"Male enhancement" is the market's name, and FDA's, for pills, honeys, chocolates, coffees and similar products sold to improve erections or sexual performance without a prescription. FDA notes they are sometimes falsely advertised as dietary supplements or all-natural treatments (FDA sexual enhancement and energy product notifications). This page is an honest assessment of them: what FDA found when it tested them, why that matters for your heart and blood pressure, how to check a product yourself, and what the trials show for the herbs on the labels. It has no buy buttons and no affiliate links. If you are dealing with erectile dysfunction (ED), our erectile dysfunction guide covers causes, checks and every proven treatment.
Do male enhancement pills work? The short answer
Not in the way they are sold. A 2021 review identified the top 16 ED supplements and top 16 testosterone supplements at popular US online retailers, including Amazon and Walmart, and searched for trials of their 37 ingredients. It found no published randomized trial of any whole supplement product, and 68% of the ingredients were graded C or D for contradicting, negative or missing evidence PMID: 32358510. For how genuinely low testosterone is diagnosed and treated, see our guide to low testosterone. A 2023 analysis of 25 ED supplements sold in Italy concluded that 80% matched its criterion of "no expected efficacy", often because ingredients were included at negligible doses or without evidence PMID: 37686709.
A network meta-analysis of 15 randomized placebo-controlled trials in 1,000 men described a "background of general ineffectiveness of most nutraceutical interventions", in which L-arginine (alone or with tadalafil) and one carnitine combination taken with sildenafil were the only supplement regimens to show a statistically significant benefit PMID: 39279185.
Some reviews are more positive about individual ingredients, such as ginseng, tribulus and L-arginine, as the table below shows. But FDA's testing has repeatedly found another way some "natural" products produce an effect: a hidden prescription drug.
What FDA found inside sexual enhancement products
FDA states that many products claiming to help with sexual enhancement, including male enhancement supplements, ED treatments, "male energy" pills and stamina pills, "are likely to be contaminated with dangerous hidden ingredients". It adds that its list "covers only a small fraction of the contaminated products on the market" and that a product's absence from the list "does not mean it is safe" (FDA sexual enhancement and energy product notifications). When this page was checked on October 3, 2026, that list held more than 400 notifications dating back to 2012, 30 of them issued in 2026.
The pattern in FDA's notices is consistent: FDA laboratory analysis confirms a drug "not listed on the product label". Recent examples, quoted from FDA:
- MAXMAN Coffee (September 2, 2026) contains sildenafil and tadalafil, the active ingredients in Viagra and Cialis (FDA notice).
- DEEP (September 15, 2026) contains amino tadalafil, which FDA describes as "similar to tadalafil" (FDA notice).
- Erectus Plus (May 29, 2026) contains sildenafil, tadalafil and testosterone propionate, a controlled substance (FDA notice).
- Black Panther Miracle Honey for Men (July 8, 2025) contains sildenafil, tadalafil and acetaminophen, which FDA warns may cause an unintentional overdose and liver damage (FDA notice).
- HimGo (February 10, 2025) contains sildenafil and diclofenac, an anti-inflammatory that FDA says may increase the risk of heart attack, stroke and stomach bleeding (FDA notice).
- WAP Sensual Enhancement (April 6, 2026, updated August 25, 2026) contained sildenafil, tadalafil and flibanserin, the drug in Addyi, a prescription medicine FDA-approved for acquired, generalized hypoactive sexual desire disorder in women under 65 (Addyi (flibanserin) — DailyMed Drug Label; see our low libido guide); later samples contained yohimbine, tadalafil and flibanserin (FDA notice).
Researchers who analyzed FDA's warnings reached the same picture. Of 776 adulterated supplements FDA identified from 2007 through 2016, 353 (45.5%) were marketed for sexual enhancement, and sildenafil was the most common hidden ingredient in them. Of 28 products named in repeat warnings more than six months apart, 19 contained a new unapproved ingredient the second or third time PMID: 30646238. A follow-up covering 2007 through 2021 counted 1,068 unique adulterated products, with sexual enhancement and weight loss products the most common, and found that a single product could contain up to five drug ingredients PMID: 35285963.
