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The Best Male Enhancement Pills: Fact or Fiction?

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 1/26/2021

If you’ve spent time online reading about improving sexual performance, boosting testosterone or treating issues like erectile dysfunction (ED) or premature ejaculation (PE), you’ve no doubt seen advertisements for “male enhancement” products.

Male enhancement is a general term that’s used to refer to products that claim to boost sexual performance, increase testosterone, lengthen your penis and, well, enhance your masculinity.

While there are proven options available for treating conditions like ED and PE, the unfortunate reality is that most male enhancement pills and other products aren’t backed up by much in the way of scientific evidence.

Worse yet, investigations have found that many contain unlabeled, possibly harmful ingredients that could affect your health.

Below, we’ve dug into the science behind the world of male enhancement pills to find out what’s available, what works and what doesn’t.

We’ve gone over some of the “best,” most popular male enhancement supplements available to find out what they actually contain and whether or not they’re backed up by real science. We’ve also looked at some common male enhancement scams that you should be aware of.

Finally, we’ve listed real, science-based products and medications that can help to improve your sexual functioning, increase your testosterone and improve your quality of life as a man. 

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Male Enhancement Pills: The Basics

  • “Male enhancement” is a general term that’s used to describe pills, herbal supplements and other products that claim to enhance sexual performance, increase the size of your penis, prevent premature ejaculation and more.

  • You can find a large range of male enhancement pills on Amazon, eBay and other online marketplaces. Many are heavily promoted on porn sites, forums and elsewhere online.

  • Many male enhancement pills are promoted via referral programs that pay commissions to bloggers, vloggers and other influencers. Because of this, it pays to be skeptical when you see a glowing recommendation for a particular supplement.

  • Most male enhancement pills are marketed with big claims about their results, but very few are supported by any kind of scientific research.

  • Since most male enhancement pills are supplements rather than medications, they’re regulated by the FDA as foods, not as drugs. This means they usually aren’t subject to the same strict clinical trials or approval process.

  • Many male enhancement pills claim to only contain natural, herbal ingredients. However, investigations by the FDA have found that many male enhancement products are spiked with sildenafil (the active ingredient in Viagra®) and other pharmaceutical ingredients.

  • While over-the-counter male enhancement pills aren’t recommended, there are options available if you have erectile dysfunction or premature ejaculation. We’ve talked about these below and explained how you can legally purchase them. 

What Are Male Enhancement Pills?

The term “male enhancement” is used to refer to pills, powders and other health supplements that are marketed as enhancing certain aspects of male health. Most male enhancement pills contain herbal ingredients or minerals such as zinc or magnesium.

For the most part, male enhancement pills are promoted as being able to do one or several of the following things:

  • Strengthen your erections and treat erectile dysfunction

  • Increase your stamina and treat premature ejaculation

  • Enhance your sexual pleasure and/or performance

  • Boost testosterone and strengthen your libido

  • Increase the length and/or girth of your penis

  • Improve your sperm count and fertility

  • Increase your semen volume

  • Reduce stress or sexual performance anxiety

Male enhancement pills don’t require a prescription, meaning they’re available over the counter from retail stores and online marketplaces. They’re often promoted online using ads and direct marketing promotions. 

FDA-approved medications for issues like erectile dysfunction or premature ejaculation usually aren’t referred to as “male enhancement” drugs. These medications require a prescription and can’t be purchased over the counter. 

The Most Popular Male Enhancement Pills

Male enhancement pills are a big business, with thousands of products available on countless websites and offline from gas stations, convenience stores and sex stores.

Overall, when it comes to over-the-counter male enhancement pills, the most popular products are a mixed bag. While some products contain ingredients that might have real benefits, others make use of herbal ingredients that aren’t supposed by scientific research. 

Some male enhancement products, including products labeled as “natural,” have been found to contain unlabeled prescription medications that can be harmful if misused.

Below, we’ve listed six of the most popular male enhancement pills available. For each product, we’ve looked at its ingredients, their effects and the company’s history to determine whether or not it’s worth your attention. 


ExtenZe® is one of the most popular male enhancement pills on the market. It’s promoted as a supplement for increasing energy and vitality, improving your sex life, enhancing pleasure and generally improving your sexual health. 

Some versions of ExtenZe claim to offer extended effects, while others also claim to increase testosterone production.

