Potential Side Effects and Health Risks to Consider

Doctors may recommend supplements in specific situations where patients are not getting enough nutrients from their diet or have a certain health condition. While prescription drugs undergo rigorous testing and approval by the Food and Drug Administration (FDA), federal regulations for dietary supplements are less strict. By law, dietary supplements must contain at least one vitamin, mineral, amino acid, enzyme, or other substance used by the body.

• Sildenafil citrate increases blood flow to help achieve erections in ED patients.
• L-arginine is converted to nitric oxide, essential for penile vasodilation.
• Horny goat weed icariin inhibits PDE5 and improves erectile response.
• Tribulus terrestris is claimed to increase androgen levels and libido.
• Ginseng is an adaptogen that supports energy, endurance, and sexual function.
• Maca root enhances sexual desire and energy levels.
• DHEA supplementation may restore libido by balancing hormones.
• Zinc supports testosterone synthesis and improves sperm quality.
• Yohimbine enhances nerve impulse transmission for erectile function.
• Fenugreek may boost libido through increased testosterone.
• Vitamin D supports sexual health by improving hormone balance and mood.

But the rest of the ingredients may include drugs that are untested for safety or effectiveness.

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Sexual enhancement supplements may contain ingredients like the following: Unlike drugs, dietary supplements do not go through a testing or approval process with the U.S. Food and Drug Administration (FDA). In addition, manufacturers are not required to give the FDA any backup to their safety claims. This is a difficult question to answer, as the sexual effects of these substances may not be widely studied—at least not in humans. For example, in a 2019 Journal of Sexual Medicine paper, researchers examined 413 studies on sexual enhancement supplements.

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Only 17% of the studies involved humans. Lack of peer-reviewed study—or any kind of study in humans—raises questions as to whether supplements are as effective as their manufacturers claim. When researching supplements online, consumers may see vast praise from reviewers, with claims like “It completely cured my erection problems!” or “Sex is better than ever!” However, the internet is rife with unreliable reviews. Some companies pay reviewers to give positive reviews, even if the reviewer did not have a positive experience (or any experience) with the product. In the above study, researchers used review analysis software to filter out reviews that met the criteria for being unreliable. The FDA can take action if it finds any supplement to be unsafe once it reaches the market and can remove the product from the marketplace. Since the FDA does not approve supplements for treating medical conditions, companies cannot market them for that purpose.

To learn more about supplements, visit the National Institutes of Health.

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Ingredients in erectile dysfunction drugs, such as sildenafil in Viagra, can be dangerous when mixed with medications for treatment of other conditions. Can sexual health supplements be an option? It’s important to know what supplements are and how they work. Supplements are substances intended to be added to your diet and come in many forms, including in pill, powder or liquid. They are not drugs and can be purchased without prescription at grocery stores, drug stores, natural food stores and other retail outlets. Your doctor should also be able to answer your questions.

• Sildenafil is a phosphodiesterase-5 inhibitor that improves erectile function.
• L-arginine is converted into nitric oxide which promotes penile blood flow.
• Horny goat weed contains icariin, improving erectile function similarly.
• Tribulus terrestris may boost testosterone and sexual performance.
• Ginseng helps reduce fatigue and improve sexual stamina.
• Maca root enhances libido and sexual satisfaction.
• DHEA supplementation can restore hormonal levels aiding sexual health.
• Zinc deficiency decreases testosterone; supplementation improves libido.
• Yohimbine boosts nerve signaling and blood flow to the penis.
• Fenugreek is believed to support testosterone and sexual desire.
• Vitamin D can influence testosterone levels and sexual performance.

Sexual enhancement supplements are a subset of dietary supplements, specifically marketed to address issues related to sexual health and performance. In additions to nutrients like amino acids, vitamins and minerals, they may contain herbs, such as horny goat weed, ginseng and maca root.

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These experts can provide information on the safety of a product’s ingredients and what side effects may occur. Read the supplement label and packaging insert. If anything looks amiss, the manufacturer should be able to give more information. Check the FDA’s list of tainted sexual enhancement products. The FDA maintains a public list of supplements that could be risky.

