How Can I Enhance Potency?

I’m 77 years old and recently married a 70-year-old “teenager.” What can I do to meet the challenge and make myself more potent? 

This question comes up quite often. The answer is that there are plenty of options outside of Viagra, Cialis, and the other pharmaceutical potency enhancers. Here are a few of them.

L-Arginine

My top recommendation is to take 2–8 g of the amino acid L-arginine about an hour before bedtime (start with the lower amount and increase if needed). L-arginine increases the release of nitric oxide (NO) in the body. NO is naturally produced by sexual stimulation, and it causes the smooth muscle tissue and arteries to relax. In the penis, this means an increase in the amount of blood flowing in, a decrease in amount of blood flowing out, and overall improved erection potential. 

This recommendation comes with two caveats, however:

• Be sure you take enough antioxidants to mop up the possible surge in free radicals that can follow a big release of NO after taking L-arginine. To do this, take an antioxidant supplement that includes a form of vitamin E called gamma tocopherol.
• Don’t take more than 4 g of L-arginine for at least six months after you’ve had a heart attack. At eight months out from a heart attack, you can take the higher doses provided that you are taking a good antioxidant supplement.

Acetyl-L-Carnitine

Acetyl-L-carnitine has a central nervous system effect similar to testosterone, and it boosts energy for hearts weakened by heart attacks, longstanding hypertension, and heart failure. This particular carnitine also contributes to memory and sexual enhancement. Take 1–3 g daily in divided doses on an empty stomach.

Ginseng

This is a helpful herbal remedy, but make sure you use an organic product. Ginseng works cumulatively. You won’t see an effect on ED right away, but you’ll enjoy its great overall “tonic” and energizing effect more immediately. Follow specific product instructions. If you take ginseng, monitor your blood pressure. I’ve had some patients over the years whose blood pressure was raised by Asian ginseng.

Muira Puama

Another natural solution, potency wood (Muira puama), has been used by natives of Brazil as an aphrodisiac and nerve stimulant. I suggest 250 mg daily to start. You can increase the dosage up to 500 mg as needed.

Prescription Testosterone

Finally, elderly men with low levels of testosterone may want to consider a pharmaceutical testosterone cream or patch. Ask your doctor to measure your testosterone level. If it’s on the low side, an appropriate topical cream may be in order.