What is behind Erectile Dysfunction & Performance
Nitric-oxide blood-vessel relaxation and flow. Evidence A — Human trial evidence.
Serum testosterone — the anabolic signal behind muscle, drive and libido in men. The evidence shows a finding that overturns the common story: suppression under stress is centrally mediated — the brain down-regulating the axis — 'despite intact gonadal capacity'. The organ is rarely the problem. Evidence A — Human trial evidence.
The chemistry of wanting, not of liking. Dopamine sets how much effort a goal feels worth — which is why its loss reads as apathy long before it reads as sadness. More is not better: the same system that drives pursuit drives compulsion. Evidence A — Human trial evidence.
The hypothalamic–pituitary–gonadal axis — the command line of sex-hormone production and reproductive health. Evidence A — Human trial evidence.
The pulse generator of reproduction. Its own neurons lack estrogen receptors, so all steroid feedback must route through kisspeptin — the reason that upstream node is drawn. Evidence A — Human trial evidence.
Desire, arousal and function — three separable parts of sexual health. Evidence A — Human trial evidence.
Evidence on these pathways
Dopamine → Melatonin. “Through α1B-D4 and β1-D4 receptor heteromers dopamine inhibits adrenergic receptor signaling and blocks the synthesis of melatonin induced by adrenergic receptor ligands.” — Circadian-Related Heteromerization of Adrenergic and Dopamine D4 Receptors Modulates Melatonin Synthesis and Release in the Pineal Gland. PLoS Biology, 2012, volume 10, e1001347. doi:10.1371/journal.pbio.1001347
Dopamine → Mood (Positive Affect). “Boosting dopamine also increased happiness resulting from some rewards.” — Dopaminergic Modulation of Decision Making and Subjective Well-Being. Journal of Neuroscience, 2015, 35(27), 9811-9822. doi:10.1523/JNEUROSCI.0702-15.2015 | PMC4495239
Total Testosterone → Acne. “Androgen-mediated excess sebum production is implicated as a necessary early step in AV pathophysiology and is therefore considered an important therapeutic target in AV treatment.” — The cutaneous effects of androgens and androgen-mediated sebum production and their pathophysiologic and therapeutic importance in acne vulgaris. Journal of Dermatological Treatment; 2024; volume 35; start page not printed on the retrieved record. doi:10.1080/09546634.2023.2298878 | eISSN:1471-1753 | pISSN:0954-6634
Dynorphin → Dopamine. “blockade of KOR (expressed on DA neurons and their terminals) could increase DA release” — Naloxone precipitated withdrawal increases dopamine release in the dorsal striatum of opioid dependent men. Translational Psychiatry 2021;11(1):445. doi:10.1038/s41398-021-01548-8
Formulas that act on these pathways
Acts on 3 of these pathways: Total Testosterone, Dopamine, HPG Axis.
Acts on 3 of these pathways: Total Testosterone, Dopamine, HPG Axis.
Acts on 3 of these pathways: Total Testosterone, HPG Axis, GnRH.
Acts on 2 of these pathways: Total Testosterone, Dopamine.
Acts on 2 of these pathways: Total Testosterone, HPG Axis.
Acts on 2 of these pathways: Total Testosterone, Dopamine.
What this page does not claim
This page names the pathways involved and the published evidence on each. It does not claim that any formula treats, cures or prevents Erectile Dysfunction & Performance. A pathway opens here only on graded, published evidence, under a standard fixed before the evidence was gathered, and every figure above carries its grade.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.