By Dr. John A. Robinson, NMD & Dr. Cristina Romero-Bosch, NMD
The Hormone Zone
When most people think about sexual health, they think about hormones, libido or perhaps medications such as Viagra. But healthy sexual function requires something much more complex: a coordinated conversation between the brain, hormones, blood vessels, nerves and genital tissues.
That is why an emerging therapy called photobiomodulation (PBM) has become so interesting to us.
Photobiomodulation uses specific wavelengths of red and near-infrared light to influence cellular function without intentionally heating or damaging tissue. Sometimes called red-light therapy or low-level laser therapy, PBM is being investigated across medicine for its potential effects on mitochondrial function, inflammation, circulation, tissue repair and peripheral nerves.
Those same biological systems are critically important to sexual function. While PBM is not yet an established treatment for most sexual disorders, the research raises an intriguing question: Could light eventually become another tool for improving sexual health in both women and men?
Sexual Function Begins With Blood Flow
Sexual arousal is fundamentally a vascular event.
In men, nitric oxide helps relax smooth muscle within the penis, allowing increased arterial blood flow and expansion of the erectile tissues necessary for an erection. In women, similar nitric-oxide-dependent vascular changes increase blood flow throughout the vulva, vagina and clitoral complex, contributing to clitoral engorgement and physical arousal.
One of the most interesting areas of PBM research involves nitric oxide and endothelial function. Experimental evidence suggests that red and near-infrared light can influence nitric-oxide bioavailability and endothelial signaling. This creates an obvious potential application in sexual medicine because poor endothelial function doesn’t stop at the coronary arteries—the small blood vessels supplying the penis and clitoris are affected as well.
In fact, erectile dysfunction can sometimes be an early manifestation of systemic vascular dysfunction. Female genital arousal is also highly dependent upon healthy microcirculation, even though this aspect of women’s sexual health receives considerably less attention.
The potential pathway is straightforward: PBM may support nitric-oxide and endothelial physiology, which may improve genital blood flow, which could then support better penile erection or clitoral engorgement and potentially increase the sensory stimulation generated during sexual activity.
But Sexual Health Is Also About the Nerves
Blood flow is only part of the story. You can have excellent circulation and still experience sexual dysfunction if the sensory signal isn’t being transmitted properly.
The penis and clitoris contain extensive sensory innervation that transmits information through peripheral nerves, the spinal cord and ultimately the brain. The brain then has to interpret that information as sexually meaningful and pleasurable.
This is where PBM becomes even more interesting.
A systematic review of experimental peripheral-nerve research found that PBM was associated with several markers of nerve recovery, including increased myelinated fibers, improved organization of the myelin sheath, improved electrophysiological function, reduced inflammation and increased growth-factor and vascular responses. A newer 2025 systematic review of randomized clinical trials in people with peripheral nerve or incomplete spinal-cord injuries similarly found a trend toward improvements in strength, sensitivity and pain, although studies and treatment protocols varied substantially.
This doesn’t prove that red light can regenerate clitoral or penile nerves. But it provides a compelling reason to investigate the possibility.
Could PBM Improve Genital Sensation?
One of the most fascinating clues comes from the literature on post-SSRI sexual dysfunction, or PSSD.
A published case described a man who developed persistent penile anesthesia following treatment with the SSRI paroxetine. His sensory changes persisted for more than two years after discontinuing the medication. Following a series of low-power laser treatments, he reported a partial return of penile touch and temperature sensation.
Interestingly, his erectile dysfunction and inability to ejaculate did not resolve. That distinction is important because it demonstrates something we frequently emphasize at The Hormone Zone: sexual function isn’t one thing.
Desire, genital sensation, blood flow, arousal, orgasm and pleasure are interconnected, but they are not identical physiological processes. Improving sensation doesn’t necessarily restore erection or orgasm, just as improving testosterone doesn’t automatically correct a damaged sensory nerve.
The investigators proposed that sensory ion channels known as TRP channels might be involved. While that remains a hypothesis, it raises the possibility that PBM could affect not only damaged nerves but also the electrical and biochemical behavior of sensory nerve endings.
Photobiomodulation for Men’s Sexual Health
For men, the most obvious potential application is erectile function. Because PBM may influence nitric oxide, mitochondrial function, oxidative stress and endothelial health, researchers have begun investigating whether these mechanisms could support erectile physiology.
Much of the direct evidence remains preclinical, so we should not yet describe PBM as a proven treatment for erectile dysfunction. Nevertheless, the biological rationale is interesting, particularly for men with vascular dysfunction.
An even more intriguing possibility is penile rehabilitation following nerve injury, including cavernous-nerve injury following prostate surgery. Erections depend upon intact neural signaling, and when the cavernous nerves are damaged, reduced nitric-oxide signaling can eventually contribute to hypoxia, smooth-muscle deterioration and fibrosis within penile tissues.
Because PBM has been investigated for both peripheral nerve recovery and vascular biology, it may eventually become part of multimodal penile rehabilitation alongside established strategies such as PDE5 inhibitors, vacuum therapy, hormonal optimization when appropriate, exercise and aggressive treatment of cardiovascular and metabolic risk factors.
