Tom Seeger is making a specific argument here, and it's one that cuts through a lot of noise in the men's health space. The claim isn't that cold water is some kind of aphrodisiac. It's more precise than that. He's saying that erectile function is downstream of mitochondrial health — and that cold exposure is one of the most reliable tools we have for improving mitochondrial health. Follow that chain of reasoning, and the conclusion becomes almost inevitable.
The mechanism is worth understanding clearly. Erections depend on nitric oxide, which signals smooth muscle relaxation and vasodilation, allowing blood to fill the tissue. Nitric oxide production is energetically expensive — it requires healthy, functioning mitochondria in the endothelial cells lining your blood vessels. Damage those mitochondria through chronic inflammation, poor diet, sedentary living, and the whole downstream cascade weakens. You don't have an "erection problem." You have a metabolic problem that happens to express itself there.
This framing aligns with a growing body of work on vascular health and sexual function. The same mechanisms driving cardiovascular disease — endothelial dysfunction, impaired nitric oxide signaling, mitochondrial inefficiency — appear to drive erectile dysfunction. They're not separate conditions. They're the same condition expressing in different places. Research on exercise and vascular health consistently shows improvements in erectile function as a secondary outcome, and the likely pathway is the same: better mitochondrial capacity means better nitric oxide production means better blood flow everywhere.
Cold exposure specifically drives something called mitophagy — the removal of damaged mitochondria — followed by mitobiogenesis, the creation of new ones. The cold stress essentially forces cellular housekeeping. You're not just adding more mitochondria. You're replacing broken ones with functional ones.
The mitochondrial-nitric oxide connection is well-supported. Where you'll find more debate is in the specific protocols. How cold, how long, how often? The research on cold exposure and metabolic adaptation is still relatively young, and most of the strong data comes from studies using cold water immersion at 50 to 59 degrees Fahrenheit for 10 to 20 minutes. Shorter exposures at milder temperatures likely have effects — but the magnitude is less clear.
Seeger's framing of Viagra as a temporary fix is fair, though worth nuancing. For men with acute vascular dysfunction, pharmaceutical support while rebuilding mitochondrial health through lifestyle changes is a reasonable bridge. The issue is when medication becomes the endpoint rather than a transition tool.
If you're serious about long-term sexual health — and metabolic health more broadly — cold exposure deserves a consistent place in your protocol. Three to four sessions per week, aiming for water temperatures in the low to mid 50s Fahrenheit, five to ten minutes per session. Pair it with regular aerobic exercise, which independently supports endothelial function and nitric oxide production. These aren't competing protocols. They compound each other.
What strikes me most is how often sexual health serves as the canary in the coal mine. Men rarely seek help for vascular health until something more visible goes wrong. But erectile dysfunction frequently precedes cardiovascular events by years. The body is signaling — early, clearly — that something systemic is off. Cold exposure, in this context, isn't just a sexual health intervention. It's a cardiovascular intervention, a metabolic intervention, a longevity intervention. The sexual health benefit is almost a side effect of getting the deeper systems right.