From my review of the literature, the hypothesis that Adderall’s sympathetic stimulation might interfere with nitric oxide-mediated vasodilation is intriguing but not definitively proven. While there are some mechanistic studies suggesting that increased adrenergic tone could counteract the relaxation needed for an erection, clear dose-response relationships remain largely unestablished. Most evidence still calls for cautious interpretation, and individual patient factors—such as underlying cardiovascular health—really matter. Clinically, if patients notice new-onset erectile difficulties while on Adderall, it’s prudent to consult with a healthcare provider who can assess the broader context and potentially adjust the regimen or explore alternative treatments.