Clinical and review data consistently show that standardized pine bark extract enhances male vascular and metabolic function. Supplementation has been linked to improved endothelial health, nitric oxide availability, and microcirculation, which translate into better erectile performance and cardiovascular support. Studies in men with metabolic syndrome or mild erectile dysfunction report significant improvements in sexual function, blood pressure, and lipid metabolism. Its potent antioxidant activity also protects against oxidative stress–related testosterone decline and inflammation. Collectively, pine bark extract supports vascular performance, endurance, and male reproductive health.
Pine bark extract is a key ingredient in Testo FORMULA.
1) Erectile Dysfunction & Sexual Function
1: Csikós E, Horváth A, Ács K, Papp N, Balázs VL, Dolenc MS, Kenda M, Kočevar Glavač N, Nagy M, Protti M, Mercolini L, Horváth G, Farkas Á, On Behalf Of The Oemonom. Treatment of Benign Prostatic Hyperplasia by Natural Drugs. Molecules. 2021 Nov 25;26(23):7141. doi: 10.3390/molecules26237141. PMID: 34885733; PMCID: PMC8659259.
2: Stanislavov R, Rohdewald P. Improvement of erectile function by a combination of French maritime pine bark and roburins with aminoacids. Minerva Urol Nefrol. 2015 Mar;67(1):27-32. PMID: 25664962.
3: Ledda A, Belcaro G, Cesarone MR, Dugall M, Schönlau F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU Int. 2010 Oct;106(7):1030-3. doi: 10.1111/j.1464-410X.2010.09213.x. Epub 2010 Feb 22. PMID: 20184576.
4: Trebaticky B, Muchova J, Ziaran S, Bujdak P, Breza J, Durackova Z. Natural polyphenols improve erectile function and lipid profile in patients suffering from erectile dysfunction. Bratisl Lek Listy. 2019;120(12):941-944. doi: 10.4149/BLL_2019_158. PMID: 31855055.
5: Stanislavov R, Rohdewald P. Sperm quality in men is improved by supplementation with a combination of L-arginine, L-citrullin, roburins and Pycnogenol®. Minerva Urol Nefrol. 2014 Dec;66(4):217-23. PMID: 25531191.
6: Cai T, Morgia G, Carrieri G, Terrone C, Imbimbo C, Verze P, Mirone V; IDIProst® Gold Study Group. An improvement in sexual function is related to better quality of life, regardless of urinary function improvement: results from the IDIProst® Gold Study. Arch Ital Urol Androl. 2013 Dec 31;85(4):184-9. doi: 10.4081/aiua.2013.4.184. PMID: 24399119.
2) Exercise Performance & Recovery
1: Aldret RL EdD, ATC, CSCS, Bellar D PhD, FNSCA, CSCSD, RSCCD. A Double-Blind, Cross-Over Study to Examine the Effects of Maritime Pine Extract on Exercise Performance and Postexercise Inflammation, Oxidative Stress, Muscle Soreness, and Damage. J Diet Suppl. 2020;17(3):309-320. doi: 10.1080/19390211.2019.1578847. Epub 2019 Mar 19. PMID: 30887868.
2: Heffernan SM, McCarthy C, Eustace S, FitzPatrick RE, Delahunt E, De Vito G. Mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine: A randomized controlled pilot trial. Complement Ther Med. 2020 May;50:102349. doi: 10.1016/j.ctim.2020.102349. Epub 2020 Feb 19. PMID: 32444040.
3: Semen KO, Weseler AR, Janssen MJW, Drittij-Reijnders MJ, le Noble JLML, Bast A. Effects of Monomeric and Oligomeric Flavanols on Kidney Function, Inflammation and Oxidative Stress in Runners: A Randomized Double-Blind Pilot Study. Nutrients. 2020 Jun 1;12(6):1634. doi: 10.3390/nu12061634. PMID: 32492913; PMCID: PMC7353060.
4: Vinciguerra G, Belcaro G, Bonanni E, Cesarone MR, Rotondi V, Ledda A, Hosoi M, Dugall M, Cacchio M, Cornelli U. Evaluation of the effects of supplementation with Pycnogenol® on fitness in normal subjects with the Army Physical Fitness Test and in performances of athletes in the 100-minute triathlon. J Sports Med Phys Fitness. 2013 Dec;53(6):644-54. PMID: 24247188.
3) Cognitive Function & Stress Response
1: Dutta T, Anand U, Mitra SS, Ghorai M, Jha NK, Shaikh NK, Shekhawat MS, Pandey DK, Proćków J, Dey A. Phytotherapy for Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review and Meta-analysis. Front Pharmacol. 2022 May 3;13:827411. doi: 10.3389/fphar.2022.827411. Erratum in: Front Pharmacol. 2024 Mar 14;15:1365806. doi: 10.3389/fphar.2024.1365806. PMID: 35592415; PMCID: PMC9110892.
