Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/22/2023
Search online for “sex pills” and you’ll find hundreds of options, from sketchy supplements sold over the counter in your local sex store or gas station to real, evidence-based medications that are available after a consultation with your healthcare provider.
In fact, there’s a chance you’re here because you were browsing around, searching for reviews on over-the-counter sex pills.
We figured we'd save you the trouble of learning the hard way that these pills don't work when it comes to enhancing your erections, making your penis bigger or boosting your sexual stamina.
Many of these herbal pills and dietary supplements are even dangerous — a topic we’ve talked about more in our guides to Rhino pills and male enhancement products.
Today, we’re talking about sex pills that actually work — science-based medications that prevent common bedroom issues like erectile dysfunction (ED) and premature ejaculation (PE).
Below, we’ve dug into the scientific evidence behind sex pills and explained what works, as well as what likely doesn’t.
We’ve also shared specific medications and sexual enhancement supplements that you can use to improve your performance in bed and enjoy a better, more satisfying sex life.
Over-the-counter sexual performance pills are easy to purchase online and in numerous stores. While these supplements are cheap and easily available, there’s no real scientific research showing that they work.
At the moment, the most effective sex pills are Food and Drug Administration-approved ED treatments, such as sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®). These pills are backed up by real studies showing results.
Medications are also available for PE, including antidepressants referred to as selective serotonin reuptake inhibitors (SSRIs) and topical treatments you can apply to your penis before sex.
Currently, all of the most effective sex pills require a prescription. However, getting one isn’t a complicated process, and you can access most sexual medications online if you suffer from ED or PE.
Like all medications, sexual pills for men can cause side effects. Most of these are mild, but there are a few that you should be aware of before using any type of medication to improve your performance in bed.
Sex pills work, but they aren’t magic. Looking for a sex pill to solve all your bedroom issues is as unreasonable as going to Arby's and expecting a five-star steak dinner, guys.
However, used correctly, and particularly when combined with healthy sexual habits (something we’ve discussed further down the page), sex pills can make it easier to maintain an erection and feel confident in bed.
They can also help you improve your sexual stamina, meaning you should be able to have sex for longer.
We’ve listed some of the best sex pills for treating ED, preventing PE and boosting confidence in bed below.
According to the National Institutes of Health, approximately 30 million men in the United States are affected by some degree of erectile dysfunction.
Erectile dysfunction is one of the most common sexual performance issues for men. Although it often develops with age, it can occur at any time in your life and has numerous potential causes, from your physical health to your mental state during sex.
Right now, the most effective pills for improving your erections and reducing your risk of dealing with ED are PDE5 inhibitors.
These medications come in tablet form and work by inhibiting the effects of the enzyme PDE5, which is found in the arteries that supply blood to your penis. This helps to increase blood flow to your penis, making it easier to get and maintain an erection.
Sildenafil is a fast-acting, popular medication that treats ED. It’s available under the brand name Viagra and as a generic medication. As the first prescription drug for ED, sildenafil received FDA approval in 1998.
Sildenafil is used as needed. It lasts for about four hours per dose and should be taken 30 to 60 minutes before sex. It’s a great option if you need relief from ED for one night, not for the entire day.
Like all ED medications, sildenafil can cause side effects, including headaches, flushing, muscle soreness, changes in your vision and nasal congestion.
We’ve discussed these in our guide to sildenafil side effects, which also covers drug interactions you should be aware of if you’re considering sildenafil as a sexual enhancement pill.
Tadalafil, the active ingredient in Cialis, is a longer-lasting ED pill. Instead of offering relief from ED for a single night, it can last for 36 hours per dose — a benefit that’s earned it the nickname of “weekend” ED pill.
Because it lasts for so long, tadalafil is a great choice if you like to have sex more than once a day, or if you prefer to have sex spontaneously without carefully timing your medication use.
The downside of Cialis is that because it’s so long-lasting, its side effects may stick around for longer than other medications.
Vardenafil, the active ingredient in Levitra, is similar to sildenafil. It lasts for slightly longer and provides relief from ED for around four to five hours. It’s also less affected by food, meaning it could be a better choice if you normally take your ED medication with or after dinner.
The side effects of vardenafil are similar to those of other ED pills, including headaches, nasal congestion, flushing and indigestion.
Avanafil, which is currently only sold under the brand name Stendra, is a new medication for ED that offers several advantages over other sexual performance pills:
It works faster. Avanafil starts to work in as little as 15 minutes, meaning it can be taken closer to sex than other ED medications.
It’s less affected by food. Some older ED medications, such as sildenafil, are slower to work if taken with food. Avanafil is less affected by food than other ED drugs, meaning it can be taken with dinner or another meal.
It has fewer side effects. Stendra’s effects in the body are more selective, meaning it’s less likely to cause some side effects that are common with other ED medications.
Our guide to avanafil goes into more detail about the key differences between avanafil and other medications for ED.
Sexual stamina pills work by preventing premature ejaculation, letting you have sex for longer before you feel like reaching orgasm and ejaculating.
