Sexual health issues among male population, specifically, Erectile Dysfunction(ED), has become one of the major chronic health conditions with over 50% of male population in the age band of 40-70 years facing ED. Research has found that men having obesity or suffering from type 2 diabetes &/or high blood pressure are at high risk of Erectile dysfunction. Besides, chronic stress can also lead to ED. All these are interconnections with a common underlying cause- Nitric Oxide(NO) Deficiency. NO is the most important gas produced inside our body which plays a key role in cellular communication, acts as vasodilator, regulates blood flow, oxygen uptake & delivery & facilitates insulin signalling. Infact Erectile Dysfunction is caused by lack of vasodilation & blood flow attributed to NO deficiency NO is produced through two pathways -Endothelial Cell : ENOS, enzyme when coupled with Endothelial cell produces NO by metabolising L-arginine in presence of oxygen. L-arginine is a semi essential amino acid produced inside our body through the Urea Cycle. We do not need to consume excess L-arginine as it could activate Arginase Enzyme & NOS could produce Superoxide, causing oxidative stress. Oxidative stress, inflammation, high glycemic diet as well as oxidation of Tetrahydrobiopterin(BH4 to BH2) which uncouples ENOS, thereby shutting down NO production. As we age ENOS’s ability to produce NO reduces by 10% every year & therefore by the time we reaches age of 50, ENOS ability to produce reduces by 50% & therefore second pathway becomes more important Oral microbiome triggers Nitrate-Nitrite-NO pathway: Microbes in our mouth can metabolise nitrate in green leafy vegetables into nitrite which when mixed with stomach acid produces NO. If your oral microbiome is imbalanced, it could reduce its ability to produce NO. Certain lifestyle choices can disrupt NO production including use of mouthwash, Fluoride in toothpaste, processed foods & deficient sleep If you think Supplements /Drugs such as Viagra, Ashwagandha & Shilajit could help in curing erectile dysfunction, you are in for the biggest shock. Drugs such as Viagra is not a NO donor but is NO dependent. NO when produced activates a messenger cyclic GMP which is a vasodilator. Viagra makes sure that cGMP does not break down. However if your body is not producing NO, Viagra will never work as the substrate on the basis of which it functions is not activated. DO not fall for these supplements as they will never work if your body is not production NO. Our today’s talk deep dive into role of NO & oral microbiome in Erectile Dysfunction.