Hidden analogues: copies of ED drugs that were never tested
Some products contain not sildenafil, tadalafil or vardenafil themselves but chemical variations of them. A 2018 review counted 80 synthetic PDE5-inhibitor drugs found as adulterants in supplements: 50 analogues of sildenafil, 21 of tadalafil and 7 of vardenafil PMID: 28903860. An earlier review by scientists at the Dutch national public health institute explained why that matters: analogues "are experimental drugs in essence because most have no known efficacy or safety profile", and harms from them are probably underreported PMID: 22464558.
Are male enhancement pills safe? Why hidden drugs are dangerous
Sildenafil and tadalafil are effective, FDA-approved prescription drugs (Viagra (sildenafil) — DailyMed Drug Label; Cialis (tadalafil) — DailyMed Drug Label). The problem with a tainted supplement is that you take them without knowing it, at an unknown dose, without the checks a prescription involves.
Nitrates. Both labels list use with nitrates, such as nitroglycerin for chest pain, as a contraindication because the drugs "potentiate the hypotensive effect of nitrates", meaning they can make blood pressure fall much further. The Cialis label adds that if a man who has taken tadalafil needs nitrates in a life-threatening situation, at least 48 hours should pass first, and only under close medical supervision (Cialis (tadalafil) — DailyMed Drug Label). Both labels also rule out use with guanylate cyclase stimulators such as riociguat (Viagra (sildenafil) — DailyMed Drug Label; Cialis (tadalafil) — DailyMed Drug Label). FDA's notices make the same point about every hidden PDE5 drug: it "may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels" (FDA notice, Rhino 69 Gummy).
Unknown and excessive doses. The Viagra label warns that lower blood pressure, fainting and prolonged erection may occur at higher sildenafil exposures (Viagra (sildenafil) — DailyMed Drug Label). In a 2013 analysis of 91 samples of "herbal" or "all natural" sexual enhancement products, 18 of the 40 samples containing sildenafil or tadalafil held more than 110% of the highest approved drug product strength, and contents varied widely between samples of the same product. Sample collection was coordinated by Pfizer Global Security PMID: 23634714.
Other hidden drugs. Not every adulterant is an ED drug, as the acetaminophen, diclofenac, testosterone and flibanserin findings above show. In one Singapore case series, eight men who were not being treated for diabetes developed severe hypoglycemia (dangerously low blood sugar) after taking an illegal sexual enhancement product adulterated with glibenclamide, a diabetes drug, and seven had brain abnormalities on MRI PMID: 19017925.
Delayed care. FDA warns that health fraud products may cause people to delay or stop appropriate medical treatment (FDA: common questions about medication health fraud). With ED that matters, because ED is linked to a higher risk of later cardiovascular disease PMID: 21920268.
Male enhancement pills for high blood pressure or heart patients
Men with heart disease or high blood pressure face the greatest risk. FDA notes that people with diabetes, high blood pressure, high cholesterol or heart disease often take nitrates (FDA notice, Rhino 69 Gummy). The prescription labels also advise caution when PDE5 drugs are combined with alpha-blockers or other blood pressure medicines, because the effects on blood pressure can add up and cause dizziness or fainting, and they say ED treatments should not be used by men for whom sexual activity is inadvisable because of their heart condition (Viagra (sildenafil) — DailyMed Drug Label; Cialis (tadalafil) — DailyMed Drug Label). A clinician can check those things before prescribing; a gas station counter cannot. Yohimbine, a common supplement ingredient covered below, has its own cardiovascular warnings.
Male enhancement pills with alcohol
The Cialis label says that substantial drinking (5 units or more) with tadalafil can increase heart rate, lower standing blood pressure and cause dizziness and headache (Cialis (tadalafil) — DailyMed Drug Label). FDA warns that flibanserin, found hidden in WAP Sensual Enhancement, can cause dangerously low blood pressure and fainting, "especially when combined with alcohol" (FDA notice). With a tainted product, you cannot know which of these you are combining with a drink.
Do rhino pills work, and are they safe?
