Reviewed by Kristin Hall, FNP
Written by Nicholas Gibson
If you’ve ever searched for information about enhancing your sexual performance, you’ve likely come across reviews and advertisements for fast-acting “male enhancement” pills.
These pills, which often contain herbal ingredients, are marketed as treatments for issues such as erectile dysfunction (ED), premature ejaculation (PE) and other common complaints related to sexual performance.
Many of these supplements also claim to make your penis larger, enhance your semen volume and offer other sexual benefits.
Unfortunately, most of the claims made about male enhancement products aren’t supported by any scientific evidence. Investigations have also shown that many over-the-counter pills make use of unlabeled, potentially dangerous ingredients.
However, real, science-based treatments are available for common sexual performance issues such as ED and PE. Below, we’ve explained what’s available, as well as which options offer the fastest relief and biggest sexual health benefits.
The term “male enhancement” is used to promote a range of different products, including pills that claim to improve erections, stop premature ejaculation and promote penis enlargement — basically, they claim to improve your sex life in general.
As we’ve discussed in our guide to the best male enhancement pills, most of the male sexual enhancement supplements available online and over-the-counter (like Extenze, ProSolution Plus, or VigRX Plus) aren’t backed up by any real scientific research.
If you’d like to treat erectile dysfunction and improve your sexual health, the best options are science-based, Food and Drug Administration-approved ED medications such as sildenafil (Viagra®), tadalafil (Cialis®), avanafil (Stendra®) and others.
These medications typically start working in less than an hour. Some even begin to work in as little as 15 minutes.
We offer a range of ED medications online, following a consultation with a healthcare provider to discuss your symptoms and determine if a prescription is appropriate.
Male enhancement pills or male enhancement supplements can seem appealing. Most are marketed aggressively using bold claims about their effects on your sexual performance — such as promising intense orgasms, revved-up sexual desire, or an increase in penis size, sometimes even with a money-back guarantee.
They’re also available without any need to get a prescription, making them easier to access than proven ED medications. Behind the suggestive ads and online testimonials, the reality of these “sex pills” is that very few are backed up by real science.
As such, any claims about being “fast-acting” or “highly effective” should be treated with a large amount of skepticism.
It’s important to understand that most of these products are dietary supplements, not medications or prescription drugs. They contain natural ingredients such as horny goat weed, maca, tribulus terrestris or ginseng.
This means that they’re regulated by the FDA as food and, unlike medications, don’t need to back up their marketing claims with real evidence from clinical trials and other tests.
We’ve talked about this topic more in our guide to the best male enhancement pills, with specific examples of popular male enhancement products.
Now, this doesn’t mean that it’s not possible to enhance your sexual performance or treat issues like erectile dysfunction or premature ejaculation.
Proven, science-based treatments for these issues are available and often have been for a long time.
However, they’re medications, not supplements. This means that you’ll need to talk to a licensed healthcare provider before you can purchase and use them. You can even talk to a hims healthcare provider right here on our platform.
We’ve listed these options below, with sections for common sexual performance issues such as erectile dysfunction, premature ejaculation and low sex drive.
The fastest-acting, most effective treatments for erectile dysfunction are medications referred to as PDE5 inhibitors.
These medications increase blood flow to the blood vessels in your penis, making it easier for you to get and maintain an erection when you feel sexually aroused.
Currently, the FDA has approved four PDE5 inhibitor medications for erectile dysfunction, all of which are available in pill form. They are:
Sildenafil. This is the active ingredient in Viagra. It’s available as a generic medication and typically works for about four hours per dose. Research published in the British Journal of Clinical Pharmacology shows that sildenafil (generic Viagra) starts working in 30 minutes for most people.
Vardenafil. This is the active ingredient in Levitra®. Like sildenafil, it’s also available as a generic medication. Research published in The Journal of Sexual Medicine shows that vardenafil starts working in 30 minutes or less.
