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The advertising industry has had its fair share of criticism for promoting male enhancement pills that have been rejected by numerous health experts around the world. These so-called OTC (over-the-counter) ‘sex boosters’ that men take have been linked to serious health issues such as loss of hearing and vision, heart attack and other conditions that can become fatal without prompt intervention.
The United States Food and Drug Administration (US FDA) has reported the presence of certain undeclared ingredients like tadalafil and sildenafil in some sexual enhancement products, which are generally used to treat erectile dysfunction. Older adults, the largest consumers of male enhancement pills, often have existing conditions like diabetes, hypertension or other cardiac issues. Medications to treat these ailments are known to contain nitrates, which interact with the hidden ingredients present in these pills. This increases the risk of complications like low blood pressure, dizziness and fainting, says Dr Shashidhar B, an andrologist at Manipal Hospital, Bangalore.
A cross-sectional study conducted in the UAE involving 1101 men found that around 40% of the participants used sexual enhancement supplements, out of which around 32% reported adverse effects. The use of such supplements was more prevalent in older adults (aged 60–69 years) and those with diabetes, hypertension and obesity. Surveys conducted across other major countries, such as the US, Japan, the UK and Australia also report similar results. The Market Data Forecast predicts that the global sexual wellness market is expected to be worth USD 44.23 billion by 2028.
Male enhancement pills: Why do men opt for them?
Young men, who are often influenced by peers and pornography, start setting unrealistic expectations for their sexual relationships, says Dr Shashidhar. “Psychological pressure is one of the primary reasons why young men buy OTC pills for boosting their libido (sexual drive) or achieving a long-lasting erection,” he adds.
He also shares that mid-life crisis can cause men to experience issues like irritability, mood swings, depression, anxiety, sleep issues, weight gain and poor decision-making. This can disrupt work-life balance and induce stress. Men who aren’t able to manage the stress effectively often become embarrassed to address their sexual issues with a doctor. Instead, they opt for OTC pills as quick fixes.
Apart from that, sexual disorders such as erectile dysfunction, low sperm count, premature or delayed ejaculation, reduced sex drive and low testosterone levels are common among the elderly population, especially those who’ve undergone prostate surgery or have diabetes or cardiac issues; this can be another reason for choosing male enhancement pills.
Dietary vs sexual supplements: How do they differ?
Dr Shashidhar says, “Dietary supplements are used to address deficiencies in certain minerals and vitamins, which are necessary for hormonal balance and normal functioning of the body. They are safe and effective if consumed within the prescribed limits.”
The efficacy of dietary supplements is backed by comprehensive research. Moreover, doctors prescribe them after considering certain factors relating to the individual, including their medical history and current medications. On the contrary, healthcare professionals usually disapprove of sexual supplements, as they may not necessarily meet the safety and efficacy protocols. The study conducted in the UAE highlighted that sexual enhancement supplements containing ingredients like maca, ginseng, L-arginine and zinc caused issues like palpitation (shortness of breath) as well as gastrointestinal and skin problems in the participants.
Ill-effects of using male enhancement pills
According to experts, misuse of sexual supplements can give rise to an array of complications, which include:
♦ Bleeding: Self-proclaimed sexologists often advise people to take herbal sexual supplements like Yohimbe. However, it causes bleeding (resulting from platelet dysfunction) and gastrointestinal issues, says Dr Prashanth Ganesh, senior consultant, urology & andrology, Apollo Hospitals, Bangalore.
♦ Coronary artery disease: A research study assessing the effects of sexual supplements containing ephedra concluded that atherosclerotic coronary disease (a condition where the buildup of substances like fats and cholesterol in the arterial walls makes them narrow, restricting blood supply to the heart) and sudden death were more common among those who took them.
♦ Loss of libido: A gradual loss of sex drive and secondary erectile dysfunction (resulting from factors like stress and depression) can result from the long-term use of male enhancement pills, says Dr Shashidhar.
♦ Gut issues: Dr Pradeepta Kumar Sethy, director, gastroenterology, Medica Superspecialty Hospital, Kolkata, says ashwagandha, often used in libido supplements, can be harmful if taken in excess. “High doses may cause digestive issues or interfere with other medications. Individuals with autoimmune conditions or other underlying issues should exercise caution when taking such supplements,” he adds.
Further, he also shares that some libido supplements may contain probiotics and zinc, which can cause symptoms like bloating, nausea, vomiting and other gastric issues if consumed in excess.
♦ Other issues: Long-term use of male enhancement pills can cause liver or kidney failure. Penile fibrosis (scarring on the penile surface, causing reduced penile elasticity) is another serious outcome that requires surgical intervention, says Dr Ganesh.
The commonly available drugs for treating erectile dysfunction — though safe to use — can cause side effects such as a headache, stuffy nose, sore throat and stomach discomfort. Some people may encounter sudden hearing or vision loss as well. In rare cases, one can also experience priapism [prolonged erection for over four to five hours], which requires surgical intervention, explains Dr Shashidhar.
Male enhancement pills: Who should absolutely avoid them?
Dr Shashidhar says that people with diabetes and a history of heart attacks should avoid male enhancement pills. Inculcating certain lifestyle changes can have a positive impact on their sexual health.
Those undergoing or with a history of prostate surgery should stick to natural ways to improve their sexual health, which include a healthy diet, regular exercise, meditation and Kegel exercises, says Dr Ganesh. Additionally, those undergoing certain treatments or taking medications are highly recommended to consult a specialist to better understand the safety and efficacy of these pills.
As of January 2024, the US FDA has released an updated list of about 428 sexual enhancement products that have often been found to be adulterated with active pharmaceuticals (not mentioned in the label) and are sold without standard scientific evaluations. Hence, it advises against buying such products to prevent severe consequences.
Takeaways
- Experts advise against taking over-the-counter male enhancement pills, as they can give rise to several health conditions.
- The primary complications resulting from these ‘sex boosters’ include bleeding, coronary artery disease, loss of libido and kidney or liver failure.
- Those with diabetes, cardiac issues or a history of prostate surgery should avoid such pills. Rather, they can opt for natural ways to improve their sexual health, which include a healthy diet, regular exercise, meditation and Kegel exercises.