"Rhino" is not one brand but a name used across many products. More than 30 of FDA's sexual enhancement notifications, from 2015 to 2026, name products with "Rhino" in the title, from "Rhino 7 Platinum 5000" to "Rhino 69 Gummy" (FDA sexual enhancement and energy product notifications). For Rhino 69 Gummy, for example, FDA laboratory analysis confirmed tadalafil not listed on the label (FDA notice). For the Rhino-named products FDA tested, any effect would likely come from that undeclared drug, of unknown dose and origin, which is exactly the risk described above.
FDA has also issued notices naming products sold under well-known brand names. In 2018, FDA advised consumers not to buy or use Extenze Plus and Extenze Nutritional Supplement after products identified during an examination of international mail shipments were found to contain sildenafil; for Extenze Plus, FDA identified the lot tested as LOT H061084 (FDA notice, Extenze Plus; FDA notice, Extenze Nutritional Supplement). FDA's findings apply to the products and samples it names; this page draws no conclusion about products FDA has not named.
Gas station male enhancement pills
FDA says fraudulent products are sold online, in stores and at gas stations, and are marketed without FDA review and approval (FDA: medication health fraud). The 2013 study above collected almost all of its samples from convenience stores and filling stations in two US metropolitan areas. None claimed to contain synthetic drugs, yet 74 of 91 samples (81%) contained PDE5-inhibitor drugs or analogues, and only 14 warned against use with nitrates PMID: 23634714. The low price and a "natural" label say nothing about what is inside.
Are male enhancement pills FDA approved?
No. Under US law, FDA "does NOT have the authority to approve dietary supplements for safety and effectiveness, or to approve their labeling, before the supplements are sold to the public", and companies are responsible for making sure their products meet safety standards. FDA also says that a product intended to treat a disease is a drug, even if it is labeled as a dietary supplement, and that "natural" does not ensure that a product is safe (FDA 101: Dietary Supplements).
Watch for these warning signs, which FDA lists: claims that a product is made in an "FDA-approved facility" (FDA does not approve facilities), claims to be an alternative to an FDA-approved drug or to have similar effects to a prescription drug, "miracle" claims backed mostly by personal stories, and medicines without the required Drug Facts label (FDA: common questions about medication health fraud).
How to check a product in FDA's Health Fraud Product Database
- Open FDA's Health Fraud Product Database. It lists products cited in FDA warning letters, online advisory letters, recalls, public notifications and press announcements, and the table filters as you type.
- Type the product name exactly as printed on the package, then try shorter parts of it, because many products share words and numbers ("Platinum", "69", "7000").
- Open any match and read the notice: the date, the hidden ingredient and, where FDA gives one, the lot number.
- For sexual enhancement products specifically, FDA's sexual enhancement and energy product notifications page lists the notices by date.
- Treat "no match" as "not yet tested", not as "safe". FDA says the database "only includes a small fraction of the potentially hazardous products marketed to consumers online and in retail establishments" (FDA Health Fraud Product Database).
If you think a product has harmed you, FDA asks consumers and health care professionals to report it to its MedWatch program (FDA notice, MAXMAN Coffee).
Common male enhancement ingredients: what the trials show
Leaving adulteration aside, what about the herbs and amino acids on the label? In the review of top-selling US products, tribulus, L-arginine, horny goat weed and yohimbine were among the most common ingredients, along with zinc, aspartate and Eurycoma longifolia PMID: 32358510. The table covers those four plus ginseng and maca, two other herbs sold for sexual function. The verdicts reflect the trials, which are generally small and short.