Men experiencing diminished penile sensation from neuropathy, medication effects or other neurological causes may represent another population worth studying.
Photobiomodulation for Women’s Sexual Health
Female sexual medicine may offer an even broader opportunity.
The clitoris is an erectile neurovascular organ just like the penis, yet we rarely evaluate female sexual dysfunction with the same vascular and neurological sophistication used in men.
PBM could potentially affect several aspects of female sexual health. Improved endothelial function could support clitoral and vulvar blood flow. Better clitoral engorgement could increase the intensity of mechanical stimulation reaching sensory nerves, while PBM’s potential effects on peripheral nerve biology raise questions about whether it could eventually help women experiencing diminished genital sensation.
There is also emerging clinical evidence involving vulvar pain. A 2025 randomized controlled trial involving women with provoked vestibulodynia found greater reductions in vulvar pain with PBM than with sham treatment. Importantly, overall sexual-function scores were not significantly different between groups, reminding us again that reducing pain and restoring sexual function are not necessarily the same thing.
Nevertheless, for women whose sexual difficulties involve vulvodynia, dyspareunia, pelvic-floor dysfunction or altered genital sensation, PBM may eventually become an interesting component of a broader treatment strategy.
The Five Ways PBM Could Potentially Affect Sexual Health
| Biological Target | Potential Sexual Effect |
|---|---|
| Nitric oxide | Supports penile erection and clitoral engorgement |
| Endothelial function | Improves genital microcirculation |
| Mitochondrial function | Supports cellular energy and tissue resilience |
| Peripheral nerves | May support sensory nerve function and recovery |
| Inflammation and tissue repair | May help pain, tissue irritation and recovery |
The important concept is that PBM probably shouldn’t be thought of as an aphrodisiac. It may not directly create sexual desire because libido involves hormones and complex brain reward systems.
Instead, PBM may potentially improve some of the physiological hardware necessary for sexual response.
The Future May Be Multimodal Sexual Rehabilitation
This is where we believe sexual medicine is heading.
Imagine a man with declining erectile function being evaluated not simply for testosterone but for hormonal status, endothelial health, nitric oxide, metabolic health, penile blood flow and neurological function. Treatment might combine hormonal optimization when indicated, exercise, cardiovascular risk reduction, PDE5 support and potentially PBM as another component of penile rehabilitation.
The female equivalent could include evaluation of estrogen, testosterone, thyroid function, genital tissue health, pelvic-floor function, clitoral blood flow and clitoral sensation. Treatment might then combine hormonal optimization, pelvic-floor therapy, nitric-oxide support, targeted sensory stimulation and potentially PBM.
For someone with diminished genital sensation, treatment might look different again, emphasizing peripheral nerve health, sensory rehabilitation and repeated genital stimulation designed to strengthen the connection between genital sensory input and the brain’s sexual-reward pathways.
This is an important distinction because the goal of sexual medicine shouldn’t simply be to produce an erection or force an orgasm. The goal is to restore the entire sexual-response circuit: desire, blood flow, genital arousal, sensation, neurological processing, pleasure and orgasm.
Photobiomodulation is not yet a proven answer to sexual dysfunction, and we still need better clinical trials to determine the best wavelengths, doses, treatment locations and patient populations. But the combination of vascular, mitochondrial and neurological effects makes PBM one of the more intriguing emerging technologies in this field.
At The Hormone Zone, we believe sexual health deserves the same physiological curiosity that we bring to cardiovascular health, brain health, hormones and longevity. Sexuality is deeply connected to all of these systems, and technologies that help us better support blood flow, nerve function and tissue health deserve serious investigation.
Because maintaining our capacity for desire, sensation, intimacy and pleasure isn’t separate from healthy aging. It is part of the art and science of living the well lived life.
Sources
- Rosso MP, Buchaim DV, Kawano N, et al. Photobiomodulation Therapy (PBMT) in Peripheral Nerve Regeneration: A Systematic Review. Bioengineering. 2018;5(2):44.
- Weimer GH, Kolling da Rocha CF. Photobiomodulation treatment in incomplete spinal cord injuries or peripheral nerve injuries: a comprehensive systematic review of randomized clinical trials. Lasers in Medical Science. 2025;40(1):286.
- Photobiomodulation and nitric oxide signaling. Review of PBM effects on nitric-oxide bioavailability and endothelial dysfunction.
- Photobiomodulation therapy for the treatment of vulvar pain among those with provoked vestibulodynia: a randomized controlled trial. Journal of Sexual Medicine. 2025;22(4):579–587.
- Waldinger MD, et al. Penile anesthesia in post-SSRI sexual dysfunction treated with low-power laser irradiation. European Journal of Pharmacology. 2015.
Clinical perspective: PBM should currently be considered an emerging adjunct rather than an established stand-alone treatment for erectile dysfunction, clitoral dysfunction or loss of sexual sensation. The strongest rationale comes from its effects on nitric-oxide/endothelial biology, peripheral nerves, mitochondrial function and inflammation, while direct sexual-health clinical trials remain limited.
