outcomes than either alone for most cases.
Annual labs
Track total + free testosterone, SHBG, estradiol, LH, FSH, lipid panel, ApoB, HbA1c, and morning cortisol. Lab work tells you whether the stack is moving anything. Symptoms alone are a poor proxy.
References
- L-Citrulline — supplement research overviewExamine.com link
- Cormio L, et al. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology. 2011;77(1):119-122.PubMed link
- Lauer T, et al. Oral L-citrulline supplementation enhances the effects of L-arginine on plasma nitric oxide markers. Br J Nutr. 2008;100(2):255-261.PubMed link
- Panax ginseng — supplement research overviewExamine.com link
- Jang DJ, et al. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66(4):444-450.PubMed link
- Hong B, et al. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction. J Urol. 2002;168(5):2070-2073.PubMed link
- Zinc — supplement research overviewExamine.com link
- Prasad AS, et al. Zinc status and serum testosterone levels of healthy adults. Nutrition. 1996;12(5):344-348.PubMed link
- Fallah A, et al. Zinc is an Essential Element for Male Fertility: A Review of Zn Roles in Men''s Health. J Reprod Infertil. 2018;19(2):69-81.PubMed link
- Maca — supplement research overviewExamine.com link
- Gonzales GF, et al. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002;34(6):367-372.PubMed link
- Shin BC, et al. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010;10:44.PubMed link
- Tongkat Ali — supplement research overviewExamine.com link
- Tambi MI, et al. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia. 2012;44 Suppl 1:226-230.PubMed link
- Talbott SM, et al. Effect of Tongkat Ali on stress hormones and psychological mood state in moderately stressed subjects. J Int Soc Sports Nutr. 2013;10(1):28.PubMed link
Related protocols
Other hormones protocols and protocols sharing ingredients with this one.
Women's Libido & Desire
hormones
Female sexual desire is multifactorial — hormonal status (estrogen, testosterone, progesterone, thyroid), relationship dynamics, mental health, stress, sleep, medication side effects (especially SSRIs and oral contraceptives), and physical comfort all matter, often more than any single supplement. Hypoactive Sexual Desire Disorder (HSDD) affects roughly 1 in 10 women, and the most common drivers in our culture are chronic stress, sleep debt, medication side effects, and relational rather than biochemical factors. Supplements address one slice of the picture and are not a substitute for proper medical evaluation when desire loss is severe or distressing. That said, a handful of supplements have real trial evidence in women specifically — not extrapolated from male data. Maca has the most consistent evidence for libido and desire in both pre- and postmenopausal women, with effects that appear independent of hormonal change. Ashwagandha shows benefit on female sexual function through stress modulation. Vitamin D and zinc are deficiency-correction nutrients — if you''re low, repletion helps; if you''re replete, additional supplementation does nothing. L-citrulline has indirect support for genital blood flow. Most women''s libido issues are NOT supplement-deficiency problems, but for the subset where they are, this stack is well-targeted.
Andropause / Men 50+
hormones
Andropause — formally late-onset hypogonadism — is real but gradual. Total testosterone declines roughly 1% per year after age 30, and symptoms (lower libido, erectile changes, mood and energy decline, muscle loss, visceral fat gain, occasional hot flashes) accumulate slowly across the 40s and 50s. Unlike menopause, there is no clean inflection point — which is exactly why it is often missed or attributed to "just aging." The first step is honest measurement: morning total + free testosterone, SHBG, LH, FSH, estradiol, PSA, lipids, fasting glucose, CBC. Numbers and symptoms together drive the decision tree. For properly-indicated men, testosterone replacement therapy (TRT) is genuinely transformative — and supplements cannot replicate it. This protocol is for the broader 50+ male wellness picture: milder cases of declining T, men who don't yet meet TRT criteria, or men using supplements as an adjunct to lifestyle work before pursuing prescription routes. Effect sizes from supplements are modest and only meaningful when sleep, strength training, body composition, and alcohol intake are already in order.
Perimenopause Support
hormones
Perimenopause is the 4-10 year transition leading into menopause, typically starting in the late thirties to mid-forties. It is dominated not by low estrogen but by hormonal volatility — estradiol swings, increasingly anovulatory cycles, progesterone decline. The symptom pattern differs from menopause itself: irregular cycles, heavy or unpredictable periods, mid-cycle bloating, PMS-like mood shifts intensifying, sleep disruption, brain fog, anxiety surges, and emerging hot flashes. Many women in their forties are dismissed as "just stressed" when they are in fact in early perimenopause. This stack supports cycle regularity, mood stability, and sleep through the transition. It is not a replacement for medical evaluation — a menopause-trained provider can offer cyclic progesterone or low-dose hormone therapy when indicated.
Testosterone Support for Men
hormones
Supplements can support endogenous testosterone production but they cannot replace it. If your morning total testosterone is below 300 ng/dL and you have symptoms, that is a medical conversation — not a supplement question. What supplements CAN do is correct common deficiencies (vitamin D, zinc) that suppress production, and modestly support output via adaptogens like ashwagandha. Effect sizes are real but modest, and only meaningful when lifestyle fundamentals (sleep, training, body composition) are in order.
PCOS Support
hormones
Polycystic ovary syndrome (PCOS) affects roughly 10% of reproductive-age women and is one of the most under-diagnosed endocrine conditions. The core pathology involves insulin resistance, androgen excess, and ovulatory dysfunction — and the supplement category here has unusually good evidence. Myo-inositol is the gold-standard supplemental intervention for PCOS, with effects approaching metformin for restoring ovulation and reducing hyperandrogenism. NAC has small but consistent evidence for ovulation and insulin sensitivity. Vitamin D, magnesium, and berberine support the underlying insulin-resistance pathway. This stack complements lifestyle (the most impactful intervention) and medical therapy when needed. It does NOT replace metformin, GLP-1 agonists, or ovulation induction in women actively trying to conceive — but it can reduce reliance on them in milder cases.
Menopause Support
hormones
The menopausal transition disrupts more than just reproductive hormones — estradiol decline affects sleep, mood, bone density, cardiovascular risk, cognition, and skin. Hormone replacement therapy (HRT/MHT) remains the most effective intervention for moderate-to-severe symptoms and the long-term benefits for bone and cardiovascular health are well-established when started within the first ten years post-menopause. Supplements are first-line for women with mild symptoms, contraindications to HRT, or as a complement to HRT for symptom subsets. Black cohosh has the strongest evidence for vasomotor symptoms (hot flashes); magnesium and omega-3 support sleep, mood, and bone health.
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Coming to App StoreDisclaimer: These statements have not been evaluated by the FDA. This protocol is educational, not a substitute for personalized medical advice. Talk to your doctor before starting any new supplement regimen — especially if you're pregnant, breastfeeding, on medications, or managing a chronic condition. Last updated 5/20/2026.