Sexual Medicine for Aging and Chronic Conditions

We’ve done our best to bring you a collection that meets a high bar for safety with minimal adverse effects.

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We’ve done our best to bring you a collection that meets a high bar for safety with minimal adverse effects. But not all male enhancement pills are safe, and there are ingredients in even some of the safest options that could pose a danger to you. Prescription ED medications (PDE-5 inhibitors like Viagra, specifically) can lower blood pressure.20 This is why any prescriber needs a recent blood pressure reading and knowledge of your cardiovascular health history before prescribing them. Supplemental male enhancement pills often employ ingredients that aim to act in similar ways. That makes them potentially dangerous for men with low blood pressure or men taking medication that affects their blood pressure.

Erectile dysfunction care at Mayo Clinic

Other ingredients in supplements may have unexpected consequences for certain men. For example, ashwagandha has been linked to increased thyroid hormone production, which could lead to hyperthyroidism in some.21 Some ingredients bring the possibility of mild adverse reactions, but they’re worth knowing. Epimedium leaf: irregular heartbeat, low blood pressure Take a close look at the ingredients in the pills you have your eye on, and talk to your doctor before starting it to make sure there are no unexpected risks to your health or potential contraindications with any of your current medications. Insider Tip: There are many counterfeit male enhancement supplements on the market that use packaging nearly identical to the real thing. In one test run, the FDA found “undeclared active pharmaceutical ingredients” in 100% of the products it purchased through Amazon and 86% of the products it purchased through eBay.

Vitamins and supplements for ED

Be sure to buy your enhancement pills directly from the supplier. Sellers on Amazon and other platforms may provide you with dangerous goods.16 51 Best overall and best for low testosterone High doses of its most promising ingredients Does not include zinc to help boost testosterone Claim of “zero known side effects” is disingenuous Performer 8 uses some of the more thoroughly researched ingredients to address different potential causes of ED or other sexual performance issues. It’s the only supplement in our guide containing ashwagandha, an extract that studies show can increase testosterone levels and reduce anxiety. Specifically, Performer 8 uses KSM-66, a branded form of ashwagandha that’s a high-quality, standardized extract. That means you get the same potency in each dose, and Performer 8’s ashwagandha dosing is in line with the amounts used in clinical studies. But not all male enhancement pills are safe, and there are ingredients in even some of the safest options that could pose a danger to you. Prescription ED medications (PDE-5 inhibitors like Viagra, specifically) can lower blood pressure.20 This is why any prescriber needs a recent blood pressure reading and knowledge of your cardiovascular health history before prescribing them. Supplemental male enhancement pills often employ ingredients that aim to act in similar ways. That makes them potentially dangerous for men with low blood pressure or men taking medication that affects their blood pressure. Other ingredients in supplements may have unexpected consequences for certain men. For example, ashwagandha has been linked to increased thyroid hormone production, which could lead to hyperthyroidism in some.21 Some ingredients bring the possibility of mild adverse reactions, but they’re worth knowing. Epimedium leaf: irregular heartbeat, low blood pressure Take a close look at the ingredients in the pills you have your eye on, and talk to your doctor before starting it to make sure there are no unexpected risks to your health or potential contraindications with any of your current medications. Insider Tip: There are many counterfeit male enhancement supplements on the market that use packaging nearly identical to the real thing. In one test run, the FDA found “undeclared active pharmaceutical ingredients” in 100% of the products it purchased through Amazon and 86% of the products it purchased through eBay.

Be sure to buy your enhancement pills directly from the supplier. Sellers on Amazon and other platforms may provide you with dangerous goods.16 51 Best overall and best for low testosterone High doses of its most promising ingredients Does not include zinc to help boost testosterone Claim of “zero known side effects” is disingenuous Performer 8 uses some of the more thoroughly researched ingredients to address different potential causes of ED or other sexual performance issues.

It’s the only supplement in our guide containing ashwagandha, an extract that studies show can increase testosterone levels and reduce anxiety. Specifically, Performer 8 uses KSM-66, a branded form of ashwagandha that’s a high-quality, standardized extract. That means you get the same potency in each dose, and Performer 8’s ashwagandha dosing is in line with the amounts used in clinical studies. Performer 8 also boasts one of the highest doses of ginseng of any pills that made our cut.22 Special Offer: 35% OFF a 1-Month Supply from Semenax Here’s a closer look at Performer 8’s ingredient list: You can purchase Performer 8 in 1-, 3-, and 5-month supplies for the following prices: The monthly cost at the highest bulk tier is $39. One- and 3-month supplies also come with free e-books covering nutritional approaches to improving sexual performance and exercises you can do to improve your stamina in the bedroom. These are relatively mid-range prices among male enhancement pills, with products like Max Performer and Male Extra offering deeper savings with their 12-month supplies. But it’s worth remembering that those two companies offer 100-day guarantees to Performer 8’s lifetime promise, and neither of them contains ashwagandha. Shipping from Performer 8 is free and discreet, and it takes about a week.

