Background:

Male health disorders such as erectile dysfunction (ED), infertility, benign prostatic hyperplasia (BPH), chronic prostatitis (CP), and prostate neoplasia (PIN and carcinoma) share a convergent molecular etiology centered on endothelial dysfunction, nitric oxide (NO) deficiency, and mitochondrial–hormonal dysregulation.

Traditional pharmacologic treatments address symptomatic endpoints but fail to restore the integrated vascular, endocrine, and metabolic balance required for long-term recovery.

Objective:

This paper delineates the mechanistic and clinical foundations of L-Arginine-centered nutritional pharmacology, conceptualized within the Keyora Endothelial–Mitochondrial–Genomic Axis, and explores its synergistic interaction with lycopene, Saw Palmetto, Astaxanthin, selenium, vitamins C/E, and α-linolenic acid (ALA) in the comprehensive management and prevention of male urogenital and reproductive disorders.

Methods:

A translational synthesis of molecular, physiological, and clinical evidence was conducted across 180 peer-reviewed studies and 32 randomized controlled trials (RCTs).

Mechanistic mapping identified six major regulatory circuits:

• NO–cGMP endothelial signaling
• Nrf2–NF-κB redox balance
• 5-α-reductase and androgenic modulation
• PGC-1α–SIRT1 mitochondrial biogenesis
• DNA damage repair and epigenetic stability, and
• immune and inflammatory reprogramming.

These findings were integrated into a systems framework describing multi-axis coherence restoration across vascular, hormonal, and metabolic domains.

Results:

L-Arginine supplementation, alone or in combination with synergistic nutrients, consistently improved NO bioavailability, microvascular perfusion, testosterone balance, and mitochondrial energy function.

In clinical contexts, this translated to measurable benefits:

• Erectile Dysfunction: Enhanced flow-mediated dilation and erectile rigidity (up to 35% IPSS improvement).
• Male Infertility: Increased sperm motility, morphology, and DNA integrity.
• Prostate Disorders (BPH/CP): Reduced prostatic inflammation, DHT levels, and oxidative markers.
• PIN and Early Carcinogenesis: Suppressed HIF-1α–VEGF signaling, reduced oxidative DNA lesions, and improved genomic stability.

Across all domains, the L-Arginine–Lycopene synergy functioned as a closed-loop biochemical system, linking oxygen delivery, mitochondrial bioenergetics, and DNA protection.

Conclusion:

L-Arginine operates not as an isolated amino acid but as a metabolic conductor orchestrating endothelial, hormonal, and genomic harmony.

Within the Keyora framework, its integration with antioxidant and lipid cofactors constitutes a nutritional systems pharmacology capable of restoring physiological coherence across male reproductive and urogenital axes.

This paradigm redefines clinical nutrition as a form of molecular rehabilitation, emphasizing preventive and restorative modulation of interconnected biological networks - from perfusion to energy, from genome to function.