Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 4/27/2021
Search online for “sexual performance pills” and you’ll find hundreds of enhancement products, herbal supplements and other tablets that claim to enhance your stamina, increase the size of your penis and treat common issues like erectile dysfunction (ED).
While many of these products make big claims, the science behind sexual performance pills is mixed at best.
Some, like FDA-approved medications for erectile dysfunction and premature ejaculation (PE), are backed up by real studies showing that they work.
Others, like most of the herbal supplements sold online, in sex stores and in gas stations, aren’t backed up by much of anything.
Below, we’ve looked into the science behind sexual performance pills and explained what works and what likely doesn’t.
We’ve also listed specific medications that you can use to enhance your erections, stamina and other aspects of your sexual performance.
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.
These medications are designed to make it easier to get and maintain an erection during sex. They’re very effective, but require a healthcare provider’s prescription.
We offer sildenafil, tadalafil and several other ED medications online, following a private consultation with a licensed healthcare provider.
We also offer sertraline for premature ejaculation, as this medication is sometimes used off-lable to help control climax and enjoy sex longer.
Since several different sexual performance pills are available to treat a variety of issues, there’s no one-size-fits-all process that they follow to improve your performance in bed.
Instead, different treatments for sexual performance work by targeting specific aspects of your body that are affecting your sexual performance.
For example, most medications for erectile dysfunction work by limiting the effects of the PDE5 enzyme, which regulates the flow of blood to your penis.
Since erections are all about healthy blood flow, this can make it easier for you to get and keep an erection when you feel sexually aroused.
Others, such as some medications used to treat premature ejaculation, were originally used to treat other conditions, but offer secondary benefits for sexual performance.
For example, some SSRIs that are used to treat premature ejaculation are mostly prescribed to treat depression.
In studies, researchers found that these medications were effective at delaying ejaculation and improving sexual performance in men with PE. As such, some are now prescribed off-label specifically to prevent premature ejaculation and improve sexual stamina.
It’s worth noting that not every aspect of your sexual performance can be improved with a pill or other product.
For example, despite the claims made by some male enhancement pills, there’s no medication or supplement that can increase the size of your penis.
Likewise, while some medications can help you to get an erection when you’re aroused, they’re not necessarily treatments for issues like low sexual desire.
As such, it’s important to keep your expectations realistic when it comes to sexual performance treatments. While some aspects of your sexual performance can be improved with medication, others can be a little more complicated.
Although not all aspects of your sexual performance can be improved with medication, proven treatments do exist for issues like erectile dysfunction and premature ejaculation.
Used correctly, these medications can help you to get and stay hard during sex and last longer before you reach orgasm and ejaculate.
Below, we’ve listed the best medications for treating erectile dysfunction, premature ejaculation and other sexual performance issues.
For each medication, we’ve explained the basics of how it works, as well as how you can use it to improve your performance in bed.
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 several potential causes.
According to the National Institutes of Health, approximately 30 million men in the United States are affected by some degree of erectile dysfunction.
Currently, the most effective pills for improving your erections and treating ED are medications called 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 enhance blood flow to your penis, making it easier to get and maintain an erection.
We’ve gone into more detail about this process and how these medications work in our guide to PDE5 inhibitors.
Sildenafil is a fast-acting, popular medication that treats ED. It’s available under the brand name Viagra and as a generic medication under a variety of different names.
For best results, sildenafil should be taken 30 to 60 minutes before sex. On average, it works for about four hours, although its effects are usually strongest during the first one to two hours.
Sildenafil is a safe medication for most men. However, like all medications, it may cause certain side effects. For the most part, these side effects are mild and only occur while the medication is active in your body.
Our complete guide to sildenafil side effects goes into more detail about the most common side effects of this medication.
Tadalafil, the active ingredient in Cialis, is a long-lasting ED medication. In fact, it provides relief from ED for up to 36 hours per dose -- roughly nine times as long as sildenafil.
Because of its long-lasting effects, tadalafil is sometimes referred to as the “weekend” treatment for erectile dysfunction.
Tadalafil should be taken approximately one hour before sex. Like sildenafil, it can cause certain side effects and may interact with other medications.
Vardenafil, the active ingredient in Levitra®, is a relatively fast-acting ED medication with similar effects to sildenafil.
On average, vardenafil starts to work in 60 minutes and provides relief from erectile dysfunction for approximately four to five hours.
The side effects of vardenafil are similar to those of other ED medications, including headaches, flushing, nasal congestion and indigestion.
Avanafil, sold under the brand name Stendra®, is a newer-generation ED medication that starts working quickly and is less likely to cause certain side effects than older drugs.
Compared to sildenafil, tadalafil and vardenafil, avanafil has several key differences:
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 ED medications.
Premature ejaculation is another common sexual performance issue for men. Although precise numbers vary, research suggests that between four and 39 percent of men deal with premature ejaculation at some point in life.
Right now, the most effective treatments for premature ejaculation are antidepressants such as sertraline and topical sprays that work by reducing the sensitivity of your penis.
Sertraline is an antidepressant. It belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs.
Although sertraline is usually prescribed to treat depression, it’s also used off-label to slow down intravaginal ejaculation latency -- a medical term for the average amount of time it takes for you to reach orgasm and ejaculate during sex.
Several studies have found that men who use sertraline are less likely to ejaculate early during sex.
For example, in one study, men with a mean ejaculation time of one minute were treated with sertraline at a dosage that increased from 25mg per day to 100mg per day over a period of six weeks.
At the lowest dosage of 25mg, the men’s mean ejaculation time increased to 7.6 minutes. At a dosage of 50mg, the men’s mean ejaculation time increased to 13.1 minutes.
The 100mg dosage produced the longest mean ejaculation time, at 16.4 minutes. However, at this dosage, some of the men found it difficult or impossible to ejaculate during 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 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. Like sertraline, these medications are only available with a prescription from a licensed healthcare provider.
Although they’re technically not sexual performance pills, sprays and topical creams are widely used to treat premature ejaculation.
These products, such as our Premature Ejaculation Spray, work by altering the sensitivity level of your penis. This allows you to have sex for longer, all without your penis feeling overly numb or uncomfortable.
Like with other treatments for premature ejaculation, research shows that sprays can increase ejaculation latency. For example, one small study found that men’s average time to ejaculation increased from under two minutes to more than 11 minutes after using a lidocaine spray.
Our full guide to how lidocaine sprays work goes into more detail about using this type of spray to improve your sexual performance.
While there’s no single pill that you can take to improve your sexual performance, medications like sildenafil, tadalafil and others can treat ED and make it easier for you to get and stay hard during sex.
Similarly, medications like sertraline may increase your stamina if you’re affected by premature ejaculation.
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