ExtenZe has a long list of ingredients that includes yohimbe, DHEA, GABA, niacin, tongkat ali and others. Although some of these are linked to improvements in hormonal health and a mild increase in blood flow, there isn’t much evidence that they boost sexual performance. 

Frustratingly, the ExtenZe label doesn’t specify how much of each ingredient is included in each pill. Instead, it groups ingredients together as part of a proprietary blend — a common issue with supplements that makes it difficult to know what you’re truly getting.

Another, much bigger problem is that investigations by the FDA have found that some ExtenZe pills contain unlabeled ingredients.

For example, a 2018 investigation found that ExtenZe pills contained unlabeled sildenafil — the active ingredient in Viagra. Although sildenafil is safe when used as prescribed, including it as an unlabeled ingredient increases the risk of side effects and drug interactions

In addition to issues with unlabeled ingredients ExtenZe has been the subject of several class action lawsuits related to deceptive marketing tactics, false advertising and other issues.

VigRX Plus

VigRX® Plus is another common male enhancement supplement. It’s advertised as a “clinically studied” and “doctor recommended” herbal supplement for improving confidence, vitality and performance. 

Interestingly, the company behind VigRX Plus has commissioned several studies to look at its effects on sexual performance:

  • One of these studies, which was carried out in 2010 for VigRX, found that the herbal supplement produced a small increase in intravaginal ejaculation latency time in men with premature ejaculation. However, the effect wasn’t statistically significant.

  • A separate study from 2012, which looked into the effects of VigRX Plus on erectile dysfunction, found that VigRX Plus improved the erectile function and overall sexual satisfaction of men with mild to moderate ED more than a placebo.

While these results look promising, VigRX has also attracted attention from counterfeiters and regulators. Specifically, health regulators in Australia, New Zealand and Singapore have posted safety warnings about counterfeit VigRX, which were found to illegally contain undeclared drugs, such as sildenafil.

At the time of publication, the FDA hasn’t issued any warnings about VigRX on U.S. shores.


TestRX® is a testosterone booster supplement. It’s marketed as a general supplement for male health and wellbeing that claims to boost energy, build muscle, enhance erectile function and provide other related benefits.

Each serving of TestRX contains ingredients like zinc, magnesium, fenugreek and B, D and K vitamins.

As we’ve talked about in our guide to increasing testosterone, some of these ingredients are linked to improvements in testosterone in certain situations. 

Specifically, studies have shown that zinc and magnesium may help to increase testosterone production in people with nutritional deficiencies. Some scientific research has also found that fenugreek may have testosterone-boosting properties.

However, research is mixed on whether these ingredients can increase testosterone for men who aren’t deficient.

Male Extra

Male Extra® is a natural male enhancement pill that’s marketed as a supplement for increasing the hardness, size and sustainability of your erections. 

The creators of Male Extra claim that it works by expanding the blood vessels that lead to your erectile tissue, allowing for increased blood flow when you have an erection and longer-lasting sexual performance.

The main ingredients in Male Extra are niacin, zinc, l-arginine, l-methionine, pomegranate fruit extract, cordyceps sinensis and methylsulfonylmethane (MSM). 

As we mentioned above, some of these ingredients are associated with a modest increase in testosterone production in men with nutritional deficiencies. Others, such as niacin, may have positive effects on erectile health and sexual performance.


Viasil® is described as a “100% natural male performance enhancer” that claims to fight back against erectile dysfunction and improve sexual performance. Its dual-action, natural formula claims to reduce anxiety, revive your sex drive and increase nitric oxide and APT levels for better erections. 

The ingredients in Viasil are herbs and extracts that are commonly promoted as alternatives to medications like sildenafil. There’s zinc, horny goat weed, ginkgo biloba, tribulus, pomegranate and a variety of other purportedly blood flow-promoting active ingredients.

While some of these ingredients may offer benefits for blood flow, the scientific evidence is thin when it comes to their benefits for ED or general sexual performance, with very few large-scale studies available. 

Although Viasil might have some positive effects on blood flow and ED, the scientific evidence behind its ingredients individually and in combination isn’t particularly comprehensive. 

ProSolution Plus

ProSolution® Plus is a “male potency” supplement that claims to treat premature ejaculation and erection quality issues. It's also promoted as a treatment for increasing male sexual health and stamina.

