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How Do Sex Pills Work?

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Nicholas Gibson

Published 04/29/2021

Updated 03/08/2024

Like potholes strewn across the internet superhighway, sex pills, tablets and herbal supplements are easy to find in the deep corners of every porn site or sketchy blog you can think of.

You can also find them in sex stores and gas stations — usually somewhere between the loose cigarettes and bags of synthetic weed.

While there are evidence-based, proven options out there for treating sexual function issues like erectile dysfunction (ED) and premature ejaculation (PE), the sex pills you can find online and in sex stores without a prescription aren’t worth trying.

Not only is the science behind these purported miracle pills extremely thin, but lab analysis has found that some contain dangerous, unlabeled ingredients — including some that can cause serious health issues.

Below, we’ve explained why herbal sex supplements and male enhancement pills aren’t worth your time, trust or money, as well as how these products can be harmful (and even fatal).

We’ve also shared some safer, evidence-based treatments that you may want to consider if you have ED, PE or other common sexual performance issues.

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We’ll cut right to the chase: those non-prescription sex pills you see online and on gas station shelves don’t really work, at least not in any significant way. They also come with lots of risks. So despite the rave Performer 8 review you just read, the science isn't there and the risks aren't worth it.

There are two main types of sex pills out there. The first are underregulated, untested supplements sold via those sketchy sites we mentioned earlier — you know, the kind of content you only ever stumble upon, ahem, totally by accident.

These products are often marketed as male enhancement supplements, and they tend to make some bold claims about what they can do, such as:

Check the ingredients list for these products and you’ll usually see a variety of minerals, herbal extracts and exotic-sounding substances — things like ashwagandha, ginseng, magnesium or horny goat weed (epimedium).

Other common ingredients include:

As we’ve covered in our guide to increasing your testosterone levels, some of these ingredients are linked to improvements in testosterone production in men with nutritional deficiencies.

However, this doesn’t necessarily mean that they have the same effects in healthy men, or that they’ll produce any improvement in things like your erections, sexual stamina or overall sex life.

The second type of sex pills are regulated, FDA-approved medications. These are the pills your healthcare provider may prescribe if you’re diagnosed with ED or PE.

The first type of sex pills don’t really seem to do much. To be more precise, we don’t have any evidence that shows they’re actually effective for treating ED, PE or just improving your sexual abilities in general. Horny goat weed does contain icariin, which is a mild PDE5 inhibitor (meaning the ingredient works in a similar way as oral ED medications), but it still doesn’t nearly stack up to actual prescription ED medication.

The second type — the ones your healthcare provider might prescribe — really do work, but are far from do-it-all medications for every sex-related problem. 

So, if the sex pills you see advertised online don’t really increase your penis size, make it easier to get hard or give you porn star-like sexual stamina, how come they’re allowed to claim they do this?

In short, they aren’t, and they could get in trouble for making such claims (unless they’ve done some clever wordsmithing). Additionally, as dietary supplements, rather than medications, non-prescription sex pills aren’t subject to the same regulations about testing for effectiveness. 

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Not only are non-prescription sex pills not rigorously tested for effectiveness, but they’re also not subject to the same strict Food and Drug Administration safety regulations that apply to real medications. 

Instead, the FDA applies much looser regulatory criteria to dietary supplements, viewing them as “foods” rather than medications. 

This means that many sexual tablets may not be properly checked to make sure that they’re safe for human use. 

It also means that we don’t know exactly how or where many sexual enhancement supplements are made. Some pills could be manufactured in modern facilities, but others may be produced in facilities that aren’t clean or safe.

Because these products are loosely regulated and don’t have to play by the same rules as real medications, there have been numerous scandals regarding spiked ingredients in sex pills over the years.

Some of these scandals have involved ingredients that could be dangerous, including unlabeled prescription drug ingredients. 

These ingredients can cause serious interactions and potentially severe side effects, especially when they’re taken with prescription medications for hypertension (high blood pressure), heart disease and other common medical conditions. 

