You’ll also find pomegranate extract in Male Extra, which has improved erectile performance among men in at least one small study.45 And no other pill on this list includes it. One- and 3-month supplies also come with free e-books covering nutritional approaches to improving sexual performance and exercises you can do to improve your stamina in the bedroom. It’s the only supplement in our guide containing ashwagandha, an extract that studies show can increase testosterone levels and reduce anxiety. Additionally, while male enhancement pills may provide short-term benefits for some individuals, they should not replace medical advice or prescribed treatments for erectile dysfunction (ED).Male enhancement pills are available in stores and online as natural therapies to enhance sexual function in a variety of methods.For example, we appreciate the inclusion of saw palmetto, but studies looking into its efficacy for sexual health use doses around three times what you see in VigRX Plus.27Even if your penis is smaller than average, it may not matter to your partner.That makes this one of the most affordable male enhancement options out there if you’re willing and able to put up the nearly $400 yearly investment.Even though 57 of 58 products were labeled as “all natural” and no sample claimed to include synthetic substances, 81% contained PDE-5i.Compared to some of the less impressive male enhancement products out there, Innerbody Labs Testosterone Support is a little pricey.Dietary supplements meant for sexual enhancement and improved energy levels in men are testing positive for “hidden ingredients,” according to an FDA health advisory notification. Additionally, sildenafil, avanafil, and tadalafil combined with nitrate pharmaceuticals (often found in diabetes, high blood pressure, high cholesterol, or heart disease medication) can trigger dangerously low blood pressure. In an interview with NBC News, urologist Jesse Mills, MD, cautioned against dietary supplements for treating erectile dysfunction. “It is clear from the results of our decade of testing that retailers and distributors, including online marketplaces, do not effectively prevent these types of potentially harmful products from being sold to consumers,” said the FDA. In simpler terms, consumers are unknowingly exposing themselves to pharmaceuticals that could negatively interfere with additional medications and supplements. Extensive rounds of testing found that many of these so-called “all-natural” products contain ingredients left off the product label. VigRX Plus is one of just three formulas in our guide to contain Bioperine, a black pepper extract that can increase your absorption of the supplement’s other ingredients.If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices.The local emergency medical services team found his blood glucose to be 32 mg/dL, and he received oral glucose.Furthermore, PDE-5i can have potentially dangerous interactions with other pharmaceuticals that are rarely warned against with counterfeit PDE-5i.These items, sold online and over the counter, claim to provide benefits, such as increasing testosterone levels, preventing erectile dysfunction, and boosting stamina.The market is also rife with expensive products that do little more than a good, less expensive vitamin D capsule could.Tempted by products that claim to increase penis size?Stay on top of latest health news from Harvard Medical School.This personalized approach not only ensures a higher chance of success but also protects you from the adverse effects of unregulated products. Our medical experts review it based on testing, research, and interviews. Innerbody uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Check out our guide to the best penis extender for more information. The common link between these patients was the use of an ED supplement that contained glyburide (a sulfonylurea used to treat diabetes), as well as illicit PDE-5i (31). In a well-known example, 150 non-diabetic patients were hospitalized with hypoglycemia in Singapore. Microbial growth analysis of phosphodiesterase-5 inhibitors (PDE-5i) products (29). Contamination with either adulterants or bacteria poses risks to consumers of counterfeit PDE-5i. Many laboratories of counterfeiters are exposed to the open air and use unsterile water that would not be safe for drinking. What are male enhancement pills? In an analysis of 24,708 patients receiving a PDE-5i, 70% had an underlying medical diagnosis, with 50% of these patients having vasculogenic disease. Of these users, 68% did so without a prescription, as patients often do not realize that they are getting false and possibly dangerous products, and 60% of these users believed they received the same product as from a legitimate pharmacy (13). These patients with higher socioeconomic statuses having the resources to pay for pharmaceuticals out-of-pocket, combined with the stigma of ED, creates an environment ripe for an illicit market. The best male enhancement pills combine various ingredients to improve sexual function, virility, and libido. If you have only mild symptoms (e.g., the