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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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Valentina Barreto/Stocksy United

If you’re seeking ways to increase your penis size or libido, you might 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 review of studies 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 under 3 inches when erect. This is known as a micropenis.

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

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

The male enhancement pills available on the market today are often labeled as dietary supplements. They claim to increase blood flow to the penis 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.

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% of participants reported it improved their ability to engage in sexual activity.

Wearable devices

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.
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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% 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.

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’re experiencing symptoms of ED, discuss your options with your doctor 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, if your symptoms stem from a change in your nutrition, increased stress at home, or depression, then a PDE5 inhibitor like Viagra and Cialis isn’t likely to help you.

If you’re also considering adding herbal supplements or male enhancement pills to your daily routine, it’s a good idea to talk with your doctor first.

Your doctor will have a better understanding of their effectiveness and how they stack up against other treatments. In fact, if there are ingredients that your doctor thinks that you would benefit from taking, they may be able to offer it to you in a safer, better regulated form.

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.

While many of these enhancement pills make bold claims about making you last longer or perform better during sex, the truth is that there isn’t enough substantial evidence to back up these claims.

In addition, many of these over-the-counter pills face less intense scrutiny by the FDA, which means that the ingredients and their amounts listed on the label may not be accurate and could contain hidden ingredients.

If your erections are not as strong as they used to be or it takes you longer to become erect, it may be worth meeting with your doctor to discuss what you have been experiencing. It may be possible that you’re experiencing changes in how blood flow to your penis, which would result in a less strong erection.

Your doctor may recommend a proven erectile dysfunction medication instead of male enhancement pills.

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.

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

  • back pain

  • muscular pain

These pills can also interact with other medications you may be taking.

No, many online pharmacies and stores often market 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.

Because most male enhancement pills are not approved by the Food and 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.

While a 2018 review did find that ashwagandha could improve sperm count and motility — which could help treat infertility — evidence that it improves ED symptoms or improves sexual performance is still lacking and requires further research.

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.