Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 8/8/2021
If you’ve searched for male enhancement pills, you’ve probably come across over-the-counter male enhancement supplements that claim to give you a larger penis, rock-hard erections and improved sexual performance in the bedroom.
Many of these products are marketed as natural alternatives to medications prescribed to treat erectile dysfunction (ED) and premature ejaculation (PE).
The dirty little secret behind most over-the-counter male enhancement products is that despite their marketing claims, there’s no real scientific evidence that they work.
However, effective, science-based treatments are available that can help you stay hard when you have sex, last for longer in bed if you’re prone to premature ejaculation and improve certain other aspects of your sexual function.
Below, we’ve discussed the reality of male enhancement pills and the current scientific research that exists on their effects.
We’ve also shared the most effective treatments for erectile dysfunction, premature ejaculation, low sex drive and other common male sexual performance issues.
Before we get into specific pills for improving erections and extending sexual stamina, it’s vital to get one thing out of the way.
When it comes to enhancing sexual performance, there are two different types of pills available: natural, over-the-counter supplements marketed as male enhancement pills, and FDA-approved medications for specific conditions, such as ED and PE.
Many of the pills in the first category make big promises about their sex-related effects, such as more intense orgasms, higher levels of testosterone, enhanced penis size, better blood circulation, increase semen volume, boosted energy levels and a generally better, more exciting sex life.
These supplements’ list of quality ingredients usually contain herbal, natural components like horny goat weed, muira puama, hawthorn berry, black ginger extract and others.
Although over-the-counter supplements are readily available without any need for a prescription, none of them have been shown to be safe or effective for treating issues like ED.
There’s also very limited scientific evidence that these ingredients have any real effects on male sexual performance in general.
More worryingly, some of these male enhancement supplements have been tested and found to contain unlabeled pharmaceutical ingredients, often in excessive doses.
To protect against these ineffective and potentially dangerous products, the FDA maintains a list of male enhancement products that have been found to contain controlled substances, untested or prescription ingredients.
Because of the risks of getting an unsafe, untested or ineffective product, it’s best to avoid male enhancement products sold online, in convenience stores and elsewhere.
While over-the-counter male enhancement pills are generally best avoided, science-based pills are available to treat erectile dysfunction and help you maintain better, stronger erections.
These pills are called PDE5 inhibitors. They work by relaxing blood vessels and increasing the level of blood flow to your penis, making it easier for you to get and keep an erection when you feel sexual arousal
Currently, the FDA has approved several PDE5 inhibitors to treat ED:
Sildenafil. The active ingredient in Viagra®, this is one of the most common medications for treating erectile dysfunction. It lasts for approximately four hours and should be taken around one hour before sex.
Tadalafil. The active ingredient in Cialis®, this is a long-lasting ED medication that lasts for 24 to 36 hours per dose. It’s occasionally referred to as the “weekend pill” for treating erectile dysfunction.
Vardenafil. The active ingredient in Levitra®, this ED medication offers similar effects to sildenafil. It’s relatively fast acting and provides relief from ED for about four to five hours per dose.
Avanafil. Available under the brand name Stendra®, this is a newer ED medication that works in as little as 15 minutes. As a newer medication, Stendra offers a more favorable side effect profile than sildenafil, tadalafil or vardenafil.
These medications all come in tablet form, allowing you to discreetly take them before sex.
Some, such as tadalafil, can be used on a daily basis at a lower dosage, allowing you to enjoy easier spontaneous sex without having to worry about ED.
Unlike male enhancement supplements, prescription PDE5 inhibitors are supported by scientific research. In fact, they’re recommended within the world of medicine as a first-line treatment for erectile dysfunction.
You can learn more about how these medications work in our full guide to the most common ED treatments and drugs.
We offer several FDA-approved erectile dysfunction medications online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
Premature ejaculation is one of the most common forms of sexual dysfunction in men, with data suggesting that approximately 30 percent of men are affected.
Like when it comes to ED, there’s very little scientific evidence that any of the herbal extracts and ingredients used in over-the-counter supplements can treat PE.