2: Hsu CD, Hsieh LH, Chen YL, Lin IC, Chen YR, Chen CC, Shirakawa H, Yang SC. Complementary effects of pine bark extract supplementation on inattention, impulsivity, and antioxidative status in children with attention-deficit hyperactivity disorder: A double-blinded randomized placebo-controlled cross- over study. Phytother Res. 2021 Jun;35(6):3226-3235. doi: 10.1002/ptr.7036. Epub 2021 Feb 8. PMID: 33559134.
3: Trebatická J, Kopasová S, Hradecná Z, Cinovský K, Skodácek I, Suba J, Muchová J, Zitnanová I, Waczulíková I, Rohdewald P, Duracková Z. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006 Sep;15(6):329-35. doi: 10.1007/s00787-006-0538-3. Epub 2006 May 13. PMID: 16699814.
4: Dvoráková M, Sivonová M, Trebatická J, Skodácek I, Waczuliková I, Muchová J, Duracková Z. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox Rep. 2006;11(4):163-72. doi: 10.1179/135100006X116664. PMID: 16984739.
5: Dvoráková M, Jezová D, Blazícek P, Trebatická J, Skodácek I, Suba J, Iveta W, Rohdewald P, Duracková Z. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (pycnogenol). Nutr Neurosci. 2007 Jun-Aug;10(3-4):151-7. doi: 10.1080/09513590701565443. PMID: 18019397.
6: Chayasirisobhon S. Use of a pine bark extract and antioxidant vitamin combination product as therapy for migraine in patients refractory to pharmacologic medication. Headache. 2006 May;46(5):788-93. doi: 10.1111/j.1526-4610.2006.00454.x. PMID: 16643582.
7: Trebatická J, Ďuračková Z. Psychiatric Disorders and Polyphenols: Can They Be Helpful in Therapy? Oxid Med Cell Longev. 2015;2015:248529. doi: 10.1155/2015/248529. Epub 2015 Jun 9. PMID: 26180581; PMCID: PMC4477218.
8: Simpson T, Kure C, Stough C. Assessing the Efficacy and Mechanisms of Pycnogenol® on Cognitive Aging From In Vitro Animal and Human Studies. Front Pharmacol. 2019 Jul 3;10:694. doi: 10.3389/fphar.2019.00694. PMID: 31333448; PMCID: PMC6619435.
9: Theadom A, Mahon S, Barker-Collo S, McPherson K, Rush E, Vandal AC, Feigin VL. Enzogenol for cognitive functioning in traumatic brain injury: a pilot placebo-controlled RCT. Eur J Neurol. 2013 Aug;20(8):1135-44. doi: 10.1111/ene.12099. Epub 2013 Feb 5. PMID: 23384428.
10: Tenenbaum S, Paull JC, Sparrow EP, Dodd DK, Green L. An experimental comparison of Pycnogenol and methylphenidate in adults with Attention- Deficit/Hyperactivity Disorder (ADHD). J Atten Disord. 2002 Sep;6(2):49-60. doi: 10.1177/108705470200600201. PMID: 12142861.
11: Pipingas A, Silberstein RB, Vitetta L, Rooy CV, Harris EV, Young JM, Frampton CM, Sali A, Nastasi J. Improved cognitive performance after dietary supplementation with a Pinus radiata bark extract formulation. Phytother Res. 2008 Sep;22(9):1168-74. doi: 10.1002/ptr.2388. PMID: 18683195.
12: Belcaro G, Luzzi R, Dugall M, Ippolito E, Saggino A. Pycnogenol® improves cognitive function, attention, mental performance and specific professional skills in healthy professionals aged 35-55. J Neurosurg Sci. 2014 Dec;58(4):239-48. Epub 2014 Mar 28. PMID: 24675223.
13: Belcaro G, Dugall M, Ippolito E, Hu S, Saggino A, Feragalli B. The COFU3 Study. Improvement in cognitive function, attention, mental performance with Pycnogenol® in healthy subjects (55-70) with high oxidative stress. J Neurosurg Sci. 2015 Dec;59(4):437-46. PMID: 26635191.
4) Cardiovascular & Metabolic Health
1: Weichmann F, Rohdewald P. Pycnogenol® French maritime pine bark extract in randomized, double-blind, placebo-controlled human clinical studies. Front Nutr. 2024 May 2;11:1389374. doi: 10.3389/fnut.2024.1389374. PMID: 38757130; PMCID: PMC11096518.
2: Robertson NU, Schoonees A, Brand A, Visser J. Pine bark (Pinus spp.) extract for treating chronic disorders. Cochrane Database Syst Rev. 2020 Sep 29;9(9):CD008294. doi: 10.1002/14651858.CD008294.pub5. PMID: 32990945; PMCID: PMC8094515.
3: Mohammadi S, Fulop T, Khalil A, Ebrahimi S, Hasani M, Ziaei S, Farsi F, Mirtaheri E, Afsharianfar M, Heshmati J. Does supplementation with pine bark extract improve cardiometabolic risk factors? A systematic review and meta- analysis. BMC Complement Med Ther. 2025 Feb 22;25(1):71. doi: 10.1186/s12906-025-04819-9. PMID: 39987124; PMCID: PMC11847364.
