Redefining Medicine Vascular and Sexual Health as Root Cause Drivers for Male Longevity | Miles Spar, MD
Feb 24, 2026
Dr. Chris D'Adamo, an epidemiologist and clinical research leader, explains trial design and evidence for finished-product supplement trials. Miles Spar, MD, a men's health and performance clinician, discusses nitric oxide and hydrogen sulfide physiology. They explore how these gasotransmitters interact, results from a 600-person randomized trial, implications for vascular and sexual function, and clinical strategies for upstream endothelial care.
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Nitric Oxide Is A Broad Signaling Molecule
- Nitric oxide is a short-acting gasotransmitter that causes vasodilation and supports blood flow to many tissues.
- It also acts as a signaling molecule with beneficial effects across the brain and body.
Blood Flow Is The Main Driver Of ED
- The primary driver of erectile dysfunction is insufficient blood flow due to vascular issues.
- Other contributors exist, but vascular health explains the majority of ED cases.
Hydrogen Sulfide Extends Nitric Oxide Effects
- Hydrogen sulfide is a second gasotransmitter that synergizes with nitric oxide to support vasodilation.
- It acts as a natural PDE5 inhibitor, helping cyclic GMP-mediated dilation last longer.