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With good information, people can make informed decisions. And the best information for a person’s individual situation comes directly from their doctor, not from a supplement manufacturer that doesn’t know the consumer and might not have patients’ best interests at heart. Jenkins, Lawrence C., MD, MBA, et al.“AUA2022: REFLECTIONS: The Safety and Efficacy of Sexual Supplements”(August 1, 2022) “Can Testosterone Supplements Improve Your Sex Drive?”(Updated: September 30, 2022) “Can supplements save your sex life?”(No date) Balasubramanian, Adithya BA, et al.“An Analysis of Popular Online Erectile Dysfunction Supplements”(Full-text. Bell, Alex“Natural remedies and supplements for erectile dysfunction”(Updated: January 10, 2023) “Dietary supplements for urologic conditions may pose risks to patients”(January 25, 2023) “Questions and Answers on Dietary Supplements”(October 26, 2022) “Tainted Sexual Enhancement Products”(Content current as of February 7, 2023) The market for men’s sexual health supplements is growing as many men turn to them to tackle sexual issues. While it may be tempting to buy pills and bottles to boost your sexual performance, you might want to think twice before putting down your money. While many of these products say they can increase sexual desire or performance, it’s unclear if they are safe or actually work. Some people might see results, but for others it could be risky, especially if not used with a doctor's guidance. Always talk to your doctor about any sexual health problems you may be experiencing. “Do not self-diagnose and think that supplements are going to cure or prevent a problem from occurring,” Dr. Simone says.

“Your doctor can discuss any sexual concern you may have and determine if there is an underlying cause for your symptoms that needs to be treated.” Treating underlying health issues like high blood pressure, heart disease or diabetes can help improve sexual function. “If you have sexual side effects from medication you can ask your doctor if you can change your medication. Your doctor can also help you determine which supplements, if any, might help you,” Dr. Simone says.

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These products may not have evidence to back up their claims, and they could also lead to unwanted side effects. “Most supplements for sexual function have not been studied scientifically,” says Luigi Simone, MD, a primary care physician at Scripps Clinic in Encinitas. “They may have a placebo effect, which is not insignificant, but as far as the claims of increasing libido or sexual endurance, those have definitely not been proven.” Male sexual enhancement supplements may not be safe for everyone as they can cause side effects, allergic reactions and interactions with other medications. Some supplements may even contain potentially dangerous impurities or hidden pharmaceutical drugs that can be dangerous. So be careful when using these products.

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Talk to your doctor before trying a sexual enhancement supplement. “Don’t be afraid to bring up a sexual ed tablets health concern,” says Dr. Simone. “We’ve heard them all and are always ready to help you.” Doctors may prescribe drugs such as Viagra to treat impotence in men. However, using them with other medications may cause problems. Improving your sexual health doesn’t always require medication or supplements. Lifestyle changes can be effective in treating sexual problems. Losing weight, reducing stress and a healthy lifestyle have all been shown to increase testosterone levels in men, Dr. Simone says. A majority of men will deal with some kind of sexual performance issue in their lifetimes.1 Any kind of erectile dysfunction can be devastating, and for men who might shy away from prescription solutions, male enhancement pills pose a compelling alternative.

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For example, erectile dysfunction can be an early symptom of diabetes or heart disease. It’s also common in men with obesity. For many men, taking steps to control blood sugar, blood pressure, weight, and other health issues leads to better erections—and better sex. Seeing a doctor for a sexual issue can help solve the problem and lower the risk of having other health issues, and perhaps avoid a major health crisis, in the future. Also, adopting healthy habits can go a long way in improving erections—and sex in general.

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Many people feel more energetic, confident, and attractive when they take good care of their health. When faced with a sexual problem, trying a supplement may seem like an easy plan to try. But it’s important to do some homework first: Sexual issues are common, and one of the best ways to start addressing them is getting a full check up with a doctor. If another health condition, like diabetes or heart disease, is causing the sexual issues, then it’s important to treat that. (Sexual problems often improve when the underlying cause is treated.) Ask a doctor or pharmacist about the supplement. Some claim to resolve erectile and performance issues, while others aim to help with fertility and semen volume. However, male enhancement supplements come with a few major pitfalls. For starters, it’s too easy to end up with counterfeit pills containing dangerous ingredients you never realized you were going to consume. The market is also rife with expensive products that do little more than a good, less expensive vitamin D capsule could.

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Once the questionable reviews were removed from the analysis, positive claims dramatically fell. After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and an 89% decrease in reviews reporting increased erection confidence. In short, claims on effectiveness may not be backed up by scientific study, and positive reviews might not be truthful. Supplements may include ingredients that are not listed on the package label. (These are called undeclared ingredients.) There have been cases where sexual enhancement supplements have included erectile dysfunction drugs like sildenafil and tadalafil.

3 uncommon but severe side effects

These drugs are effective for many men, but not all men can take them safely. They can be especially dangerous for men who take nitrates. But if the ingredients are not declared, it’s difficult for people to know if a product contains substances that could harm them. A sexual problem is often a sign of an underlying medical condition. And often, treating that underlying condition solves the problem. We took a hard look at the male enhancement pills on the market and whittled the immense field down to a few products we think have the most potential to be effective while offering you the safest experience.