• Penile injections with vasoactive substances are more invasive options.
• Vacuum erection devices create a temporary erection for sexual activity.
• Surgical options include penile implants for severe erectile dysfunction.
• Urological assessment is essential prior to invasive treatments.
• Recovery time and risks vary among surgical treatments.
• Some conditions require combination therapies for best results.
• Managing side effects is crucial for invasive or pharmacological treatments.
• Follow-up care ensures the success and safety of treatment plans.

Credit card statements will show “P8” for the purchase, making it difficult for anyone to figure out what you ordered. Potent pomegranate extract may improve erectile performance Up to a 12-month supply available at a deep discount L-Arginine may be dangerous for men with blood pressure issues Two of Male Extra’s most important ingredients are zinc and vitamin B3, also known as niacin. Niacin has a litany of health benefits, many of which begin with its ability to provide cellular energy.42 Male Extra also recently upped its zinc dose, taking it from 14mg to 45mg of zinc citrate and increasing the likelihood that the supplement can help men with low testosterone or a zinc deficiency.43 One unusual ingredient tadacip 20mg in Male Extra is methyl sulfonyl methane. Simply put, this provides the body with sulfur, which some research shows can positively influence sexual performance.23 It’s generally recognized as safe by the FDA and appears to have minimal side effects.44 However, you don’t see it in too many other male enhancement pills, and Male Extra is the only product in our guide to employ it. Whether that speaks to its efficacy, safety, or cost in production is unclear, but it’s an interesting point to note. You’ll also find pomegranate extract in Male Extra, which has improved erectile performance among men in at least one small study.45 And no other pill on this list includes it. Here’s a breakdown of the ingredients in Male Extra: The most disappointing dose in the bunch is likely the 25mg of cordyceps.

6. Medications that affect sex hormones

Performer 8 also boasts one of the highest doses of ginseng of any pills that made our cut.22 Special Offer: 35% OFF a 1-Month Supply from Semenax Here’s a closer look at Performer 8’s ingredient list: You can purchase Performer 8 in 1-, 3-, and 5-month supplies for the following prices: The monthly cost at the highest bulk tier is $39. One- and 3-month supplies also come with free e-books covering nutritional approaches to improving sexual performance and exercises you can do to improve your stamina in the bedroom. These are relatively mid-range prices among male enhancement pills, with products like Max Performer and Male Extra offering deeper savings with their 12-month supplies. But it’s worth remembering that those two companies offer 100-day guarantees to Performer 8’s lifetime promise, and neither of them contains ashwagandha. Shipping from Performer 8 is free and discreet, and it takes about a week.

FYI on ED

Credit card statements will show “P8” for the purchase, making it difficult for anyone to figure out what you ordered. Potent pomegranate extract may improve erectile performance Up to a 12-month supply available at a deep discount L-Arginine may be dangerous for men with blood pressure issues Two of Male Extra’s most important ingredients are zinc and vitamin B3, also known as niacin. Niacin has a litany of health benefits, many of which begin with its ability to provide cellular energy.42 Male Extra also recently upped its zinc dose, taking it from 14mg to 45mg of zinc citrate and increasing the likelihood that the supplement can help men with low testosterone or a zinc deficiency.43 One unusual ingredient tadacip 20mg in Male Extra is methyl sulfonyl methane. Simply put, this provides the body with sulfur, which some research shows can positively influence sexual performance.23 It’s generally recognized as safe by the FDA and appears to have minimal side effects.44 However, you don’t see it in too many other male enhancement pills, and Male Extra is the only product in our guide to employ it. Whether that speaks to its efficacy, safety, or cost in production is unclear, but it’s an interesting point to note.

The mental side of sex

You’ll also find pomegranate extract in Male Extra, which has improved erectile performance among men in at least one small study.45 And no other pill on this list includes it. Here’s a breakdown of the ingredients in Male Extra: The most disappointing dose in the bunch is likely the 25mg of cordyceps. There aren’t a lot of relevant studies looking at the mushroom’s potential to treat male sexual dysfunction, but there are several available animal studies. In one rodent study, doses ranged from 100mg/kg of body weight to 1,000mg/kg. In a 220lb male, that’s the equivalent dose range of 10-100g, much larger than Male Extra’s 25mg. There aren’t a lot of relevant studies looking at the mushroom’s potential to treat male sexual dysfunction, but there are several available animal studies.

