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Male enhancement pills have not been proven by research to improve sexual performance. Instead, erectile dysfunction medications can be a more effective alternative. Here’s a look at the best options.

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If you’re seeking ways to increase your penis size or libido, you may be interested in taking male enhancement pills. But while these products often advertise penis enlargement and enhanced performance, there’s limited research supporting these claims.

A 2021 study found that the average erect penis is between 5.1 and 5.5 inches, or 12.95 and 13.97 centimeters. Typically, a penis is only considered atypically small if it measures less than 3 inches when erect. This is known as a micropenis.

If you’re interested in finding the best male enhancement pills because you’re having difficulties having or maintaining an erection during a sexual encounter, you should speak with your primary care doctor or a urologist to determine if erectile dysfunction (ED) could be the reason.

While ED is most common among older men, a 2017 study suggests that as many as 30 percent of men seeking treatment for newly diagnosed ED are under 40 years old.

The male enhancement pills that are available on the market today are often labeled as dietary supplements. They claim to increase blood flow to the penis in order to increase the duration of an erection. They also claim to boost overall arousal, stamina, and performance.

Many male enhancement pills use a combination of natural ingredients, which can include:

  • ashwagandha, a shrub typically used in Ayurvedic medicine
  • maca root, a native Peruvian plant
  • Yohimbe extract, a Western African herbal supplement
  • black ginger extract, the stem of a Thai plant called Kaempferia parviflora

Individually, popular belief claims the effectiveness of these ingredients. For example, a 2016 study found that black ginger extract increased physical fitness performance and muscular endurance, though it was performed on mice. So, there isn’t a ton of research that supports how effective they really are.

But there’s no data to directly support the effectiveness of male enhancement pills.

“I always caution patients about these medications, as many of them haven’t been studied in a controlled manner,” says E. Charles Osterberg, MD, FACS, a board certified urologist.

Because most male enhancement pills are not approved by the U.S. Food & Drug Administration (FDA), there’s no scientific evidence to back up their claims.

While there have been studies on similar ingredients and their effectiveness in treating ED, the research does not support the effectiveness that male enhancement pills claim to have.

A slightly older 2011 study on the effectiveness of ashwagandha in treating psychogenic ED found that the medicinal herb was not effective.

According to Osterberg, psychogenic ED is when the erectile tissue and properties work just fine, “but there may be some other reason why that individual’s having trouble with erections, whether it be performance anxiety, stress, or situation related.”

Even in the case of psychogenic ED, it’s best to consult a doctor who can recommend the best next steps.

The FDA released a warning about nearly 50 male enhancement and weight loss products (which are not FDA approved) available to purchase through online marketplaces that contain hidden ingredients. Of those products, 80 percent contained undeclared active pharmaceutical ingredients.

The FDA also maintains an updated list of tainted sexual enhancement products on its website.

The risks of taking male enhancement pills are high. Many male enhancement pills aren’t transparent about their ingredients. Taking pills with unknown ingredients could result in serious side effects, especially if they interact with other medications or supplements you’re taking.

Before trying any new supplements or herbal medicines, you should speak with a doctor to determine what ingredients are in them and how they could potentially affect you — especially if you’re taking other medications.

A note on supplements

Prescription medications go through rigorous testing and approvals before they’re first available to people at a pharmacy. However, the same is not true for dietary supplements. Male enhancement pills fall into this category as well.

In fact, the FDA doesn’t review dietary supplement products or determine their effectiveness before they’re available on the market.

The FDA can, however, take dietary supplements off the market if they are found to be unsafe. It can also force a stop on product sales if any marketing claims are found to be false or misleading.

That leaves the responsibility of producing safe, reliable supplements to the manufacturers and distributors. The FDA stands behind no claims made by these supplement companies.

Erectile dysfunction medication

If you’re experiencing difficulties achieving or maintaining an erection, speak with a doctor about getting a prescription for an ED medication, such as Viagra, Cialis, or Levitra.

These medications are proven to be effective in the treatment of ED. In an older but widely cited 2002 study on the effectiveness of sildenafil (the active ingredient in Viagra), 95 percent of participants reported it improved their ability to engage in sexual activity.

Hims

Hims offers several ED medications, including pills for one-time use and those for daily use. Hims carries brand names, like Viagra and Cialis, and the generic versions — sildenafil and tadalafil.

After completing an evaluation and connecting with one of their medical professionals, your treatment will be delivered directly to you.

