Search "how to improve sexual performance" and you'll get thousands of results, most of them guesswork, myths, or thinly-veiled ads. Here's what's actually backed by physiology and clinical research, explained by a board-certified urologist.

Step 1: Understand What's Actually Happening

An erection is fundamentally a blood flow event. When you're aroused, your body releases nitric oxide (NO), which relaxes the smooth muscle in the penile arteries and lets blood rush in. The problem: nitric oxide production declines with age, stress, poor cardiovascular health, and other common factors, which is why erectile difficulty is so often an early warning sign of broader vascular health, not just a "bedroom" issue.

This is also why prescription ED medications like Sildenafil work the way they do, they don't create nitric oxide, they preserve the effect of the nitric oxide your body already makes. If your baseline NO production is low, the medication has less to work with.

Step 2: Stop Guessing, Start Measuring

Most men have no idea what their actual erectile health looks like, because there's never been an easy way to measure it. Nighttime (nocturnal) erections are one of the most reliable indicators doctors use to distinguish psychological from physical causes of ED, and until recently that kind of monitoring meant an overnight sleep lab visit.

The FirmTech TechRing changed that. It's a wearable erection ring with built-in sensors that tracks the firmness, duration, and frequency of your erections, day or night, and syncs the data to an app via Bluetooth. It's also designed to be worn during sex, where it helps maintain firmness by keeping blood in the penis. You can read more about how erectile health connects to overall wellness on our Information About ED page.

Knowing your baseline is what turns "I think this supplement/medication/lifestyle change is helping" into "here's the data that proves it."

Step 3: Support Nitric Oxide Production Nutritionally

Diet and targeted supplementation are two of the most direct ways to support nitric oxide production:

• L-Citrulline: converted by the kidneys into arginine, the direct precursor to nitric oxide
• Beetroot extract: naturally high in dietary nitrates, which the body converts into nitric oxide
• Panax Ginseng: studied for its role in supporting erectile function
• Muira Puama: a traditional botanical used to support male sexual health

These four ingredients, in clinically-informed doses, are the exact formulation behind AFFIRM, developed by board-certified urologist Dr. Judson Brandeis. If low testosterone is also part of your picture, AFFIRM Science's testosterone support line is formulated to work alongside it.

Step 4: See What the Combination Approach Does, With Real Data

This isn't just theory. A 2025 clinical study measured what happens when a nitric oxide–boosting supplement is added to Sildenafil, using the TechRing to objectively track nighttime erectile activity. The result: a 34% increase in erectile activity compared to Sildenafil alone, with no reported side effects. Read the full breakdown in our post, New Study: Nitric Oxide Supplement Boosts Sildenafil's Effect on Nighttime Erections by 34%, or view the original abstract in The Journal of Sexual Medicine.

Step 5: Build the Habit, Not Just the Purchase

Supplements and tracking devices work best as part of a routine, not a one-time fix:

• Take nitric oxide support consistently, daily, not just before sex
• Track a baseline for at least a week or two before judging results
• Prioritize sleep, cardiovascular exercise, and reducing alcohol, all directly affect nitric oxide production
• Talk to your doctor about how any supplement interacts with existing medications

Put It All Together

If you want the tracking and the nitric oxide support in one step, the AFFIRM + TechRing Bundle pairs both. Frequently Asked Questions

What's the fastest way to improve sexual performance naturally?
Supporting nitric oxide production through diet, targeted supplementation (like L-citrulline and beetroot extract), exercise, and sleep is the most evidence-based non-prescription approach.

Can I use a supplement and a prescription ED medication together?
Some men do, under medical guidance. A 2025 clinical study found that combining a nitric oxide supplement with Sildenafil increased nighttime erectile activity by 34% with no added side effects, but always check with your doctor first.

How do I know if a natural approach is actually working?
Objective tracking is the only way to know for sure. Devices like the TechRing measure erection firmness and frequency over time so you can see real change instead of guessing.