ability to get mostly erect but not enough for penetration, or your erectile performance is mostly reliable but a tad inconsistent), male enhancement pills may be able to help. In many cases, male enhancement pills use doses of individual ingredients that are lower than those seen in studies. We reviewed more than 100 scholarly articles pertaining to erectile health and the various ingredients included in common male enhancement supplements. We’ll continue to stay on top of new developments in male enhancement and erectile dysfunction treatment to keep this article up to date. For starters, it’s too easy to end up with counterfeit pills containing dangerous ingredients you never realized you were going to consume. However, male enhancement supplements come with a few major pitfalls. By bypassing the legitimate healthcare system, users of counterfeit PDE-5i bypass screening for concurrent medical comorbidities, as well as proper education and warnings of PDE-5i use. Improving confidence and performance can significantly impact an individual's sexual experiences, allowing for more fulfilling intimate relationships. Ingredients that improve blood flow and enhance arousal can lead to stronger, longer-lasting erections, which may create the perception of increased size during sexual activity. Consulting with a healthcare provider can help individuals determine the most effective approach to enhancing their sexual experiences. Do male enhancement pills work? Maca is a popular supplement ingredient that can only claim inconclusive results for men’s sexual function when looking at multiple studies.11 Beyond potentially boosting libido and fertility, it can positively affect mood and blood pressure.12 The best way to understand how a male enhancement pill might work is to look at its ingredients and consider how they might work together. Ultimately, even the best male enhancement pill can only go so far in addressing things like erectile dysfunction. There has been a lot of research into ashwagandha’s anxiolytic effects, but other studies looking at its ability to boost testosterone have been promising, as well. On arrival to the emergency department, his blood glucose level was in the normal range, but hypoglycemia recurred 1 hour later. On August 13, 2019, VPC was consulted by an emergency physician at an academic medical center about a man aged 57 years who did not have diabetes and was noted by his wife to have been diaphoretic and agitated the previous day. The public health implications of V8 use include the potential for substantial morbidity from hypoglycemic episodes and the potential for mortality if health care services are not accessed in a timely manner when hypoglycemia occurs. These are relatively mid-range prices among male enhancement pills, with products like Max Performer and Male Extra offering deeper savings with their 12-month supplies. Supplemental male enhancement pills often employ ingredients that aim to act in similar ways. But not all male enhancement pills are safe, and there are ingredients in even some of the safest options that could pose a danger to you. There is a common misconception that male enhancement pills are intended to make your penis larger. Other types of supplements exist under the male enhancement umbrella, including volume pills and testosterone boosters. The list likely includes only a small fraction of the potentially dangerous products marketed to consumers online and in stores, the FDA added. The FDA's testing found many of these products contain active drug ingredients not listed on the product labels, including some ingredients found in prescription drugs. These items, sold online and over the counter, claim to provide benefits, such as increasing testosterone levels, preventing erectile dysfunction, and boosting stamina. Here is a roundup of some ingredients frequently used in top-selling natural products, and what the researchers in the 2015 review concluded about their effectiveness and safety. Popular Health Centers We took a hard look at the male enhancement pills on the market and whittled the immense field down to a few products we think have the most potential to be effective while offering you the safest experience.Admittedly, they’re a lot more tedious to use than popping a couple of pills in the morning, with regimens involving several hours of daily wearing for several months in order to see growth.Before PDE-5i are prescribed, patients must be evaluated for potential drug interactions and warned of the absolute contra-indications.For example, those taking L-arginine may start to notice improvements in erectile function with regular use over several weeks.