In one rodent study, doses ranged from 100mg/kg of body weight to 1,000mg/kg. In a 220lb male, that’s the equivalent dose range of 10-100g, much larger than Male Extra’s 25mg. But even if you disregard animal studies and only look at the competition, you’ll find tadalis 20 a 1,000mg cordyceps dose in Max Performer, which greatly eclipses Male Extra’s offering. Male Extra is available in 1-, 3-, 5-, and 12-month supplies for these prices: At the highest bulk quantity, the cost for one month is $30. That makes this one of the most affordable male enhancement options out there if you’re willing and able to put up the nearly $400 yearly investment. Men with less capital to spend up-front might consider a lower bulk tier. Any shipment of three or more months comes with increasing amounts of the company’s Pro Erection gel.

• Medication combined with psychotherapy can be effective for sexual health issues.
• Serotonin reuptake inhibitors are sometimes used off-label to treat sexual dysfunction.
• Side effects of sex medications can include headache, flushing, or nasal congestion.
• Proper diagnosis of underlying conditions is key to effective sexual medicine treatments.
• Drug interactions may affect the efficacy and safety of sexual medications.
• The stigma around sexual medicine can hinder individuals from seeking help.
• Emerging treatments include stem cell therapy for erectile tissue regeneration.
• Clinical trials are ongoing to find new solutions for sexual dysfunction.

This gel uses a topical L-arginine that the company claims can increase blood flow to the penis. We have not found any research supporting the topical use of such ingredients and generally recommend against using the gel at this time. Shipping from Male Extra is free at any level. Male Extra offers a 100-day money-back guarantee. This allows you to try the product for up to three months and still have over a week to get your refund request in. It’s one of the more generous guarantees out there, but it’s still shorter than Performer 8’s lifetime guarantee. Learn more about the product in our full review. Moderate zinc dose may help raise testosterone levels No “hero” ingredient to suggest reliable efficacy Ginseng dose is on the small side Equal parts of horny goat weed, maca, cordyceps, and ginseng provide the lion’s share of potential benefits in Max Performer. But those 1,000mg doses translate into pink pills for woman different degrees of potential for each ingredient. A 1,000mg dose of cordyceps reflects successes seen in some animal studies.

What are the best sex pills available?

Each product’s site runs on the same inconsistently attended chat server. If you get through to an agent, it would be wise to let them know which product you’re asking about, as they might give you an answer for the wrong one. On the other hand, the weight of that parent company allows it to do more than some others can, including funding clinical research of some of its formulas. It also allows most of its products to be manufactured in cGMP-compliant facilities, which lends a bit to safety and quality standards (ExtenZe was the only Leading Edge Health product whose manufacturing facilities we couldn’t verify). Conversely, 1,000mg of ginseng is less than you’ll often see in clinical research. Unlike much of its competition, Max Performer includes a decent vitamin B complex containing B2, B3, B5, B6, and B12 in quantities ranging from 200-714% of your daily value. A particularly large study from China with more than 4,000 participants established a strong positive correlation between homocysteine and ED (homocysteine is an amino acid abundant in animal protein that’s associated with inflammation and heart disease).24 46 Other studies show that B vitamins can inhibit homocysteine, which should, in turn, reduce the intensity and incidence of ED.25 All that said, if a B vitamin deficiency is contributing to your sexual performance issues, you could likely find a high-quality B complex for a lot less than Max Performer costs. Here’s a full look at Max Performer's ingredients: You can purchase Max Performer in 1-, 3-, 6-, and 12-month supplies. There are no freebies included at bulk purchasing levels like e-books or other products. Here’s how the pricing shakes out: For a 12-month supply, the cost per month is $30.

Ethical concerns

But even if you disregard animal studies and only look at the competition, you’ll find tadalis 20 a 1,000mg cordyceps dose in Max Performer, which greatly eclipses Male Extra’s offering. Male Extra is available in 1-, 3-, 5-, and 12-month supplies for these prices: At the highest bulk quantity, the cost for one month is $30. That makes this one of the most affordable male enhancement options out there if you’re willing and able to put up the nearly $400 yearly investment. Men with less capital to spend up-front might consider a lower bulk tier. Any shipment of three or more months comes with increasing amounts of the company’s Pro Erection gel.

IN CLINICAL TRIALS1, WOMEN ON ADDYI EXPERIENCED:

This gel uses a topical L-arginine that the company claims can increase blood flow to the penis. We have not found any research supporting the topical use of such ingredients and generally recommend against using the gel at this time. Shipping from Male Extra is free at any level. Male Extra offers a 100-day money-back guarantee. This allows you to try the product for up to three months and still have over a week to get your refund request in.

