Nitric Oxide Supplements for Erectile Dysfunction After 65: Blood Pressure Risks

As men age, maintaining healthy erections can become more challenging. Nitric oxide (NO) supplements—often in the form of L-arginine or related compounds—are popular natural options for supporting blood flow to the penis. But after age 65, changes in blood vessels and common use of blood-pressure medications mean you should proceed thoughtfully. This guide explains how nitric oxide supplements work, what the research says about benefits and risks, and practical tips for safe use.

---

What Are Nitric Oxide Supplements?

• Nitric oxide is a gas your body makes from the amino acid L-arginine.
• NO relaxes and widens blood vessels (vasodilation), improving blood flow.
• Common OTC supplements include:
  • L-arginine
  • L-citrulline (converted to L-arginine in the body)
  • Beetroot powder (rich in nitrates)

These supplements aim to boost NO levels, opening arteries in the penis much as prescription PDE5 inhibitors (e.g., sildenafil) do, but via a natural route.

---

Potential Benefits for Erectile Dysfunction After 65

1. Improved Blood Flow

   • Enhanced vasodilation can help achieve and maintain erections.
   • Traish et al. (2006) showed that adding L-arginine to PDE5 inhibitors may further improve erectile response in men with low NO levels.

2. Increased Exercise Performance

   • Better circulation can translate to more energy and stamina during physical activity—helping overall health.

3. Modest Blood Pressure Reduction

   • Dong & Qin’s 2011 meta-analysis (20 trials, 1,498 subjects) found oral L-arginine lowered systolic BP by ~5 mm Hg and diastolic BP by ~2.8 mm Hg.
   • For someone with mild hypertension, this may be a bonus—but in older men on multiple blood-pressure meds, drops can be too steep.

---

Blood Pressure Risks After Age 65

As arteries stiffen with age, older adults often take antihypertensive drugs (ACE inhibitors, beta-blockers, nitrates). Introducing an NO supplement can:

• Compound medication effects, leading to dizziness or fainting.
• Cause sudden drops in blood pressure (postural hypotension), especially when standing.
• Trigger headaches, flushing, and heart palpitations if blood vessels dilate too rapidly.

Key considerations:

• If you take nitrates (nitroglycerin, isosorbide), combining with NO supplements may cause a dangerous BP crash.
• Those on multiple BP-lowering drugs should monitor readings closely when starting any vasodilator.

---

Who Should Be Cautious or Avoid Them

Discuss with your doctor before use if you:

• Are on nitrates or strong antihypertensives.
• Have a history of cardiovascular disease (angina, heart failure).
• Have low baseline blood pressure (<100/60 mm Hg).
• Experience frequent dizziness or balance issues.
• Take PDE5 inhibitors—adding L-arginine may amplify vasodilatory effects.

---

Practical Tips for Safe Use

1. Start Low, Go Slow

   • Begin with the lowest recommended dose (e.g., 500–1,000 mg L-arginine once daily).
   • Watch for side effects (dizziness, headache).

2. Monitor Blood Pressure

   • Check at home: lying down, seated, and standing.
   • Record readings for a week before and after starting.

3. Time It Right

   • Take on an empty stomach or per label instructions.
   • Space out from blood-pressure meds if advised by your doctor.

4. Stay Hydrated

   • Adequate fluids support healthy circulation and reduce dizziness risk.

5. Combine with Lifestyle Measures

   • Regular exercise, a heart-healthy diet, and quitting smoking all boost NO production naturally.

---

Research Highlights

• Traish AM, Park K, & Min S. (2006). “Phosphodiesterase type 5 inhibitors and L-arginine for the management of erectile dysfunction.” Journal of Sexual Medicine.

  • Found additive benefits of L-arginine with PDE5 inhibitors in men with low NO.

• Dong JY & Qin LQ. (2011). “Effect of oral L-arginine on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials.” American Heart Journal.

  • Demonstrated modest BP lowering (–5/–2.8 mm Hg), beneficial for mild hypertension but a caution when combined with other vasodilators.

• D’Amico G, Garcia-Tsao G, & Pagliaro L. (2006). While focused on liver disease, underscores the importance of monitoring systemic blood-flow changes in older patients.

---

When to Seek Medical Advice

If you experience any of the following after starting a nitric oxide supplement, stop use and seek prompt evaluation:

• Persistent dizziness or fainting.
• Chest pain or palpitations.
• Severe headache not relieved with over-the-counter pain relief.
• Vision changes or ringing in the ears.

For any symptom that feels serious or life-threatening, speak to a doctor immediately.

You may also consider a free, online "symptom check for " to help clarify next steps before your appointment.

---

Summary

• Nitric oxide supplements (L-arginine, L-citrulline, beetroot) can aid erectile function by improving blood flow.
• In men over 65, benefits may be offset by risks of low blood pressure, especially when combined with antihypertensive meds or nitrates.
• Start with low doses, monitor BP, and adopt healthy lifestyle habits.
• Always discuss any new supplement with your physician to avoid dangerous interactions.

By combining natural NO boosters with professional guidance and self-monitoring, you can safely explore options to support erectile function and overall vascular health after age 65.