Icariin works through: (1) PDE5 inhibition — prevents cGMP breakdown in penile corpus cavernosum smooth muscle, maintaining NO-mediated vasodilation (same mechanism as sildenafil, but weaker); (2) eNOS activation — increases nitric oxide production; (3) testosterone support — stimulates Leydig cell steroidogenesis (cAMP pathway); (4) osteoblast stimulation — activates BMP-2/Smad signaling for bone formation; (5) neuroprotective — protects cavernous nerve from injury (relevant for post-prostatectomy ED). The prenyl group on icariin is essential for PDE5 inhibition — non-prenylated flavonoids are inactive.
Independently graded against 173,636 indexed supplements with 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, and NIH DSLD | Last updated:
Not medical advice. Based on published clinical research and systematic reviews.