Cost: A $5 fee is charged with each first purchase. The cost for Hims products will vary depending on the type of medication you’re wanting, whether it’s a brand name or generic, and how many pills you’re buying. Hims gives these starting points for prescription prices:

  • Sildenafil (generic for Viagra): from $3 per use
  • Viagra: $70 per use
  • Tadalafil (active ingredient in Cialis): $82 per month
  • Cialis: $958 per month
  • Stendra (avanafil): from $53 per pill

Safety: The prescription drugs offered by Hims are FDA-approved medications. They must be prescribed by a licensed medical professional. However, Hims does sell other nonprescription items that have not been approved by the FDA.

How to use: Depending on the medication prescribed, you will take the pills daily or within a few hours of intercourse.

Hims pros

  • Convenience. Hims is a telemedicine company. You can make and take appointments right from your home or office. In one interaction, you can be seen by a healthcare professional, get a prescription, get a treatment plan for taking the medication, and purchase the pills.
  • Privacy. The telemedicine appointment can be done in the privacy of a home or office.
  • Access. Hims providers are trained in treating and addressing ED issues. This allows you access to knowledgeable medical professionals from whom you can get medication and answers to your questions.
  • Prompt attention. Most people will be able to make an appointment within 24 hours of requesting to be seen. What’s more, shipments are typically dispatched for delivery within a week of placing the order.

Hims cons

  • Price. Hims does not accept commercial insurance, so you’re responsible for paying for the pills as an out-of-pocket expense. Depending on the treatment you and the medical professional select, this could be quite costly.
  • Limited care. The Hims medical professionals are not a replacement for an in-person provider that can deliver comprehensive care.
  • Information security. Hims promises to keep information confidential, but to be seen and get a prescription, you must give the company a great deal of information, including a scanned photo ID and details of your medical history.

Lemonaid

Lemonaid offers Viagra, Cialis, and Cialis Daily, as well as generic sildenafil and tadalafil to treat ED. After choosing which medication you’re interested in getting prescribed, you’ll need to answer a health questionnaire. You’ll also need to take your blood pressure and fill in your blood pressure reading.

Lemonaid’s medical team will review your info, and you may be required to meet over video, depending on your state.

Cost: You will pay a one-time $25 fee for your first visit. After that, your prescription costs are:

  • Sildenafil (generic for Viagra): from $2 per pill
  • Viagra: $25-65 per pill
  • Tadalafil daily (active ingredient in Cialis): $50
  • Tadalafil: $65 per 10 pills

Safety: Lemonaid Health’s prescription medications are FDA-approved pills that are packaged and delivered in the United States.

How to use: The ED medications can be taken daily or within hours of intercourse. The right type of medication for you will depend on your lifestyle and health history. A Lemonaid doctor or licensed healthcare professional will use your health history and symptom history to decide on the best medication for you.

Lemonaid pros

  • Convenience. Your symptom history and requests are reviewed quickly, and any follow-up questions are sent within 24 hours. This means you can be seen and get a prescription in a matter of days, not weeks.
  • All-in-one service. Lemonaid will connect you with a healthcare professional who can prescribe an ED medication. You can then send the prescription to Lemonaid’s pharmacy for quick delivery.
  • Safe. Reputable companies like Lemonaid provide legitimate medications. ED drugs available on the internet can often be sold by companies that are not reputable and be counterfeit.

Lemonaid cons

  • Not a substitute for comprehensive care. Telemedicine appointments are handy when you’re busy, but an in-person visit with a doctor or other healthcare professional may be more beneficial in the long run. They may be able to help identify other issues that could be causing or contributing to ED.
  • Price. Lemonaid health does not accept commercial insurance. However, they will work with you to send prescriptions to local pharmacies that do accept your insurance.

Roman

Roman offers both brand-name and generic versions of Viagra, Cialis, and Cialis Daily.

After a free online evaluation, users will receive a follow-up message in a secure portal from a medical professional to prescribe treatment. Ongoing follow-ups and treatment adjustments are free.

Cost. The consultations at Roman are free, but there are prescription costs:

  • Sildenafil (generic for Viagra): from $2 per pill
  • generic Viagra: $34 per pill
  • Viagra: $70 per pill
  • Tadalafil (active ingredient in Cialis): from $11
  • Tadalafil daily: $8 per month
  • Cialis: from $17 per dose
  • Cialis daily: $13 per month

Safety. Roman acts as the connection between you and a healthcare professional. You will submit a questionnaire, and then you’re scheduled for an appointment with a doctor or other healthcare professional. The ED pills are FDA-approved drugs, which provides reassurance that you’re not purchasing counterfeit medications.