| Ingredient | What the evidence shows | Verdict |
|---|---|---|
| L-arginine | A meta-analysis of 10 randomized trials in 540 men with mild to moderate ED found that 1,500 to 5,000 mg a day improved ED compared with placebo or no treatment; side effects occurred in 8.3% of men taking arginine and 2.3% taking placebo, none severe PMID: 30770070. A network meta-analysis found L-arginine of "some usefulness", especially combined with tadalafil in men with organic (physical) ED PMID: 39279185. L-arginine also lowers blood pressure: in a meta-analysis of 22 randomized trials, systolic pressure fell by an average of 6.4 mmHg PMID: 34967840, so, as general guidance, men taking blood pressure medicines should check with a clinician first. | Among the better-studied ingredients, with some benefit; small trials, mild to moderate ED only |
| Panax ginseng | A Cochrane review of nine placebo-controlled trials in 587 men found ginseng may have only trivial effects on erectile function scores, mostly on low-certainty evidence, though it may improve men's self-reported ability to have intercourse. No trial compared it with prescription ED drugs PMID: 33871063. Other meta-analyses were more positive, reporting benefits for erectile function and other sexual function measures PMID: 41696741 PMID: 37686709. | Small benefit at best: average effects on validated scores fell below what counts as clinically meaningful in the Cochrane review |
| Tribulus terrestris | Mixed. A trial of 180 men found a significant improvement over placebo with one standardized extract PMID: 28364864; a 30-man trial found no difference PMID: 24630840. A 2025 meta-analysis of eight studies favored tribulus PMID: 40360723, while another meta-analysis judged the evidence insufficient PMID: 41696741. | Mixed; better trials needed |
| Maca | A systematic review found four small randomized trials and called the evidence limited, with too few trials and participants, and too low a quality, to draw firm conclusions PMID: 20691074. A 2025 meta-analysis also judged it insufficient PMID: 41696741. | Insufficient evidence |
| Horny goat weed (Epimedium, icariin) | A 2026 review found that icariin, its main active compound, may ameliorate ED-related changes in animal models through several mechanisms, but said its clinical efficacy still requires confirmation in high-quality randomized trials PMID: 42476543. No randomized trial of horny goat weed alone in men with ED was found in a PubMed search for this page (October 3, 2026). | No human trial evidence |
| Yohimbe (yohimbine) | A 1998 meta-analysis of seven placebo-controlled trials of yohimbine as a drug (yohimbine on its own, not yohimbe supplements) found it more effective than placebo PMID: 9649257. But NIH's NCCIH says there is very little research on yohimbe as a dietary supplement and that yohimbine has been associated with irregular heartbeat, blood pressure problems, heart attacks and seizures (NCCIH: Yohimbe). Of 49 US yohimbe supplements tested, the yohimbine per serving ranged from none to 12.1 mg, and only 11 stated an amount, most of them inaccurately PMID: 26391406. | Avoid: unpredictable doses and real cardiovascular risks |
Two cautions apply to every row. First, a positive trial of one extract at one dose does not show that a blended product, which may contain a fraction of that dose, works PMID: 37686709. Second, NCCIH advises against yohimbe for anyone taking MAO inhibitor or tricyclic antidepressants, because of interactions (NCCIH: Yohimbe), and FDA recommends talking with a health care professional before combining any supplement with medicines (FDA 101: Dietary Supplements).
Evidence-based options for erectile dysfunction
These options have stronger evidence or, for devices, a clearer regulatory status:
- Prescription PDE5 tablets. Sildenafil and tadalafil are FDA-approved for ED (Viagra (sildenafil) — DailyMed Drug Label; Cialis (tadalafil) — DailyMed Drug Label) and come with a known dose and a clinician's check for nitrates and heart risk. Our sildenafil vs tadalafil comparison explains how they differ, and our comparison of online ED services covers getting a prescription online.
- A drug-free gel. Eroxon was authorized by FDA through its De Novo device pathway (FDA De Novo record DEN220078). Our Eroxon review covers its trial and how its evidence compares with tablets.
- Vacuum erection devices. These work without a drug. Our vacuum erection device guide covers the evidence and the safety rules.
- A checkup. The American Urological Association recommends that men with ED be told about every treatment that is not contraindicated for them PMID: 29746858. Our erectile dysfunction guide explains the evaluation and the lifestyle factors behind many cases.
If you have already taken one
- Stop taking it, and keep the package so a clinician can see the name and lot.
- Get medical help right away for chest pain, dizziness or nausea during sex or a sudden loss of vision or hearing, and emergency care for an erection lasting more than 4 hours; the Cialis label tells patients to stop sexual activity and get medical help right away for chest pain, dizziness or nausea during sex, to seek medical attention for sudden vision or hearing loss, and to seek emergency treatment for an erection lasting more than 4 hours (Cialis (tadalafil) — DailyMed Drug Label). Tell the staff what you took, because it may contain sildenafil or tadalafil, and nitrates can be dangerous after these drugs.
- Report it to FDA's MedWatch program, as FDA asks in its notices.
- Book a visit for the ED itself, so a clinician can look for the cause and discuss proven treatments.