“PDE5 inhibitors may result in a raging boner but at the same time, it’s dilating all the blood vessels in your body,” says Seth Cohen, a urologist at NYU’s Langone Health.But testosterone boosters often contain fewer components that target erection strength and semen quality.Currently, evidence suggests that ED is not only correlated with cardiovascular disease due to shared medical comorbidities, but is, in fact, an independent risk factor for cardiovascular disease.Stem cell therapy and platelet-rich plasma (PRP) therapy are cutting-edge treatments in male rejuvenation. TRT helps men regain energy, improve mood, increase muscle mass, and enhance sexual performance. There aren't enough studies of penis-enlargement surgery to give an accurate picture of risks and benefits. And these products may have potentially dangerous ingredients not listed on the label. And no trusted medical organization endorses penis surgery for purely cosmetic reasons. One of the primary safety concerns is the potential for these pills to contain hidden ingredients, such as sildenafil or tadalafil—active components of prescription ED medications like Viagra and Cialis. In summary, while some over-the-counter male enhancement pills may offer benefits, their effectiveness is not guaranteed, and consumers should prioritize safety and informed decision-making. Understanding the ingredients and mechanisms of action in these supplements is crucial for individuals considering their use as a part of their sexual health regimen. Male enhancement pills often contain a blend of herbs, vitamins, and other natural ingredients purported to boost stamina, increase blood flow, and improve erectile function. But even if you disregard animal studies and only look at the competition, you’ll find a 1,000mg cordyceps dose in Max Performer, which greatly eclipses Male Extra’s offering. In a 220lb male, that’s the equivalent dose range of g, much larger than Male Extra’s 25mg. Two of Male Extra’s most important ingredients are zinc and vitamin B3, also known as niacin. Safety However, current scientific evidence does not support the idea that these supplements can lead to permanent increases in size. For example, those taking L-arginine may start to notice improvements in erectile function with regular use over several weeks. As with any medication, individuals interested in compounded ED treatments should consult with their healthcare provider. On the other hand, while natural supplements can offer benefits for some individuals, their efficacy is often less predictable, and their safety profiles can vary significantly. While PDE5 inhibitors may come with some side effects, such as headaches, flushing, and gastrointestinal discomfort, they are generally well-tolerated when taken as directed. A large sample of men’s supplements tested positive for undeclared ingredients. Ultimately, while some over-the-counter male enhancement pills may offer legitimate benefits, consumers should be cautious and prioritize safety by choosing products from reputable manufacturers.Some claim to resolve erectile and performance issues, while others aim to help with fertility and semen volume.Others seek to bypass the legitimate healthcare system due to either embarrassment of the underlying condition or desire for cheaper alternatives.Performer 8 includes nine powerful ingredients proven to increase sexual stamina, erection strength, and semen volume.Emotional health is often overlooked in the conversation about aging, but it’s a critical component of overall well-being.Additionally, sildenafil, avanafil, and tadalafil combined with nitrate pharmaceuticals (often found in diabetes, high blood pressure, high cholesterol, or heart disease medication) can trigger dangerously low blood pressure.Internet pharmacies have made it easier for PDE-5i users to bypass the healthcare system, as 16.5% of PDE-5i users obtained the medicine through the Internet (13).Anxiety and stress can have a significant influence on sexual life. Additionally, some herbal ingredients may interact negatively with other medications or exacerbate underlying health conditions. Other ingredients, such as ginseng, have been used for centuries in traditional medicine to enhance sexual performance and arousal. Some studies suggest that certain natural components, like L-arginine, may help improve blood flow, potentially benefiting those with mild to moderate erectile dysfunction. While the market is flooded with various products promising miraculous results, it is crucial to approach these supplements with a discerning eye. It found little or no evidence to support common health fraud claims they can improve ED or other aspects of sexual performance. Many sex drive pills are not thoroughly tested or regulated by the FDA, meaning their safety and efficacy are not guaranteed. Interactions with other medications can lead to potentially life-threatening conditions. If not treated promptly, priapism can cause permanent damage to the penis and can even require surgical intervention. For a split second, I didn’t know what I was looking at but after reading the words “time,” “size,” and “stamina,” I figured out that they were, in fact, boner pills. Mayo Clinic does not endorse companies or products. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Examples of commonly prescribed medications that have interactions with PDE-5i are included in Table 1. Many of these side effects occur because there is cross-reaction with other phosphodiesterase types located throughout the body (18,22). Other side effects include headache, dyspepsia, flushing, myalgia/back pain, visual disturbances, and nasal congestion. There are numerous known side effects of PDE-5i, some of which may be life threatening. This strategy could help ease patient concerns and re-invigorate the PDE-5i market. Table 1. Common medications and dietary supplements with interactions with phosphodiesterase-5 inhibitors (PDE-5i). “It is clear from the results of our decade of testing that retailers and distributors, including online marketplaces, do not effectively prevent these types of potentially harmful products from being sold to consumers,” said the FDA.PDE-5i have been shown to be safe medications and may ultimately be available over the counter.The issue with store-bought supplements is that they don’t comply with the same rules that drugs do, says Landon Trost, a urologist at the Mayo Clinic.Many users report positive experiences with specific products, often citing improvements in libido, stamina, and overall sexual satisfaction.Ingredient effectiveness is supported by clinical studies, and all purchases are backed by a lifetime guarantee.Despite these potential dangers, the market for counterfeit products has grown astronomically. Many studies link zinc with testosterone levels.10 Since men lose testosterone production as they age, supplementing with zinc and other testosterone-boosting ingredients can improve various sexual functions. It enables the body to produce nitric oxide, which increases blood flow to the penis.6 Studies indicate it may improve sexual function in men, but often with higher doses than seen in supplements, often between 2g and 5g daily. This amino acid is a popular ingredient in male enhancement pills to help men get and maintain firm erections. First, you’ll likely need longer than one month to discover whether male enhancement pills work for you. Many of those studies lack statistical significance as it is, so turning to an inferior dose of a poorly studied ingredient isn’t the way to gain our appreciation. But we don’t think the answer is to cram a bunch of ingredients into a pill and hope it pleases everybody. As you’ll see, these supplements’ prices fall within a pretty limited range; many of them are considerably less expensive than brand-name ED prescriptions but a lot more expensive than generic prescription alternatives. Some are more prone to these side effects than others. If a person has any of these significant side effects, they should contact the doctor immediately. By prioritizing safety and efficacy, individuals can enhance their sexual experiences and overall quality of life. FDA-approved medications provide a reliable and effective solution for those experiencing ED, offering safety and predictability. Male Enhancement Pills FAQs Food & Drug Administration (FDA) before hitting the open market. Supplements, when taken as directed and needed, can help improve your overall health. Dietary supplements have their advantages. Our content is fact checked by our senior editorial staff to reflect accuracy and ensure our readers get sound information and advice to make the smartest, healthiest choices. But most men who think their penises are too small actually have penises that are considered typical size. The fear that your penis looks too small or is too small to satisfy your partner during sex is common. But, there's little scientific support for nonsurgical methods to enlarge the penis. If they wish to improve a specific ailment, such as premature ejaculation or erectile dysfunction, approved drugs may be the best solution. They are generally created from plants, and they frequently contain several blended herbal supplements. Male enhancement drugs are used for more than just increasing sexual desire. A person with erectile dysfunction may even refuse to go to the doctor for a check-up. Male enhancement pills and testosterone boosters share a lot of ingredients. Many men investigate male enhancement as a means to penis growth or a way to alleviate problems like premature ejaculation. If the ingredient lists for the products above don’t thrill you, or you’re interested in finding non-medicinal means to improve your sexual performance, there are several compelling options out there. Other than zinc, none of the ingredients in Volume Pills found their way into our earlier breakdown of common male enhancement components. Even if a product is not included on this list, consumers should exercise caution before using these types of products. You can view the list of products flagged by the FDA at /TSEP. Stay on top of latest health news from Harvard Medical School. PLUS, you'll get the latest news on medical advances and breakthroughs from Harvard Medical School experts, and special offers on content from Harvard Health Publishing. Over-the-counter products sold as dietary supplements might contain undeclared Food and Drug Administration–approved prescription pharmaceuticals that could pose a substantial health risk to consumers who believe them to be harmless. Rejuvenation therapy, particularly TRT, helps men regain their libido, improve sexual performance, and