Specialized to premenopausal women

It’s one of the more generous guarantees out there, but it’s still shorter than Performer 8’s lifetime guarantee. Learn more about the product in our full review. Moderate zinc dose may help raise testosterone levels No “hero” ingredient to suggest reliable efficacy Ginseng dose is on the small side Equal parts of horny goat weed, maca, cordyceps, and ginseng provide the lion’s share of potential benefits in Max Performer. But those 1,000mg doses translate into pink pills for woman different degrees of potential for each ingredient. A 1,000mg dose of cordyceps reflects successes seen in some animal studies. Compared to the competition, Max Performer has the deepest discount per bottle between its one- and 12-month supplies, but that’s largely because the cost of a one-month supply is so high at the outset. Ultimately, it has the same per-bottle price at its highest bulk tier as Male Extra does, and Male Extra boasts the superior ingredient profile.

• Female sexual arousal disorder treatment includes vaginal lubricants and hormonal therapy.
• Flibanserin is approved to treat hypoactive sexual desire disorder in women.
• Testosterone patches may be prescribed to increase female libido in some cases.
• Psychoeducation can help women address emotional factors affecting sexual function.
• Pelvic floor exercises strengthen muscles involved in sexual pleasure.
• Managing stress and mental health is crucial for improving female sexual function.
• Vaginal estrogen creams can improve lubrication and discomfort during sex.
• Counselling or sex therapy may address psychological barriers to sexual satisfaction.

Shipping with Max Performer is free at all levels.

• Premature ejaculation can be managed with behavioral therapy and medications.
• Desensitizing sprays or condoms help delay ejaculation.
• Psychological counseling can address performance anxiety contributing to issues.
• Squeeze and stop-start techniques are non-pharmacological methods.
• SSRIs are often prescribed to increase the ejaculatory latency.
• Anxiety reduction exercises may improve overall sexual performance.
• Education about sexual response can improve confidence and satisfaction.
• Partner involvement enhances therapy effectiveness and communication.

You can learn more about the experience by visiting our full review. Leading Edge Health isn’t a branded male enhancement pill, but it’s the parent company behind a wide variety of men’s sexual wellness products, including Semenax, Volume Pills, VigRX Plus, and ExtenZe. There are some advantages and disadvantages associated with products under such a large brand umbrella. On the one hand, it can be difficult to differentiate among them or to understand why the company produces so many versions of male enhancement products in the first place. (If one or two formulas worked, why wouldn’t the company just stick with that?) All these products also end up with the same 67-day money-back guarantee, which is a month short of the 100-day guarantees from Male Extra and Max Performer and is significantly shorter than Performer 8’s lifetime guarantee. The website experience is also inferior across all products. Each product’s site runs on the same inconsistently attended chat server.

Do They Work?

Conversely, 1,000mg of ginseng is less than you’ll often see in clinical research. Unlike much of its competition, Max Performer includes a decent vitamin B complex containing B2, B3, B5, B6, and B12 in quantities ranging from 200-714% of your daily value. A particularly large study from China with more than 4,000 participants established a strong positive correlation between homocysteine and ED (homocysteine is an amino acid abundant in animal protein that’s associated with inflammation and heart disease).24 46 Other studies show that B vitamins can inhibit homocysteine, which should, in turn, reduce the intensity and incidence of ED.25 All that said, if a B vitamin deficiency is contributing to your sexual performance issues, you could likely find a high-quality B complex for a lot less than Max Performer costs. Here’s a full look at Max Performer's ingredients: You can purchase Max Performer in 1-, 3-, 6-, and 12-month supplies. There are no freebies included at bulk purchasing levels like e-books or other products.

Looking after your health

Here’s how the pricing shakes out: For a 12-month supply, the cost per month is $30. Compared to the competition, Max Performer has the deepest discount per bottle between its one- and 12-month supplies, but that’s largely because the cost of a one-month supply is so high at the outset. Ultimately, it has the same per-bottle price at its highest bulk tier as Male Extra does, and Male Extra boasts the superior ingredient profile. Shipping with Max Performer is free at all levels. You can learn more about the experience by visiting our full review.

Pelvic exam

Leading Edge Health isn’t a branded male enhancement pill, but it’s the parent company behind a wide variety of men’s sexual wellness products, including Semenax, Volume Pills, VigRX Plus, and ExtenZe. There are some advantages and disadvantages associated with products under such a large brand umbrella. On the one hand, it can be difficult to differentiate among them or to understand why the company produces so many versions of male enhancement products in the first place. (If one or two formulas worked, why wouldn’t the company just stick with that?) All these products also end up with the same 67-day money-back guarantee, which is a month short of the 100-day guarantees from Male Extra and Max Performer and is significantly shorter than Performer 8’s lifetime guarantee. The website experience is also inferior across all products. If you get through to an agent, it would be wise to let them know which product you’re asking about, as they might give you an answer for the wrong one.

On the other hand, the weight of that parent company allows it to do more than some others can, including funding clinical research of some of its formulas. It also allows most of its products to be manufactured in cGMP-compliant facilities, which lends a bit to safety and quality standards (ExtenZe was the only Leading Edge Health product whose manufacturing facilities we couldn’t verify).