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The clinical use of Probiotics, prebiotics, synbiotics, and postbiotics offers a potential solution for restoring gut microbial balance and improving gut health

In a placebo-controlled trial, L-citrulline, at a dose of 1.5 g/day, was found to significantly improve both erection hardness scores as well as intercourse frequency after one month of daily supplementation.[38] A 2019 systemic review and meta-analysis assessed the impact of arginine, considering 10 randomized, controlled trials that included men with mild to moderately severe ED.[39] In this review, it was found that, at a dose ranging from 1,500 to 5,000 mg/day, arginine significantly improved overall ED scores compared to placebo or no treatment

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Mechanistically, antibiotics are known to inhibit MMPs, as well as to reduce neutrophil chemotaxis and downregulate pro-inflammatory cytokines such as CXCL-8, TNF-, and IL-1 [201,202,203,204,205]

The present study was also supported by funds from the AMED-CREST from the Japan Agency for Medical Research and Development, AMED and research funds from the Yamagata prefectural government and the City of Tsuruoka