boost overall confidence in intimate relationships. Aging often brings about a decrease in sexual desire and performance, a problem that can strain relationships and diminish quality of life. Several forms of rejuvenation therapy are available, each with specific benefits tailored to different aspects of male health. Many pumps, pills, weights, exercises and surgeries claim to increase the length and width of your penis. Ads for penis-enlargement products and procedures are everywhere. Get the facts about what to expect from male-enhancement pills, pumps, exercises and surgeries. Tempted by products that claim to increase penis size? Male enhancement pills are available in stores and online as natural therapies to enhance sexual function in a variety of methods. We’ve done our best to bring you a collection that meets a high bar for safety with minimal adverse effects. You can find the right test to fit your needs by visiting our guide to the best at-home testosterone tests. If you have any reason to believe that your problems in the bedroom are related to low T, we recommend taking a testosterone test. Rejuvenation therapy often includes testosterone replacement therapy (TRT) to restore hormonal balance. Low testosterone (also known as Low T) is a common condition that can negatively impact many areas of a man’s life. As men age, testosterone levels naturally decrease, leading to symptoms such as fatigue, weight gain, reduced libido, and even depression. Testosterone plays a vital role in a man’s health, affecting everything from muscle mass and strength to mood and cognitive function. Treatments are tailored to individual needs, ensuring that men can achieve optimal health and vitality at any stage of life. For the purposes of this paper, the term “counterfeit” will be used to encompass all forms of SSFFC medications. Currently, the WHO is using the term “Substandard, Spurious, Falsely labeled, Falsified, and Counterfeit (SSFFC)” for medical products until a new definition is agreed upon (1). This can include products with bona fide ingredients, but with insufficient or excessive quantities, products with the wrong ingredients, or products with deceptive packaging. As stated, counterfeit PDE-5i rarely are packaged with the appropriate warning labels. The effects of widely variable amounts of active ingredient range from low efficacy at a minimum to severe side effects and negative drug interactions at the worst. Quantities of active ingredients are also highly variable, as seen in Table 2. In Indonesia, 100% of “Viagra” sold by street peddlers, 56% purchased in “drug stores”, and 13% acquired from legitimate pharmacies was counterfeit Viagra marked as authentic (29). Counterfeiters are taking advantage of this growing market by developing illicit and counterfeit PDE-5i products. For example, combining these pills with medications containing nitrates can result in dangerous drops in blood pressure. These side effects can be particularly dangerous for individuals with underlying health conditions or those taking other medications. Common side effects of sex drive pills include headaches, nausea, dizziness, and severe drops in blood pressure. If you’re hoping that male enhancement products will increase the size of your penis, a penis extender would be a far better option. As a category, male enhancement pills draw in men looking for more than just ED treatment. Those include zinc, vitamin B, and maca, to name a few.33 If you’re serious about addressing infertility issues, we encourage you to speak with a specialist before resorting to male enhancement pills, especially if time is a concern. But even the best candidates may struggle to find success with male enhancement pills and may need to try several formulas before seeing any results. Most other male enhancement pills explicitly list their doses and don’t rely on proprietary blends of any kind. The local emergency medical services team found his blood glucose to be 32 mg/dL, and he received oral glucose. Black maca has some evidence for improving sexual desire and erectile function. Whether in your 40s, 50s, or beyond, rejuvenation therapy provides a scientifically backed solution to maintaining health, vitality, and youthful vigor for years to come. Hormonal treatments, in particular, need to be carefully monitored to avoid side effects and maintain optimal balance. It’s essential to undergo rejuvenation therapy under the supervision of a medical professional to ensure safe and effective results. While natural male enhancement pills can contribute to improved sexual health and performance, individuals should remember that they are not a one-size-fits-all solution and may take time to show results.This discussion can help identify the best approach to managing erectile dysfunction and ensure that any compounded medication used is appropriate for their specific health needs.In addition to the intellectual property rights that counterfeiters violate, the products they make can place consumers in danger.However, even in these well-regulated countries, the market for counterfeit PDE-5i has grown.We offer