Since there’s no way to know which sex pills contain what they claim on the label and which opt for a secret formula, relying on these products is a serious gamble.

You can view recent investigations and public notifications into tainted sex tablets and pills using the FDA’s Tainted Sexual Enhancement Products list.

Choose your chew

When it comes to improving your erections, stamina and general sexual performance, or if you have a sexual performance issue that you’d like to treat, your best bet is using evidence-based, FDA-approved medication instead of a sex supplement.

Currently, the FDA has approved four oral erectile dysfunction medications

  • Sildenafil (the active ingredient in Viagra®)

  • Tadalafil (the active ingredient in Cialis®)

  • Vardenafil (the active ingredient in Levitra®)

  • Avanafil (a newer medication sold as Stendra®)

These medications belong to a class of drugs called phosphodiesterase type 5 inhibitors, or PDE5 inhibitors, and work by increasing blood flow to your penis after sexual stimulation. 

Since erections are all about strong blood flow, this makes it easier for you to get and stay hard when you’re in the mood for sex.

We can provide you with several of these active ingredients in our chewable ED medications, which provide a quick, simple alternative method for ED treatment. 

There is also an injectable medication, alprostadil, that is FDA approved for ED. And the FDA recently authorized Eroxon, a non-medicated hydro-alcoholic gel that is applied to the head of the penis and can be obtained without a prescription, for ED.

Where gas station sex pills make big promises and fall short, bona fide ED treatments pick up the slack and actually produce results. For example, in one study, researchers found that 98.4 percent of men with erectile dysfunction who used sildenafil reported better erections. 

Just be sure to take most oral medications 30 to 60 minutes before sexual activity for good results. 

And prescription medication isn’t just used to treat ED — oral ED medications can be used off label to treat issues like premature ejaculation.

Other possible treatments for premature ejaculation include:

  • Topical sprays and wipes, such as our lidocaine Delay Spray for Men

  • Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine and sertraline, which are types of antidepressants used off-label for PE

Our guide to premature ejaculation pills goes into more detail about how these treatments work to delay ejaculation and improve stamina.

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Tired of dealing with erectile dysfunction? Worried you might not last long enough in bed? Good news — options are available, but you won’t find them on sketchy blogs or behind the counter at that sex store downtown. 

If you’re interested in improving your sex drive, erections and stamina in bed, you’ll want to keep the following in mind: 

  • When it comes to sex enhancement pills, bold marketing promises don’t always mean real results. These products aren’t tightly regulated, and makers can make claims they shouldn’t be making or use tricky wording to imply the pills can do something they can’t.

  • Although some ingredients used in sex pills are linked to changes in testosterone and sexual health, the quality of research is poor, with few large-scale, placebo-controlled studies available.

  • Some sex pills can be harmful. FDA investigations have found that many sex tablets for men contain hidden ingredients, including some that can result in dangerous drug interactions and other health problems.

If you’re interested in improving your erections and sexual performance, you’ll get much better results by using evidence-based ED treatment than by relying on supplements. 

You can get started by taking part in an online ED consultation to get some medical advice about your options and, if appropriate, access medication to prevent ED and enhance your sexual function.

You can also find out more about improving your sexual health naturally in our detailed guide to maintaining an erection.

4 Sources

  1. Dietary Supplements. (2023, March 6). Retrieved from
  2. Tainted Sexual Enhancement Products. (2023, February 7). Retrieved from
  3. Dhaliwal, A. & Gupta, M. (2022, May 20). PDE5 Inhibitors. StatPearls. Retrieved from
  4. Tang, W.H., et al. (2015). Effect of sildenafil on erectile dysfunction and improvement in the quality of sexual life in China: a multi-center study. International Journal of Clinical and Experimental Medicine. 8 (7), 11539-11543. Retrieved from
Editorial Standards

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]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

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 is a founding member of Posterity Health where she is Medical Director and leads 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.

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