What clinical trials have tested sodium bicarbonate for sexual health or penile function?

1. The lone randomized trial: bicarbonate as a buffer for injection pain

The clearest clinical experiment was a randomized study of 38 men receiving intracavernosal injections for erectile dysfunction where one group received the standard vasoactive drug mix at acidic pH (~4.17) and the other received the same mix with a small amount of sodium bicarbonate to raise the pH to near neutral (~7.05); 58% of men who received the acidic preparation reported penile pain compared with 5% in the bicarbonate-buffered group, leading the authors to conclude acidity was the likely cause of the pain and that neutralizing it eliminated most discomfort ^{[2] [1] [6] [7]}.

2. What that trial does — and does not — prove

That randomized trial establishes a pragmatic, narrow finding: sodium bicarbonate can be used as a pH buffer to reduce pain from intracavernosal injections ^{[2] [1]}, but it does not test systemic ingestion, topical dabbling, or any mechanism by which baking soda could increase penile blood flow, nitric oxide production, or baseline erectile function; the investigators measured pain after injection, not long‑term erectile outcomes or oral therapy effects ^{[1] [2]}.

3. The absence of trials on oral or systemic use for ED

Multiple contemporary summaries and reviews explicitly state that no controlled clinical trials have demonstrated baking soda as a treatment for erectile dysfunction and that clinical evidence linking sodium bicarbonate to improved erectile function is effectively nonexistent beyond the injection‑buffer context ^{[3] [4] [8] [5]}; searches of the literature cited by patient‑facing and medical sites likewise return no randomized trials testing oral bicarbonate for ED.

4. Parallel research domains and why they’re not evidence for ED

Research into sodium bicarbonate more commonly appears in sports science—studies of acute buffering to reduce lactic acid and improve exercise performance—or in cellular models that explore pH effects on enzymes and macrophages, but none of those study designs translate directly into evidence that baking soda taken orally fixes erectile dysfunction in humans ^{[5] [9]}; extrapolating from athletic or in vitro data to sexual performance is physiologically speculative and unsupported by clinical trials.

5. Safety signals and practical cautions from the literature

Clinical and consumer health writeups warn that ingesting baking soda carries real risks—high sodium load, gastrointestinal upset (notably diarrhea reported in some acute-loading studies), potential blood‑pressure effects, and rare metabolic alkalosis—counterbalancing any hypothetical benefit and underscoring why randomized trials would need careful safety monitoring before recommending oral use for sexual health ^{[10] [4] [8]}.

6. Misinformation, marketing, and why the gap persists

Internet “30‑second tonic” claims and home‑remedy marketing persist despite the lack of trials; commentators and physicians cited in the reporting point out that these narratives often conflate alkalinization myths with nitric oxide physiology and that the absence of evidence has not stopped anecdote‑driven popularity—an implicit agenda serving product sales and DIY remedies rather than patient safety or rigorous science ^{[11] [8] [12]}.

7. Bottom line for clinicians, researchers and the public

For clinicians and researchers the empirical takeaway is simple: sodium bicarbonate has one narrow, validated clinical application in reducing pain from intracavernosal injections ^{[2] [1]}, and there are no randomized trials supporting oral, topical, or systemic use of baking soda to treat erectile dysfunction or enhance penile function; any future claims that baking soda cures ED require well‑designed, safety‑monitored clinical trials to move beyond speculation ^{[3] [4]}.