the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance.Besides the high profit margins, the underlying characteristics of consumers of PDE-5i make it a prime target for counterfeiters.To find the latest in erectile dysfunction treatment, buy the Harvard Special Health Report Erectile Dysfunction.The mean blood glucose level for all confirmed cases at initial evaluation was 30 mg/dL, and the lowest documented level was 11 mg/dL.Many factors are contributing to the rapid growth of the illicit market, such as the low risk of prosecution, potentially high financial reward, and ease of distribution via Internet pharmacies. They also tend to center on one or two testosterone-specific ingredients you won’t often find in male enhancement products such as vitamin D. Some male enhancement pills contain ingredients that can improve the motility and egg-penetrating ability of your semen. That said, male enhancement pills commonly target increased blood flow and relaxation of the corpus cavernosum. We took a hard look at the male enhancement pills on the market and whittled the immense field down to a few products we think have the most potential to be effective while offering you the safest experience. Do not be ashamed to talk to the doctor about sexual problems and take recommended male enhancement pills. Natural supplements can play a role in enhancing sexual performance and improving overall well-being, but they should not replace professional medical advice or treatment for erectile dysfunction. While many products on the market promise immediate results and significant improvements in sexual health, it is essential to approach these supplements with a critical eye. Most male enhancement pills focus on improving erectile function, stamina, and libido rather than altering anatomical dimensions. Do Male Enhancement Pills Make You Bigger and Help You Perform Better? Besides the high profit margins, the underlying characteristics of consumers of PDE-5i make it a prime target for counterfeiters. Meanwhile, while the punishment for buying 1 kilo of cocaine would be a minimum of 5 years to a maximum of 40 years in jail, the punishment for buying 1 kilo of sildenafil is typically 3 years (11). The total sewage load was back calculated to estimate total sildenafil consumption, and it was found that greater than 60% of identified sildenafil was not accounted for by legal prescriptions (9). In one study attempting to estimate illicit sildenafil use, concentrations of sildenafil and sildenafil metabolites were measured in sewage treatment centers in the Netherlands. Two separate analyses in Europe estimated that 0.6 to 2.5 million men are being exposed to illicit sildenafil compared to approximately 2.5 million users of legal sildenafil (8). Performer 8, our preferred male enhancement product in terms of safety, utilizes a 6g daily ginseng dose. Some of these studies have looked at doses up to 9g daily and showed few-to-no side effects.3 Other studies showed potential benefits at doses as low as 1g/daily. Performer 8 includes a streamlined set of specific ingredients, and several of those ingredients appear in doses consistent with, or at least approaching, doses used in clinical studies. We’re also wary of any product that makes a big deal out of certain ingredients, only to include them in doses that are significantly smaller than doses used in studies. In the outbreak described here, a nonprescription over-the-counter supplement was also documented to contain both sildenafil and glyburide. Additional assistance was requested from VDH and VDACS to investigate the retail facilities selling V8 and initiate seizure or quarantine of these potentially glyburide-contaminated products. VPC notified the Richmond City Health Department about the first two patients on August 14. Glyburide and sildenafil were detected in the urine of a fourth patient. Each one aligns with doses used in successful human research either to improve testosterone levels, reduce stress and anxiety, increase erectile performance, or support those ingredients as they work. Several of its testosterone-boosting ingredients have the potential to reduce stress and anxiety, while the maca and ashwagandha content should be able to significantly improve erectile performance, per several pieces of clinical research.11 63 Some other male enhancement pills cost less per month at their highest bulk levels, like Semenax’s $33/month 12-month supply. When assessing and comparing male enhancement pills, we rely on clinical research and reports from users. While the market for counterfeit pro-erectile medications is partially driven by the cost of prescription drugs, this reality could soon change. Many over-the-counter products marketed as sex drive enhancers are unregulated and may contain hidden or harmful ingredients that can pose significant risks to your health. These ingredients can include prescription drugs like sildenafil and tadalafil, which can cause serious adverse effects if not taken under medical supervision. These ingredients are often selected for their supposed benefits in improving blood