4: Ohkita M, Kiso Y, Matsumura Y. Pharmacology in health foods: improvement of vascular endothelial function by French maritime pine bark extract (Flavangenol). J Pharmacol Sci. 2011;115(4):461-5. doi: 10.1254/jphs.10r37fm. Epub 2011 Mar 24. PMID: 21436602.
5: Drieling RL, Gardner CD, Ma J, Ahn DK, Stafford RS. No beneficial effects of pine bark extract on cardiovascular disease risk factors. Arch Intern Med. 2010 Sep 27;170(17):1541-7. doi: 10.1001/archinternmed.2010.310. PMID: 20876405.
6: Navval-Esfahlan E, Rafraf M, Asghari S, Imani H, Asghari-Jafarabadi M, Karimi-Avval S. Effect of French maritime pine bark extract supplementation on metabolic status and serum vascular cell adhesion molecule-1 levels in patients with type 2 diabetes and microalbuminuria. Complement Ther Med. 2021 May;58:102689. doi: 10.1016/j.ctim.2021.102689. Epub 2021 Feb 18. PMID: 33610726.
7: Devaraj S, Vega-López S, Kaul N, Schönlau F, Rohdewald P, Jialal I. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids. 2002 Oct;37(10):931-4. doi: 10.1007/s11745-006-0982-3. PMID: 12530550.
8: Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetic patients. Diabetes Care. 2004 Mar;27(3):839. doi: 10.2337/diacare.27.3.839. PMID: 14988316.
9: Valls RM, Llauradó E, Fernández-Castillejo S, Puiggrós F, Solà R, Arola L, Pedret A. Effects of low molecular weight procyanidin rich extract from french maritime pine bark on cardiovascular disease risk factors in stage-1 hypertensive subjects: Randomized, double-blind, crossover, placebo-controlled intervention trial. Phytomedicine. 2016 Nov 15;23(12):1451-1461. doi: 10.1016/j.phymed.2016.08.007. Epub 2016 Aug 23. PMID: 27765365.
10: Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004 Jan 2;74(7):855-62. doi: 10.1016/j.lfs.2003.07.037. PMID: 14659974.
11: Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald P. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci. 2004 Oct 8;75(21):2505-13. doi: 10.1016/j.lfs.2003.10.043. PMID: 15363656.
12: Ferguson JJA, Oldmeadow C, Bentley D, Eslick S, Garg ML. Effect of a polyphenol-rich dietary supplement containing Pinus massoniana bark extract on blood pressure in healthy adults: A parallel, randomized placebo-controlled trial. Complement Ther Med. 2022 Dec;71:102896. doi: 10.1016/j.ctim.2022.102896. Epub 2022 Oct 21. PMID: 36280012.
13: Malekahmadi M, Moradi Moghaddam O, Firouzi S, Daryabeygi-Khotbehsara R, Shariful Islam SM, Norouzy A, Soltani S. Effects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res. 2019 Dec;150:104472. doi: 10.1016/j.phrs.2019.104472. Epub 2019 Oct 1. PMID: 31585179.
14: Sahebkar A. A systematic review and meta-analysis of the effects of pycnogenol on plasma lipids. J Cardiovasc Pharmacol Ther. 2014 May;19(3):244-55. doi: 10.1177/1074248413511691. Epub 2013 Dec 16. PMID: 24346156.
15: Fogacci F, Tocci G, Sahebkar A, Presta V, Banach M, Cicero AFG. Effect of Pycnogenol on Blood Pressure: Findings From a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical Studies. Angiology. 2020 Mar;71(3):217-225. doi: 10.1177/0003319719889428. Epub 2019 Nov 25. PMID: 31763928.
16: Enseleit F, Sudano I, Périat D, Winnik S, Wolfrum M, Flammer AJ, Fröhlich GM, Kaiser P, Hirt A, Haile SR, Krasniqi N, Matter CM, Uhlenhut K, Högger P, Neidhart M, Lüscher TF, Ruschitzka F, Noll G. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double- blind, randomized, placebo-controlled, cross-over study. Eur Heart J. 2012 Jul;33(13):1589-97. doi: 10.1093/eurheartj/ehr482. Epub 2012 Jan 11. PMID: 22240497.
17: Belcaro G, Cornelli U, Luzzi R, Cesarone MR, Dugall M, Feragalli B, Errichi S, Ippolito E, Grossi MG, Hosoi M, Cornelli M, Gizzi G. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res. 2013 Oct;27(10):1572-8. doi: 10.1002/ptr.4883. Epub 2013 Jan 28. PMID: 23359520.
18: Nikpayam O, Rouhani MH, Pourmasoumi M, Roshanravan N, Ghaedi E, Mohammadi H. The Effect of Pycnogenol Supplementation on Plasma C-Reactive Protein Concentration: a Systematic Review and Meta-Analysis. Clin Nutr Res. 2018 Apr;7(2):117-125. doi: 10.7762/cnr.2018.7.2.117. Epub 2018 Apr 16. PMID: 29713620; PMCID: PMC5921329.
19: Zibadi S, Rohdewald PJ, Park D, Watson RR. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res. 2008 May;28(5):315-20. doi: 10.1016/j.nutres.2008.03.003. PMID: 19083426.