Like many other male enhancement pills, ProSolution Plus primarily contains herbal ingredients like tribulus, ashwagandha and mucuna pruriens among others.

Some of these may offer health benefits for men. For example, several studies have found that ashwagandha may improve strength, testosterone and hormones related to fertility in men.

We’ve talked about this scientific research in more detail in our full guide to ashwagandha and testosterone

Others are less supported by science. For example, a study that looked at the effects of tribulus — one of ProSolution Plus’s ingredients — concluded that it was no more effective for treating ED than a non-therapeutic placebo.

How to Avoid Scams and Unsafe or Ineffective Products

  • Learn which ingredients work and which don’t. In general, herbal treatments for ED and other sexual performance issues aren’t as effective as FDA-approved medications such as sildenafil, tadalafil and others.

    However, some ingredients may offer benefits for blood flow and your general health and wellbeing. Our detailed list of supplements for ED goes into more detail on which natural ingredients are worth considering and which aren’t supported by science.

  • Look for FDA warnings before you purchase anything. Male enhancement products often contain hidden, unlabeled ingredients. In a lot of cases, these are pharmaceuticals such as sildenafil, tadalafil and other medications for treating issues such as ED.

    To make identifying and avoiding tainted sexual enhancement products easier, the FDA maintains a list of public notifications regarding male enhancement products that feature hidden, dangerous or illegal ingredients.

  • Take blog and influencer recommendations with a grain of salt. Many supplements, including male enhancement pills, are promoted using affiliate and referral programs that pay bloggers and other influencers lucrative commissions for new customers.

    As such, it’s best not to take online recommendations as gospel. Just because a product is mentioned on YouTube or in a blog post about sexual performance, it isn’t necessarily the best option available for increasing stamina or treating ED.

  • If you have a sexual issue, talk to a professional. Real, science-based treatments are available for ED, premature ejaculation and other sexual issues. Before you try any male enhancement pills, consider talking to your healthcare provider.

    If your issue is treatable, they’ll be able to tell you about medications that can treat your symptoms and improve your sexual performance. You can find more information about science-based treatments for ED, PE and other issues in the section below. 

Science-Based Options for Improving Sexual Performance

While the science behind most male enhancement pills is mixed at best, there are real, proven options available for improving many aspects of your sexual performance as a man. 

Science-based, FDA-approved medications are available to treat common sexual performance issues like erectile dysfunction and premature ejaculation. Many of these medications produce real benefits and are backed up by significant amounts of scientific research. 

Below, we’ve listed the science-based treatments that are available to treat sexual performance issues, enhance your sexual performance and improve your health as a man. 

Erectile Dysfunction (ED) Medications

If you have erectile dysfunction, using medications like sildenafil, tadalafil and others can make it easier for you to get and maintain an erection.

Most ED medications belong to a class of drugs called Phosphodiesterase-5 (PDE5) inhibitors. They work by increasing blood flow to the erectile tissue of your penis. When you’re aroused, blood can more flow to this tissue more easily, allowing you to stay hard during foreplay and sex. 

Currently, there are four FDA-approved oral medications for treating erectile dysfunction:

  • Sildenafil. The active ingredient in Viagra, sildenafil(generic Viagra) starts working in 30 to 60 minutes and provides relief from ED for around four hours.

  • Tadalafil. The active ingredient in Cialis®, tadalafil is a long-lasting medication that can provide relief from ED for up to 36 hours at a time. As such, it’s occasionally referred to as the “weekend” ED pill.

  • Vardenafil. The active ingredient in Levitra®, vardenafil offers relief from ED for slightly longer than sildenafil.

  • Avanafil. Available as Stendra®, avanafil is a second-generation ED medication that’s fast-acting and less likely to cause some side effects than older medications. 

Unlike over-the-counter male enhancement pills, which mostly use herbal ingredients that aren’t backed up by scientific research, these ED medications are supported by scientific studies that often involve hundreds or thousands of participants.

For example, a study published in BJU International, which involved 315 men with ED of varying severity, found that 82 percent of men who received sildenafil reported improved erections after 12 weeks of treatment.

A scientific review of tadalafil, another ED medication, looked at data involving hundreds of men with erectile dysfunction and concluded that tadalafil improves erections, makes penetrative sex easier and increases overall sexual satisfaction.

