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Be ready for sex whenever you're in the mood
Reviewed by Kelly Brown MD, MBA
Written by Geoffrey C. Whittaker
Published 04/04/2021
Updated 04/14/2024
If you’ve ever searched for information about enhancing your sexual performance, you’ve likely come across so-called fast-acting “male enhancement” pills, often containing herbal ingredients marketed as treatments for erectile dysfunction (ED), premature ejaculation (PE) and other common sexual performance issues.
Many of these supplements also claim to make your penis larger, enhance your semen volume and offer other benefits. But can you actually buy pills to get hard fast over the counter? And are they actually safe?
Unfortunately, most of the claims made about male enhancement products aren’t supported by scientific evidence. 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.
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Male enhancement products are a vague group of products that some often mistakenly associate with FDA-approved drugs like Viagra. It’s all a bit confusing, so here’s a cheat sheet to understanding what’s being marketed to you:
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. 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.
Investigations have also shown that many over-the-counter pills make use of unlabeled, potentially dangerous ingredients.
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 from their bold claims about intense orgasms, revved-up sexual desire or an increase in penis size. Sometimes they even come with a money-back guarantee — very intriguing.
They’re also available without a prescription, making them easier to access than proven ED medications. Behind the suggestive ads and online testimonials, though, the reality of “sex pills” is that very few are backed up by real science.
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 many have been on the market 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.
Read on to learn more about treating sexual performance issues such as erectile dysfunction, premature ejaculation and low sex drive.
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; studies published in the Journal of Urology suggest that it starts working in as few as 15 minutes.
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.
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.
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 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.
There are, however, several proven, science-based medications 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. 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.
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 well-being. It’s also one of the most vital hormones for promoting a healthy sex drive. 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. Our guide to testosterone replacement therapy discusses the side effects and other cautions of TRT in more detail.
There are always risks involved when using medications or supplements, so it’s important to do your research before you try anything new.
But because there’s a great deal of misinformation out there regarding the safety and efficacy of male enhancement pills, 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.
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.
If you’re thinking about trying male enhancement pills, we encourage you to exercise a certain degree of caution.
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 an over the counter 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.
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!
Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37