PE is really, really common. Although precise numbers vary, research published by the Indian Journal of Urology suggests that four to 39 percent of men deal with premature ejaculation at some point in life.
Currently, the most effective options for preventing PE and improving stamina are prescription antidepressants like sertraline, as well as topical products that you can apply to your penis for reduced sensitivity.
Sertraline is a selective serotonin reuptake inhibitor, or SSRI, that’s widely used to treat major depressive disorder. It’s also used off-label to increase ejaculation latency — a clinical term for the amount of time that passes before you reach orgasm and ejaculate.
As we’ve covered in our guide to sertraline for premature ejaculation, numerous studies have found that men who use sertraline are less likely to ejaculate early while having sex.
Sertraline can be taken either on a daily basis or as needed. Since it’s a relatively long-lasting medication, it’s easy to time your dosage before sex for optimal results.
We offer sertraline for PE online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
In addition to sertraline, a range of other SSRIs are prescribed off-label to treat PE and increase sexual stamina.
Other SSRIs linked to improvements in sexual stamina include paroxetine (the active ingredient in Paxil®), fluoxetine (Prozac®) and escitalopram (Lexapro®).
Research shows that all of these SSRIs produce similar improvements in ejaculation time, with only mild side effects.
We offer several SSRIs via our online psychiatry service, following a consultation with a provider who will determine if a prescription is appropriate.
Although they’re technically not sex pills, sprays and topical creams are commonly used to treat premature ejaculation.
These products, such as our Delay Spray for Men, contain topical anesthetics like lidocaine and benzocaine, which lower the sensitivity level of your penis. Most are designed for use around 10 to 15 minutes before sexual activity.
This can help you to have sex for longer and avoid ejaculating too early, all without making your penis feel overly numb or uncomfortable.
Our full guide to how lidocaine sprays work goes into more detail about using this type of spray to improve your sexual health and performance.
If you’re on the lookout for a pill with more natural ingredients, you might be tempted to consider dietary supplements like horny goat weed, maca root, ashwagandha, ginkgo biloba or ginseng.
These ingredients are favorites in male enhancement supplements. While they might look good on paper, you should be aware that they aren’t backed up by very much in the way of scientific evidence, nor are they necessarily as safe or effective as prescription medication.
For example, horny goat weed is purported to improve erections and sexual desire, but most of the studies used to support these claims involve animals, not humans.
When it comes to other popular natural male enhancements ingredients, the scientific evidence is also a little thin:
Ashwagandha is promoted as a natural testosterone booster, most studies only show a small increase in testosterone levels that may not have any impact on sex drive or male health in general.
Ginseng is marketed as everything from a stamina booster to an aphrodisiac, but most research on its effects is low in quality and our understanding of its effects is, according to the National Institutes of Health, “limited.”
Tribulus terrestris is another popular ingredient in testosterone boosters that’s marketed as a natural treatment for ED, but the limited amount of research on its effects as an ED treatment suggests that it has no effects on erectile function.
You can learn more about herbs, vitamins and other men’s sexual health supplements, as well as their purported effects, in our guide to natural home remedies for ED.
ED and PE medications work well on their own, but they’re more effective when you combine them with a healthy lifestyle.
Simple habits, such as staying physically active and eating a balanced diet, can enhance the function of your blood vessels and improve blood flow to your penis, helping you get and stay hard when you’re in the mood for sex.
To get the best results from ED pills, try practicing the following habits:
Keep yourself active by exercising at least five times a week, even if it’s just a walk or bike ride around your neighborhood.
Eat a balanced diet that’s high in complex carbs, lean proteins and fibrous vegetables, all while restricting foods that affect your heart health and blood pressure, such as salt and saturated fat.
Maintain a healthy weight to reduce your risk of developing diabetes, which is a major risk factor for ED.
Quit smoking, which can damage your heart, lungs and blood vessels and affect your sexual performance.
Limit your consumption of alcohol, which can cause “whiskey dick” and stop you from having normal sexual function.
You can learn more about maintaining a better lifestyle for your sexual health in our full guide to maintaining an erection naturally.
While there’s no single pill you can take to improve your sexual function, ED medications and PE treatments can make it easier to stay hard and delay orgasm for long enough to have more satisfying, enjoyable sex.
Combined with healthy habits and plenty of practice, you can use these medications to have a noticeable impact on your performance and confidence in bed.
If you’re comparing pills for treating ED, PE or other forms of sexual dysfunction, make sure to keep the following in mind:
There’s no one-size-fits-all pill for better sexual performance. You’ll get the best results by using medication to treat specific medical conditions, such as ED or PE.
All medications for improving sexual performance can cause side effects. These usually get better with time, but it’s always important to let your healthcare provider know if you get side effects that are persistent or bothersome.
Natural supplements that claim to offer penis enlargement, endless sexual stamina and porn star-level sexual function right away are best avoided. Not only is there no reliable evidence that these pills work, but some may contain unlabeled, unsafe ingredients.
If you suffer from ED and want to start treating it, you can access ED medications online using our telehealth service.
To get started, you can take part in an erectile dysfunction consultation to talk with a healthcare provider about your symptoms and learn about the most effective treatments for you.