Put simply, these are real, science-based medications that go through a comprehensive testing process to verify that they’re both safe and effective. In order to claim that they’re effective, they need to show this in clinical trials.

If you often find it difficult to get an erection or to keep your erection during sex, using sildenafil or a similar ED medication can have real benefits. 

We offer generic versions of several well-known ED medications online, following a consultation with a physician who will determine if a prescription is appropriate. 

You can also learn more about how ED medications work in our guide to the most common ED treatments and drugs

Premature Ejaculation Treatments

Premature ejaculation, or PE, is another common sexual problem for men. In fact, it’s one of the most common male sexual dysfunctions, with data suggesting that about 30 percent of men are affected to some degree.

Just like with erectile dysfunction, many over-the-counter male enhancement pills claim to treat premature ejaculation and enhance sexual endurance. 

While the scientific evidence for most over-the-counter pills is mixed, there are several proven, science-based medications available for preventing premature ejaculation and increasing your stamina in bed. These include:

  • Premature ejaculation spray. Several sprays, creams and other topical treatments are available to prevent premature ejaculation and help you last longer in bed, including our Premature Ejaculation Spray. These treatments use topical anaesthetics like lidocaine to temporarily make your penis less sensitive. Using them is simple — just apply directly to your penis five to 10 minutes before you start foreplay and sex.

  • Sertraline. Sertraline, or Zoloft®, is a selective serotonin reuptake inhibitor, or SSRI. It’s typically prescribed to treat depression and certain types of anxiety disorders, but is also used off-label as a treatment for premature ejaculation. Research has shown that sertraline increases time before ejaculation in men affected by PE. For example, in one study, men who typically ejaculated after one minute increased their mean ejaculatory time to 13.1 minutes after taking a 50mg dose of sertraline. We offer sertraline for pe online, following a consultation with a physician who will determine if a prescription is appropriate. You can also learn more about how sertraline works in our full guide to sertraline for premature ejaculation

Penis Enlargement Medications

One of the most common claims made by male enhancement pills is the ability to temporarily or permanently increase penis size.

While some of the purported benefits of certain male enhancement pills might be possible (for example, some supplements may provide mild benefits for blood flow or sexual performance), this one definitely isn’t.

The reason for this is simple: currently there aren’t any proven, science-based medications or supplements for increasing penis size. 

Beyond medications, most techniques for increasing penis size also aren’t very effective. The widely-discussed technique of jelqing isn’t supported by any real scientific evidence and may cause harm to the penis.

Similarly, the surgical procedures that are currently available for increasing penis size all have major drawbacks, ranging from minor results to a high risk of complications.  

Options for Increasing Testosterone

Testosterone is a vital component for optimal health and wellbeing as a man. It’s responsible for your male sex characteristics, as well as important things like your muscle mass, bone strength and sex drive. 

Increasing your testosterone production isn’t always as simple as taking a pill. However, some ingredients — including ingredients that are found in some male enhancement pills — may have a positive effect on your testosterone production. 

For example, some scientific research shows that ashwagandha, zinc, dehydroepiandrosterone (DHEA) and vitamin D may help to boost testosterone levels in certain situations.

If you’ve been diagnosed with low testosterone, your healthcare provider may recommend using testosterone replacement therapy (TRT) to bring your testosterone levels back up to normal.

TRT involves the use of synthetic testosterone patches, gels, implants, injections or tablets. It’s an effective option for increasing testosterone, but may cause side effects. We’ve talked about these more in our guide to testosterone replacement therapy

In Conclusion

Overall, it’s difficult to recommend most, if any, over-the-counter male enhancement pills. While some contain ingredients that might have some effects, most aren’t backed up by much in the way of scientific research. 

More worryingly, popular male enhancement pills (or their counterfeits) have been found to use unlabeled, potentially harmful ingredients, including prescription medications that could interact with other medications and cause side effects. 

Add misleading marketing and relatively high prices into the equation and the majority of male enhancement pills simply aren’t worth it.

If you have erectile dysfunction, premature ejaculation or another issue that affects your sexual performance, the best option is to talk to a licensed healthcare provider.

They’ll be able to prescribe science-based medication if appropriate to treat your health issues and improve your sexual performance. Not only are these medications more effective than any male enhancement pill — they’re also subject to much stricter testing and regulations. 

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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