Tadalafil. This is the active ingredient in Cialis. It’s also currently available as a generic medication. Tadalafil is a long-lasting ED medication that can provide relief for up to 36 hours per dose.
According to an article published in the journal, Therapeutics and Clinical Risk Management, tadalafil is slightly slower-acting than other ED medications and should be taken 30 to 60 minutes before the time you plan to have sex. In some cases, it may take as long as two hours for tadalafil to start working.
Avanafil. This is the active ingredient in Stendra. It’s a relatively new ED treatment and isn’t available as a generic. As a newer medication, avanafil is less likely to cause some side effects than older medications used to treat ED.
Avanafil is currently the fastest-acting medication for ED, with studies published in the Journal of Urology finding that it starts working in as few as 15 minutes.
These medications are easy to use and ideal if you often find it difficult to get or maintain a firm enough erection for satisfying penetrative sex. Our guide to what to expect from ED medication explains more about how these medications work and their potential side effects.
We offer a wide range of ED medication online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
The more affordable FDA-approved medication that treats Erectile Dysfunction at a quarter of the cost. 🙌
Affordable and helps get the job done. Generic Cialis helps you get and maintain your erections through a simple, daily dosage.
Cialis helps you get and keep stronger erections with a daily or as-needed pill.
Many male enhancement pills claim to increase your sexual stamina, allowing you to have sex for longer before you reach orgasm and ejaculate.
Just like with ED, there’s very little convincing evidence that the herbal pills sold in gas stations, convenience stores and online have any effect on your ejaculation latency time -- the amount of time that passes between the start of sex and ejaculation.
However, several proven, science-based medications are available that can treat PE and allow you to have sex for longer. These include:
Sertraline. Sertraline is a selective serotonin reuptake inhibitor, or SSRI. It's mostly used to treat depression, but is also an effective off-label treatment for premature ejaculation. It comes in pill form and can be used every day or as-needed before you have sex.
Numerous studies have found that sertraline helps to delay ejaculation.
In one study published in the International Journal of Impotence Research, a small group of 46 men affected by PE increased their average time to ejaculation during sex from only one minute before treatment to 13.1 minutes with a 50mg dose of sertraline.
Although sertraline is effective, it isn’t particularly fast-acting. In general, it’s best to take it on a daily basis or, when used as needed, four to eight hours before you plan to have sex.
We offer sertraline for PE online as a premature ejaculation treatment. You can find out more about how it and other premature ejaculation medications work in our detailed guide to premature ejaculation pills.
Premature ejaculation spray. While sprays and creams are not male enhancement pills per se, several topical sprays are available that reduce your penis’ sensitivity level and allow you to last for longer in bed.
These sprays use ingredients such as lidocaine, which are absorbed quickly by your skin and provide fast, noticeable effects. This makes them a good option for as-needed use if you suffer from PE.
Our Premature Ejaculation Spray, which contains the active ingredient lidocaine, can be applied five to 10 minutes before sex.
As a man, testosterone plays a major role in your physical and mental wellbeing. It’s also one of the most vital hormones for promoting a healthy sex drive, according to the book, StatPearls. In fact, research shows that men with low levels of testosterone often have a low level of interest in sex.
Many male enhancement pills claim to rapidly increase your testosterone levels and strengthen your libido.
There’s some evidence that certain herbal ingredients, such as zinc, ashwagandha and others, may boost testosterone. We’ve talked about these more in our detailed guide to increasing your testosterone levels.
However, none of these ingredients are fast-acting, meaning you won’t be able to take a pill just before sex and experience an immediate testosterone boost.
If you have clinically low testosterone, you may be able to increase your testosterone levels via testosterone replacement therapy (TRT). This involves using pills, patches, gels or an injectable form of testosterone to supplement your body’s own testosterone production.
While TRT is effective, it can cause side effects. Our guide to testosterone replacement therapy discusses these and other effects of TRT in more detail.
