The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis (2025)

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Volume 16 Issue 2 February 2019
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Hye Chang Rhim, BA

Korea University

College of Medicine

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Seoul

Korea

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Min Seo Kim, BA

Korea University

College of Medicine

,

Seoul

Korea

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Young-Jin Park, MD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

,

Seoul

Korea

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Woo Suk Choi, MD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

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Seoul

Korea

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Hyoung Keun Park, MD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

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Seoul

Korea

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Hyeong Gon Kim, MD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

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Seoul

Korea

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Aram Kim, MD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

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Seoul

Korea

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Sung Hyun Paick, MD, PhD

Department of Urology

Konkuk University Medical Center

Konkuk University School of Medicine

,

Seoul

Korea

Corresponding Author: Sung Hyun Paick, MD, PhD, Department of Urology, Konkuk University Medical Center, Konkuk University School of Medicine, 120-2, Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea. Tel: 82-2-2030-7673; Fax: 82-2-2030-7748. 20030010@kuh.ac.kr.

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The Journal of Sexual Medicine, Volume 16, Issue 2, February 2019, Pages 223–234, https://doi.org/10.1016/j.jsxm.2018.12.002

Published:

01 February 2019

Article history

Received:

26 July 2018

Accepted:

06 December 2018

Published:

01 February 2019

A correction has been published: The Journal of Sexual Medicine, Volume 17, Issue 3, March 2020, Page 560, https://doi.org/10.1016/j.jsxm.2020.01.021

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    Hye Chang Rhim, Min Seo Kim, Young-Jin Park, Woo Suk Choi, Hyoung Keun Park, Hyeong Gon Kim, Aram Kim, Sung Hyun Paick, The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis, The Journal of Sexual Medicine, Volume 16, Issue 2, February 2019, Pages 223–234, https://doi.org/10.1016/j.jsxm.2018.12.002

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Abstract

Introduction

The efficacy and safety of arginine supplements in erectile dysfunction (ED) remain debatable.

Aim

To assess the potential role of arginine supplements on ED as alternatives to phosphodiesterase inhibitors.

Methods

Studies published up to April 2018 that evaluated the efficacy of arginine supplements were identified from multiple databases (Google Scholar, PubMed, Medline, Embase, Kiss, DBpia, and Cochrane databases). Studies comparing arginine supplements with placebo or no treatment; focusing only on patients with mild to moderate severity of ED; and presenting outcomes such as improvement rate, International Index of Erectile Function (IIEF) score, and adverse effects were included. Subgroup analysis for arginine alone and arginine in combination with other substances was further conducted to increase interpretability.

Main Outcome Measure

The strength of the association between arginine supplements and ED was assessed using relative odds ratios and weighted mean differences with 95% CI.

Results

In total, 10 randomized controlled trials met the inclusion criteria, reporting the outcomes of 540 patients with ED. The analysis demonstrated that arginine supplements with dosage ranging from 1,500 to 5,000 mg significantly improved ED compared with placebo or no treatment (odds ratios, 3.37 [1.29, 8.77], P= .01, I2= 44). Arginine supplements also caused significant improvements in the IIEF subdomain scores of overall satisfaction, intercourse satisfaction, orgasmic function, and erectile function, whereas the IIEF sexual desire score remain unchanged. The adverse effect rate in the arginine-treated group was 8.3%, and that in the placebo group was 2.3%, none of which were severe.

Clinical Implications

Arginine supplements can be recommended to patients with mild to moderate ED.

Strength & Limitations

The strength of this study is that it is the first meta-analysis to assess the potential role of arginine supplements in ED compared with placebo or no treatment. A limitation is that the treatment dosage and duration varied among studies, which may have contributed to study heterogeneity.

Conclusion

The results of our systematic review and meta-analysis provide evidence on the effectiveness of arginine supplements for mild to moderate ED.

Erectile Dysfunction, L-Arginine, Pycnogenol, Yohimbine

© International Society for Sexual Medicine 2018

Issue Section:

Erectile Function > Review

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