The Science Behind Testosterone Boosting Supplements

They often do not live up to manufacturers’ claims, and some can be dangerous.

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Many of the products are advertised as sexual enhancement products, claiming to boost libido, increase sexual pleasure, or give a man firmer erections. A man searching for solutions for erection problems might order a supplement online, and nobody has to know he’s seeking help. For another, they’re easy to tadapox tablets find in drugstores, convenience stores, and health food stores. And third, people think they might find a solution to a problem and can avoid discussing such a personal issue with another person, even if it is a doctor. However, consumers need to approach these products with a great deal of skepticism. Below are some things to think about before taking a sexual enhancement supplement. 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.

• Sildenafil is a PDE5 inhibitor used widely for erectile dysfunction treatment.
• L-arginine serves as a nitric oxide precursor enhancing penile blood flow.
• Horny goat weed's icariin acts similarly to PDE5 inhibitors aiding erections.
• Tribulus terrestris is thought to enhance testosterone and sexual desire.
• Ginseng increases stamina and reduces physical and mental fatigue.
• Maca boosts libido and may improve mood and sexual function.
• DHEA supports hormonal balance which can affect sexual performance.
• Zinc deficiency can lead to decreased testosterone and libido.
• Yohimbine promotes blood circulation and nerve signaling for erections.
• Fenugreek impacts testosterone and sexual desire positively.
• Vitamin D deficiency is linked to erectile dysfunction and supplementation helps.

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. 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.

• Sildenafil is a PDE5 inhibitor commonly prescribed for erectile dysfunction.
• L-arginine works as a precursor to nitric oxide, enhancing blood flow.
• Ginseng acts as a natural adaptogen improving stamina and sexual vigor.
• Horny goat weed improves libido and sexual function through icariin content.
• DHEA naturally declines with age, and supplementation may restore libido.
• Zinc deficiency can impair testosterone production, supplements help restore it.
• Tribulus terrestris may improve sexual desire by modulating hormones.
• Yohimbine shares benefits for ED but can cause side effects like anxiety.
• Maca root is used for increasing sexual desire and reducing fatigue.
• Fenugreek is investigated for boosting testosterone and sexual function.
• L-citrulline enhances nitric oxide, promoting stronger erections.

In the above study, researchers used review analysis software to filter out reviews that met the criteria for being unreliable. 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.

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. 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.

Talk to your doctor first

Its effects might last longer if you have mild to moderate ED. A newer form of the medicine that dissolves on the tongue might work faster than the pill that you swallow. This medication is taken with or without food an hour before sex. It works for up to 36 hours. You can take it in a small dose daily or in a larger dose as needed.

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You can take this medicine with or without food 30 minutes before sex, depending on the dose. It lasts 4 to 5 hours, or longer if you have mild to moderate ED. These medicines all work well for ED. When choosing one, tell your doctor or other health care professional what your preferences are, such as cost, ease of use, how long the drug's effects last and side effects. Generic versions of sildenafil, vardenafil and tadalafil are available.

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Check with your health care team before you take any medicine for erectile dysfunction. Oral ED medicines might not work or might be dangerous if you also take any of the following: Often, these are prescribed for chest pain called angina. Some examples of nitrates are nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Bidil). These are commonly prescribed for an enlarged prostate or male pattern baldness. They include dutasteride (Avodart, Jalyn) and finasteride (Propecia, Proscar). Also, adopting healthy habits can go a long way in improving erections—and sex in general. 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.

• 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.

If another health condition, like diabetes or heart disease, is causing the sexual issues, then it’s important to treat that.

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Medicines that block an enzyme called CYP3A4. Oral medicine for ED also might not be safe or work well if you have: Very low blood pressure, called hypotension, or uncontrolled high blood pressure, called hypertension. Kidney disease that needs to be treated with dialysis. These include a heart attack, stroke or a serious heart rhythm disorder in the past six months. An inherited eye disease that affects the retina.

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Side effects of oral ED medicines are often mild. Visual changes, such as blue tinge to vision, sensitivity to light or blurred sight. Rarely, more-serious side effects can happen, including: Some people have suddenly lost some of their hearing or vision after taking one of these medicines. But it isn't clear whether these side effects were caused by the medicine or by health conditions that the people already had. Get medical care right away if you take oral ED medicine and have sudden loss of hearing or vision.

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An erection that doesn't go away on its own. Called priapism, this rare condition can be painful. You need to get treatment for it as soon as possible to help prevent damage to your penis. If you have an erection that lasts more than four hours, call your care team right away. Treatments for erectile dysfunction are big business, and online scams abound. (Sexual problems often improve when the underlying cause is treated.) Ask a doctor or pharmacist about the supplement. These experts can provide information on the safety of a product’s ingredients and what side effects may occur.

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If you do buy medicines over the internet: Check to see if an online pharmacy is legitimate. Never order medicines from an online pharmacy that doesn't list its phone number and physical address, has prices that seem too good to be true, or tells you that no prescription is needed. Also stay away from ones that don't have a licensed pharmacist on staff to answer your questions. Some illegal businesses sell fake versions of real medicines, which can be dangerous or might not work. In the United States, the National Association of Boards of Pharmacy can tell you whether an online pharmacy is licensed and in good standing.

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If you live in another country, check to see if pharmacy association or regulation agencies offer services like these. Make sure you get the right prescription and dose. When you order medicines and when you receive them in the mail, make sure they're the exact dose and type prescribed by your doctor or other health care professional. The dose is the amount of medicine you take. Don't be fooled into buying "herbal viagra." Never take any medicines that claim to be the "herbal" or nonprescription version of an oral medicine for ED.

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These aren't an effective option, and some contain harmful substances. Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started. Looking at store shelves and media advertising, one might think so. Around the world, people spend millions of dollars on dietary supplements each year. 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. 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.