flow, hormone levels, and energy, all of which are claimed to increase sexual desire and performance. Patients reported that the supplement was promoted by word of mouth and was purported to enhance male sexual performance.There's also no proven way to make a penis larger.In summary, while some over-the-counter male enhancement pills may offer benefits, their effectiveness is not guaranteed, and consumers should prioritize safety and informed decision-making.That makes them potentially dangerous for men with low blood pressure or men taking medication that affects their blood pressure.As you’ll see, these supplements’ prices fall within a pretty limited range; many of them are considerably less expensive than brand-name ED prescriptions but a lot more expensive than generic prescription alternatives.ExtenZe was one of the first male enhancement pills to gain national attention.As with any medication, individuals interested in compounded ED treatments should consult with their healthcare provider.Some pills can cause priapism, a prolonged and painful erection that can last for hours. Another ingredient we like to see in male enhancement products is ashwagandha. We are aware of certain side effects that crop up in studies examining these ingredients’ potential to treat ED, but some boast studies specific to their safety. The safety profiles of these various male enhancement products are a mixed bag. It is important to note that compounded medications do not undergo the same rigorous FDA review as standard medications; however, they can still be prescribed by healthcare professionals. Compounded medications can be advantageous for individuals who may not respond well to traditional oral medications or have specific health considerations. Importantly, these medications are prescribed by healthcare providers who can assess individual health conditions and determine the most suitable treatment options. Clinical studies have shown that PDE5 inhibitors can be effective for up to 76% of men, providing a safer and more predictable solution for those grappling with erectile dysfunction. Advertisers would have you believe that your partner cares deeply about penis size. A penis is considered small only if it measures less than 3 inches (about 7.5 centimeters) when erect. If your penis is about 5 inches (13 cm) or longer when erect, it's of typical size. The length of a non-erect penis doesn't consistently predict length when the penis is erect. Many men also have an exaggerated idea of what is considered a "typical" penis size. Innerbody Labs offers a fair 30-day guarantee, which should be just enough to feel some positive effects from ashwagandha and maca. What’s particularly impressive about this collection of ingredients are the doses used. Innerbody Labs Testosterone Support covers a broad patch of wellness, with a primary focus on increasing testosterone levels. A comprehensive review of the literature up to 2019 saw most studies using doses between 1,500mg and 5,000mg.50 There are at-home testosterone tests you can take to check those levels without much hassle. One study saw significantly increased testosterone levels in men supplementing with vitamin D compared to placebo.34 But testosterone boosters often contain fewer components that target erection strength and semen quality. There is no pill you can take to make your penis larger, but there are a few approaches to premature ejaculation in the form of sprays and wipes that can definitely delay orgasm in most men. If you’re looking for long-term growth, we’ll point you instead to penis extenders. VigRX Plus is one of just three formulas in our guide to contain Bioperine, a black pepper extract that can increase your absorption of the supplement’s other ingredients. Performer 8’s 60-day guarantee gives you more time to make sure you get that product’s full effects. For instance, Bird & Be has a good male fertility supplement but a total lack of any guarantee. It is unknown whether patient J resumed use of V8 after initial medical care.§ Left against medical advice.¶ Found with altered mental status the same day after leaving against medical advice. Patients D and O resumed use of V8 following their first visit for medical care and suffered recurrent hypoglycemic episodes. Alternatively, glyburide may have been used to color the tablet blue to resemble prescription sildenafil. However, given that the tablets contained sildenafil doses within the typical therapeutic dosing range, the inclusion of glyburide as a filler appears less likely. The effectiveness of over-the-counter male enhancement pills can vary significantly depending on the ingredients and individual responses. Male enhancement pills are dietary supplements designed to improve sexual performance, enhance libido, and support overall sexual health. This blog post aims to provide a comprehensive understanding of male enhancement pills, examining their ingredients, effectiveness, safety concerns, and the available alternatives. For instance, a 2015 review in The Journal of Sexual Medicine examined the scientific evidence for some of the most common ingredients