How to use. When you take the medication will depend on the type of medication the medical professional prescribes for you. Some ED medications are taken daily. Others should be taken within a few hours of intercourse.

Roman pros

  • Convenience. Ro, the parent company of Roman, began as a concierge service for making appointments. They still do that with Roman, connecting people with healthcare professionals who can prescribe ED medication. In most cases, you can only meet with the medical professional online, not in person.
  • Cost. Most consultations for ED treatment are free, as are follow-up appointments.
  • Automatic refills. You can enroll in automatic prescription refills to help avoid missing a dose or not having access to your medication when you need it.

Roman cons

  • Fewer drugs. Roman does not carry all the prescription ED medications other brands may offer. If you’re looking for a particular product, such as avanafil (Stendra), you may need to find another telemedicine provider.
  • Price. Roman does not accept commercial health insurance, so it may be more expensive than medications that are dispensed by your local pharmacy.
  • Limited availability. Roman as a telemedicine provider for erectile dysfunction treatment is not available in South Carolina or North Dakota.

Wearable devices

Eddie by Giddy

If you’re looking for a noninvasive option, consider a wearable device like Eddie by Giddy.

Eddie is an FDA-registered class II medical device. The tension band is designed to trap blood flow in the penis to maintain a longer erection. It should be removed after 30 minutes of wear.

The band comes in four sizes, and the open-bottom design is designed to protect the urethra and avoid injuries.

Cost. $150–$190 per device; subscriptions available

Safety. Eddie is a Class II medical device. (That means it is registered with the FDA, but it’s not approved by the agency.) Class II devices have fewer requirements than Class I devices. For example, human testing is not required. However, some people prefer to use devices over medications because of the lower potential for side effects when properly used.

How to use. Place the Eddie at the base of the penis, in front of the testicles. Turn the U-shaped device upside down and wrap a tension band around the ends. The red band provides the most tension; the blue band is less tight.

Eddie by Giddy pros

  • Fewer side effects. ED medications are not for everyone. Possible drug interactions and side effects may keep some people from using them. Devices like Eddie may pose fewer risks if used correctly for some people.
  • Comfortable design. The Eddie is designed to be comfortable for the person wearing it. It also has added features for stimulating partners.
  • Customer care. The company promises to help customers find the right fit among their ring sizes.

Eddie by Giddy cons

  • Price. Compared to other penis rings (about $20), the Eddie is quite expensive. Insurance does not cover the cost of the device.
  • Stretches with use. The Eddie will have to be replaced every few months because it stretches and will no longer provide proper tension.
  • Difficult to put on. Most penis rings slide onto the penis, but Eddie requires both hands to hold the ring in place and wrap the tension bands around the ends.

Surgery

Penile surgery is only recommended for functional reasons, like correcting a developmental issue or treating an injury. Surgery is not recommended for lengthening, implants, or cosmetic purposes.

In fact, there’s no surgical way to truly lengthen the penis. There’s a procedure that involves cutting the suspensory ligament of the penis. This can lead to an apparent increase in length, but without this ligament, the penis is no longer tethered to the pubic bone and has no anchor, so to speak.

Penile prosthesis surgery is sometimes done for severe cases of ED, but this does not lengthen the penis and will leave the head of the penis flaccid. In many cases, a penile prosthesis can actually result in some penile shortening, although newer models have tried to address this issue.

Penile surgery for correction of severe curvature can actually lead to penile shortening.

Cost: The cost of surgery will depend on several factors, including:

  • type of surgery
  • insurance coverage (if any)
  • whether medical professionals have in-network designation
  • your deductible or copayments
  • where you live

Safety: All surgeries carry some risk. Most surgeries for erectile dysfunction are designed to correct an issue, not enlarge the penis or lengthen it. The pro/con balance may depend on how much the development issue or injury interferes with your day-to-day life or your sexual function. If either is significantly impacted, surgery may be the best option, despite the risks.

Penile surgery pros

  • Purpose. Most penile surgeries treat an injury or correct an issue, such as a curve or bend, that may interfere with proper function.
  • Restore use. These surgeries may help you regain use of your penis or the ability to have intercourse without pain or difficulty.