There’s a great deal of misinformation out there regarding the safety and efficacy of male enhancement pills.
There are always risks involved when using medications or supplements, so it’s important to do your research before you try anything new.
We strongly caution against taking over-the-counter male enhancement supplements, especially products you find advertised online.
In fact, the FDA issued a consumer update about the risks of male enhancement products sold online.
Here are some of the potential risks associated with male enhancement pills:
Unknown ingredients. Many male enhancement supplements make generic claims linked to specific ingredients, but they may not list all of the ingredients in the product. You should always exercise caution when taking supplements because they could contain ingredients you’re allergic to or ingredients the FDA has deemed unsafe.
Unclear ingredient concentrations. An FDA report revealed that many male enhancement supplements on the market contain sildenafil, the active ingredient found in Viagra. Because these supplements often don’t disclose the concentration of that ingredient, however, it could lead to negative reactions — particularly if you have a health condition.
Potential drug interactions. Not only can some of the ingredients in male enhancement pills be dangerous, but they could interact with other medications you’re taking. Many online manufacturers don’t clearly list the active and inactive ingredients. If you’re already taking medication for other health issues, it’s very risky to add a supplement unless you know exactly what’s in it.
Dangerous side effects. Some male enhancement supplements may not be quite clear when it comes to ingredients and manufacturing methods, so it’s hard to gauge the risk for side effects. Suffice it to say that if you don’t know what’s in the product, you can’t predict how your body will react and it’s probably better not to take the risk at all.
Generally speaking, the risks do not seem to outweigh the potential benefits when it comes to male enhancement supplements.
When it comes to FDA-approved medications, however, there’s enough evidence out there that you can have an informed discussion with your healthcare provider to weigh the pros and cons in your situation.
If you’re thinking about trying male enhancement pills, we encourage you to exercise a certain degree of caution.
A disclaimer: not only do over-the-counter male enhancement remedies come with a risk for negative side effects, but some of the products out there are more than a little sketchy.
How do you know who to trust? What can you do to avoid falling for a scam?
Look for the following red flags when shopping for on-demand male enhancement products to avoid falling victim to a scam that, at best, doesn’t produce the desired result and, at worse, could harm you:
Promises of immediate results. You should always regard promises of immediate results with a healthy dose of skepticism, regardless of the product. When it comes to male enhancement, consider that it takes time for a supplement to enter your bloodstream and produce the desired result. It simply isn’t practical to expect a male enhancement product to deliver results in under an hour, let alone within minutes.
Not made in the USA. This is not a red flag you should ignore. If the product isn’t made in the USA, that means it isn’t subject to FDA regulations. It may contain dangerous ingredients and the production methods could be sub-standard.
Spammy advertisement methods. If you only heard about the supplement because you received a spam email, it’s probably not something you should trust. Stick to companies that operate with transparency and that don’t rely on tricking consumers into buying their products.
Marketed as an alternative to Viagra. When you come across a male enhancement product marketed as an alternative to FDA-approved drugs like Viagra, you should ask yourself why, if the product is so effective, the company hasn’t applied for approval.
Incomplete list of ingredients. You should never put something in your body unless you know exactly what it is. Don’t trust a natural male enhancement supplement that doesn’t include a full list of ingredients and be sure to check the list for ingredients deemed unsafe by the FDA.
Checking for red flags is an important step in avoiding scams and potentially dangerous products, but it’s important to know exactly what you’re buying as well.
Remember, scientific evidence doesn’t support the use of supplements to physically increase the length or girth of the penis. If you’re struggling to achieve and/or maintain an erection, however, medically approved treatments could help.
Although most male enhancement products aren’t supported by any scientific evidence, several fast-acting, science-based medications are available to treat erectile dysfunction and premature ejaculation.
If you’d like to use these medications, you can talk to a healthcare provider online to learn more about treating erectile dysfunction online.
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.