in over-the-counter "nutraceuticals" marketed for men's sexual health to determine if these products are effective and safe. If your chosen pill does work for you, it will likely take several weeks to a few months for the effects to set in. ED resulting from low testosterone caused by a vitamin D deficiency will take a while to correct — and may never subside if that man chooses a pill without vitamin D in it. That’s because ingredient lists and dosages are as incredibly variegated as the long list of potential causes for sexual dysfunction. That makes this one of the most affordable options at the 12-month purchasing level, but it’s worth remembering that many of the ingredients here lack the research seen with other companies’ formulas, and there’s no way to know how much of each is present. And there seems to be a direct link between obesity and poor sexual performance. For a thorough look at testosterone boosters, as well as testosterone replacement therapies, consult our comprehensive guide to the best testosterone boosters on the market. The most reliable alternatives specifically for treating ED are prescription medications like Viagra (sildenafil) and Cialis (tadalafil). When it’s successful, your penis may hold more blood than it did before, giving you a slightly larger, more robust erection. Different pills will have different effects at specific times throughout treatment. You should also stop using the supplements and speak with your doctor before switching brands. What’s more, these active ingredients are commonly found in prescription drugs. Consumers, particularly men, are seeing this play out first-hand after the FDA issued a warning about certain men’s supplements containing “hidden” prescription drugs. In fact, for PDE-5i, the illegal market in industrialized countries approaches the size of that in developing countries. The proportion of falsified drugs ranges from 1% in industrialized countries that have a well-regulated and controlled drug market to as high as 60% in some developing countries (6). It is largest in poor and developing countries, with the size of the market being inversely proportional to the amount of regulation. Surgery is typically reserved for men whose penises don't work because of a problem present at birth or an injury. When the suspensory ligament is cut, the non-erect penis may look longer because more of it hangs outside the body. But it does not change the actual length of the penis. Strategies to limit counterfeiting should be multi-faceted and target prescribing healthcare professionals, pharmaceutical companies, regulatory authorities, and patients. Unsuspecting patients often seek alternative treatments of ED due to embarrassment and lower cost, but also because of the perception that “all natural” products are somehow safer than synthetic medications. Recently, in January of 2016, the FDA announced warnings against 40 products marketed as dietary supplements that contained undeclared PDE-5i (33) (Table 3). Perhaps even more dangerous than the counterfeit PDE-5i that is marketed as legitimate pharmaceuticals, however, are those marketed as “natural” supplements. Your doctor can help you understand the underlying causes of your low libido or erectile dysfunction and recommend a safe and monitored treatment plan tailored to your specific needs. Instead of reaching for these potentially dangerous products, it’s time to schedule an appointment with a doctor. When it comes to enhancing your sex drive, it’s crucial to prioritize your health and safety over quick fixes. The researchers also noted that some products labeled "natural" actually contain traces of PDE5 inhibitors, medications in the same class that includes prescription ED drugs like Viagra. We compared hair loss products and analyzed studies to help find your best treatment options in 2026. Still, they can actually produce results that no male enhancement pill can claim.37 Studies suggest that penis pumps can both restore erectile function and prevent or reverse this size loss.47 However, this is not an indication that penis pumps will increase penis size; it’s a result specific to this group of men. With such significant profits to be made at a relatively low risk, there is a tremendous incentive for counterfeiters to tap into the growing market for PDE-5i. With the low cost of base materials and the high cost of pills, the profit margin for creating sildenafil is approximately 2,000 times that of cocaine. Many factors contribute to the disproportionately large market of counterfeit PDE-5i. Globally, antibiotics comprise the largest class of counterfeit medications, but in Europe, PDE-5i are the most commonly counterfeited medicines (7). These men often develop erectile dysfunction, and some experience a phenomenon in which the penis retracts slightly into the body, making it appear shorter. They’re actually mechanical devices designed to draw blood to the penis using vacuum pressure, resulting in an erection of sufficient hardness for penetrative sex. If confidence is part of a mental angle affecting your sexual performance, this might help.