Penile surgery cons

  • Cost. Most commercial insurance plans will not cover penile surgery unless it’s the result of a medical issue, like an injury or bend. Surgery for enlargement or cosmetic purposes will not be covered, which can lead to a very expensive bill.
  • Side effects. Surgery is a serious treatment choice. Immediate issues may include pain and swelling, as well as difficulty achieving an erection. As the penis and surrounding tissue heal, however, these issues should resolve.

Vacuum pumps

Vacuum pumps, also known as penis pumps, are tubes that fit over the penis and remove air, which increases blood flow to achieve an erection. This device can temporarily make your penis appear larger, as it causes swelling.

But if it’s not used correctly or used too frequently, the vacuum pump runs the risk of damaging the elastic tissue. This can affect erections long term.

Extender device

An extender, or penile traction device, is noninvasive and designed to stretch the penis. A 2020 study reported participants saw an increase of less than 2 centimeters after using a penile extender.

But not enough research has been done on the safety of these devices. Long-term use could potentially cause bruising or nerve damage from too much stretching.

Lotions

Male enhancement lotions and creams often contain similar ingredients as male enhancement pills, like herbs and vitamins.

There’s no evidence to prove these lotions are effective. Depending on the ingredients, they may even be harmful, and they could potentially result in serious side effects or skin reactions.

Since there’s a large risk involved when taking male enhancement pills, we do not recommend adding any new supplements to your diet without consulting a doctor or primary care practitioner first. There are safer alternatives to male enhancement pills, like doctor-prescribed ED medications and wearable devices.

Regardless of your age, if you are experiencing the symptoms of ED, it’s worth talking with your doctor to discuss your options and investigate what might be causing this recent change. ED can develop as the result of a physical health issue, a mental health concern, or a sudden change to your lifestyle and routine.

Talking with your doctor to rule out some of the more common causes of ED can help them get a better idea of what treatment options might work best for you. For example, while Viagra and Cialis are two of the most popular medications for ED, if your symptoms are stemming from a change in your nutition, increased stress at home, or depression, than a PDE5 inhibitor like Viagra and Cialis isn’t likely to help you.

If you are also considering adding herbal supplements or male enchancement pills to you daily routine, it’s a good idea to talk with your doctor first. They will have a better understanding of their effectiveness and how they stack up against other treatments. In fact, if there are ingriedents that your doctor thinks that you would benefit from taking, they may be able to recommend and offer it to you in a safer and better regulated form.

Do male enhancement pills work?

This depends on what type of male enhancement pill you’re referring to. FDA-approved medications, like Viagra and Cialis, have been shown to be very successful in the treatment of ED.

Other enhancement pills, such as those that claim to improve sexual performance or increase penis size, have not been shown to be successful in research. What’s more, many of these medications are not regulated by the FDA, and they may contain a dangerous combination of ingredients.

Is it OK to buy male enhancement pills online?

No, many online pharmacies and stores are often marketing counterfeit pills. These pills are unsafe, unregulated, and untested.

For example, a 2017 report says that many of these fake pills may have inaccurate amounts of the active ingredients. This can be dangerous without the proper warnings, and it may cause unintended side effects.

If you’re looking to take medication to improve sexual performance, speak with a doctor or other healthcare professional about legal, prescription options.

Are male enhancement pills safe?

The male enhancement pills prescribed by a clinician and provided by a licensed pharmacy are safe. These pills are FDA approved and regulated.

Other male enhancement pills may not be safe. These pills are often considered dietary supplements, and they have not been reviewed or tested by the FDA. They could interact with medications you’re taking. They may also contain dangerous combinations of ingredients.

What are the side effects of male enhancement pills?

Like any medication, male enhancement pills can cause side effects. The most common include:

These pills can also interact with other medications you may be taking. If you experience any issues when taking male enhancement pills, stop taking the pills, and consult your doctor.

There’s no evidence to prove that male enhancement pills work to increase penis size or improve performance. Many pills can actually be harmful since some brands are not fully transparent about their ingredients.

If you’re experiencing issues with achieving or maintaining an erection, you may have ED and should speak with a medical professional to determine treatment options. There are several ED medications available, and they all require a prescription.

It’s always a good idea to speak with a primary care physician, a urologist, or other healthcare professional before trying new medications or if you feel like you may be experiencing ED. ED can be an indication of an underlying medical condition.