However, research shows that some oral and topical medications can slow down the process of reaching orgasm and ejaculating, allowing you to have sex for longer:
Sertraline. This antidepressant is used off-label as a medication for treating premature ejaculation. Research has found that it can significantly increase the ejaculation interval (amount of time before orgasm and ejaculation ejaculation) in men with PE.We offer sertraline for PE online, following a consultation with a healthcare provider who will determine if a prescription is appropriate. You can learn more about how sertraline works in our guide to sertraline as a treatment for premature ejaculation.
Paroxetine. Another antidepressant, paroxetine can also be used on-demand to reduce the severity of PE and improve sexual performance. Research shows that it works well, although it occasionally produces mild, tolerable side effects.We offer paroxetine for premature ejaculation, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
PE sprays and lotions. These products contain anaesthetics that reduce your penis’s sensitivity level and allow you to have sex for longer. For example, our Delay Spray for Men contains the topical anaesthetic lidocaine. Applied a few minutes before sex, these products let you adjust your level of sensitivity so that you can last for longer and have more enjoyable sex.
Some research has also found that medications for erectile dysfunction, such as sildenafil, may also offer benefits for treating premature ejaculation.
As well as treating premature ejaculation and producing harder, stronger erections, many male enhancement supplements are marketed as increasing testosterone levels, boosting sex drive, increasing orgasm intensity and even increasing penis size.
Testosterone is one of the most important hormones for male health. It plays a role in everything from your muscle size and strength to your sex drive, or libido.
While it’s often possible to increase your testosterone production, doing so usually isn’t as easy as taking a herbal extract or pill.
Research has found that some ingredients, such as ashwagandha, zinc, magnesium, vitamin D and the hormone dehydroepiandrosterone (DHEA) may increase testosterone levels in men.
We’ve covered this ingredient list and their effects in more detail in our guide to increasing your testosterone production.
You may be able to find some of these ingredients in men’s health supplements and in certain male enhancement supplements sold over the counter.
Some habits, such as exercising regularly, limiting your alcohol consumption and maintaining a healthy weight, may also help promote optimal testosterone production.
Right now, the only medication that’s clinically used to boost testosterone levels is testosterone itself in the form of testosterone replacement therapy (TRT).
While TRT is effective, it can cause side effects, and it isn’t available over the counter. In order to use testosterone, you’ll usually need to have a low enough testosterone level to be clinically diagnosed with low testosterone.
Currently, there are no supplements or medications available that are proven to make orgasms more intense or sex more pleasurable.
This is one area where science hasn’t yet caught up to public demand. Believe us, if there was a pill that could make sexual activity more intense, exciting and enjoyable, the pharmaceutical industry would make sure we knew about it.
While there’s currently no pill for making orgasms more intense or sex more enjoyable, making certain changes to your lifestyle and sexual habits might make things more pleasurable for you and your partner in the bedroom.
Like with orgasm intensity and sexual pleasure in general, there’s no science-based supplement or medication that can increase penis size.
Currently, the only option for increasing penis size is surgery, with procedures costly and results mixed. We’ve talked about these procedures and their effects, costs and risk of complications in more detail in our guide to penis enlargement surgery.
While some penis pumps might offer a temporary size boost, they don’t appear to actually have any permanent effect on your penis’s length or girth.
As such, it’s best to take any claims about male enhancement pills or other men’s sexual health products “increasing penis size” with a grain of salt.
When it comes to providing harder erections, delaying ejaculation and improving other aspects of your sexual health, there’s little evidence that over-the-counter male enhancement products are effective.
However, FDA-approved ED medications can improve your erections and, if you’re affected by ED, enhance your sexual experience.
Similarly, medications such as sertraline, paroxetine and topical delay sprays are currently the most effective treatments for premature ejaculation.
While over-the-counter male enhancement pills can seem tempting, you’ll get the best results with science-based, proven treatments.
Stick to what works and you’ll be able to get firmer erections, have more stamina and experience better sexual health overall, allowing you to enjoy more fulfilling, satisfying sex with your partner.