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Treatment for erectile dysfunction with L-Arginine
As already stated in previous articles, oral medications are not only part of the first line of treatment for erectile dysfunction, but they are also preferred by doctors and patients for their practicality, safety and cost, among others.
Within the oral therapeutic alternatives, we find more and more evidence in relation to the so-called nitric oxide donors, particularly L-Arginine. Nitric oxide is considered as a main mediator of the erection, by facilitating the relaxation of the smooth muscle of the arteries of the penis and therefore the blood supply that allows tumescence and stiffness. L-Arginine is one of the nitric oxide donors, and several studies in animals and humans have provided evidence of its vasodilatory effects of penile arteries.
In this case we will refer to a study designed to determine if oral administration of a high dose of L-Arginine would be effective for men with erectile dysfunction of predominantly organic cause. The publication of this research is from the year 1999 in the journal BJU International, and its title is Effect of oral administration of high doses of L-Arginine as a donor of nitric oxide in men with organic erectile dysfunction: results of a double-blind study, randomized, placebo controlled.
This study included fifty patients between the ages of 55 and 75 with organic erectile dysfunction that lasted more than six months.
The patients studied underwent a complete physical exam, completed the O'Leary questionnaire that contains eleven questions that address the issues of sexual impulse, erectile function, problem assessment and sexual satisfaction in general. An additional questionnaire on sexual function developed especially by the authors addressed the number of erections, the quality of erections, libido and sexual performance. Finally, all participants were asked to keep a journal of sexual activity during the study period.
Patients were randomized to receive L-Arginine or placebo therapy for six weeks. The daily dose of 5 g. of L-Arginine or placebo was divided and administered in three doses. The patients were evaluated fourteen days before and zero, fourteen, thirty-five and forty-two days after the start of treatment.
Of the fifty original participants, thirty-two were assigned to treatment with L-Arginine and eighteen to placebo (controls). Some patients dropped out of the study during the process due to different causes. At the end, nine out of twenty-nine men treated with L-Arginine, but only two out of seventeen treated with placebo, reported a significant improvement in sexual function in their diaries. Here is a key fact: the initial level of urine nitric oxide in the nine men treated with L-Arginine who had a subjective improvement in their sexual activities was significantly lower than that of the other patients, and that level had doubled to end of the study
This study confirms, in principle, the results of other researchers such as Zorgnotti and Lizza. The subjective improvement in this group of patients, not accompanied by changes in the objective variables evaluated, suggests that L-Arginine therapy may be especially beneficial in patients with low nitric oxide production.
This study opens a new perspective for the evaluation and treatment of patients with erectile dysfunction of predominantly organic cause. It remains to be established whether higher doses of L-Arginine or a longer treatment period would be more effective in patients with erectile dysfunction who show no evidence of low nitric oxide production.
Drafted for Boston Medical Group by Ezequiel LГіpez Peralta.
Psychologist. Master in Clinical Sexology and Couples Therapy.

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