We’re also wary of any product that makes a big deal out of certain ingredients, only to include them in doses that are significantly smaller than doses used in studies.
How effective are Viagra, Cialis, vardenafil, and Stendra?
Men may see online advertisements for non-prescription products that claim to vardenafil oral improve erectile function. But these claims are often misleading, and taking such products could be dangerous. (Learn more about sexual enhancement supplements here.) Burnett, Arthur L., MD“Erectile Dysfunction: AUA Guideline (2018)”(2018) “Which drug for erectile dysfunction?”(August 9, 2022) “Erectile dysfunction: Viagra and other oral medications”(December 20, 2022) National Institute of Diabetes and Digestive and Kidney Diseases “Treatment for Erectile Dysfunction”(Last reviewed: July 2017) Connelly, Dawn“Three decades of Viagra”(May 25, 2017) 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. 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.
The Best Practice: Treat Erectile Dysfunction with a Urologist
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. 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. They’re not perfect, and they may not make a dramatic difference for most men. But there are men for whom they’ll make a real difference.
Care at Mayo Clinic
So we find the products that combine that potential with a money-back guarantee that’s generous enough to protect your money while you give them a try. If you’re in a hurry, here’s a quick look at our top recommendations: Best on a super-tight budget: ExtenZe Best for low testosterone: Testosterone Support by Innerbody Labs Performer 8 includes nine powerful ingredients proven to increase sexual stamina, erection strength, and semen volume. Performer 8 is a safe and natural way to revitalize your sexual vitality and is only available directly through Performer8.com. Ingredient effectiveness is supported by clinical studies, and all purchases are backed by a lifetime guarantee. When assessing and comparing vardenafil 10 mg tablet male enhancement pills, we rely on clinical research and reports from users. Many of those studies lack statistical significance as it is, so turning to an inferior dose of a poorly studied ingredient isn’t the way to gain our appreciation. Performer 8 includes a streamlined set of specific ingredients, and several of those ingredients appear in doses consistent with, or at least approaching, doses used in clinical studies.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 100mg | 10 Pills | 28.91€ 27.53€ | |
| Viagra Generic | 50mg | 20 Pills | 40.52€ 38.59€ | |
| Cialis Super Active | 20mg | 120 + 16 Pills | 382.15€ 363.95€ | |
| Viagra Soft Tabs | 100mg | 180 + 10 Pills | 314.95€ 299.95€ | |
| Cialis Generic | 5mg | 180 + 10 Pills | 159.65€ 152.05€ | |
| Cialis Soft Tabs | 20mg | 30 + 4 Pills | 87.43€ 83.27€ | |
| Cialis Generic | 60mg | 10 Pills | 41.22€ 39.26€ | |
| Levitra Generic | 40mg | 10 Pills | 41.37€ 39.40€ | |
| Cialis Generic | 5mg | 90 + 6 Pills | 115.91€ 110.39€ | |
| Cialis Professional | 20mg | 60 + 2 Pills | 183.83€ 175.08€ | |
| Apcalis SX Oral Jelly | 20mg | 50 + 6 Sachets | 146.39€ 139.42€ |
Its inclusion of ashwagandha allows its formula to address testosterone levels directly lady era tablets and reduce stress and anxiety.2 That can yield positive results in your body’s ability to generate an erection while preventing the psychological factors associated with ED from creating a negative feedback loop in which one or two failed erections create self-doubt and stress that leads to more failed erections. The safety profiles of these various male enhancement products are a mixed bag.
| Name | Active Ingredient | Onset Time | Duration | Common Side Effects | Prescription Required |
|---|---|---|---|---|---|
| Viagra | Sildenafil | 30-60 min | 4-6 hours | Headache, flushing, nasal congestion | Yes |
| Cialis | Tadalafil | 30-60 min | Up to 36 hours | Muscle pain, indigestion | Yes |
| Levitra | Vardenafil | 25-60 min | 4-5 hours | Dizziness, blurred vision | Yes |
| Stendra | Avanafil | 15-30 min | Up to 6 hours | Flushing, back pain | Yes |
Since many of the studies looking into common male enhancement ingredients often lack large enough sample sizes to say anything positive with confidence, it’s also difficult to say how safe these products may or may not be. In many cases, male enhancement pills use doses of individual ingredients that are lower than those seen in studies.
What Causes Erectile Dysfunction and Why Treatment Options Differ
It takes some time for the drug to work, and these time frames vary by medication. For example, men usually get an erection about 30 to 60 minutes after taking sildenafil or vardenafil. Men who take tadalafil as needed (not daily) may need to wait 30 to 45 minutes. For those who take avanafil, the wait may be 15 to 30 minutes. ED medications also vary in how long they are effective.
Cost of erectile dysfunction pills
For example, once sildenafil or vardenafil take effect, a man might be able to get an erection for four to five hours. For avanafil users, the time frame is about six to twelve hours. Tadalafil has the longest effective time—usually 24 to 36 hours for as- needed users. Men who take tadalafil daily should be able to get an erection at any time. When prescribing ED drugs, doctors take many factors into account.
ED drugs are not safe for all men.
They consider a man’s overall health and the drugs and supplements he currently takes. Sometimes, it takes time to find the most effective ED drug. These medications have been shown to be quite effective, but results vary from man to man. If a particular drug doesn’t work as well or has bothersome side effects, a man’s doctor may prescribe a different drug or suggest a different ED treatment. It’s important to remember that in the United States, ED drugs are available only by prescription. That might be a good thing for their safety, but without research into how these ingredients may interact when taken together — even at lower doses, and particularly over a long period of time — it would be irresponsible to declare them safe. We are aware of certain side effects that crop up in studies examining these ingredients’ potential to treat ED, but some boast studies specific to their safety.
- Age is a major risk factor due to increased vascular issues and declining testosterone.
- Diabetes mellitus damages nerves and blood vessels, a leading organic cause of ED.
- Hypertension and atherosclerosis narrow penile arteries, restricting blood flow.
- Metabolic syndrome (obesity, high blood pressure, insulin resistance) strongly correlates with ED.
- Radical prostatectomy or other pelvic surgeries can damage nerves controlling erections.
- Spinal cord injuries or neurological disorders (MS, Parkinson's) disrupt nerve signals.
- Hormonal disorders: Low testosterone, high prolactin, or thyroid problems.
- Certain prescription medications: Antihypertensives, antidepressants, antipsychotics, diuretics.
Other ingredients are mainly studied for very different potential benefits — like L-carnitine, which boasts a fair amount of research into its potential as a weight loss supplement.38 As long as the doses in those studies are comparable, we can begin to create a more comprehensive picture of each ingredient's side effect risk.
- Online Consultation Platforms: Telemedicine services for personalized ED treatment advice.
- Herbal Clinics: Specialized clinics offering natural ED solutions.
- Fitness & Diet Tips: Lifestyle changes to naturally improve erectile health.
- Stress Reduction Techniques: Mindfulness, meditation to reduce performance anxiety.
- Sleep Optimization: Better sleep improves overall blood flow and libido.
- Regular Exercise: Improves vascular health supporting erections.
- Balanced Diet: Rich in antioxidants and nutrients supporting sexual function.
- Alcohol & Smoking Cessation: Reduces factors that impair blood flow.
- Weight Loss Programs: Reduce obesity-related ED risk factors.
- Hydration & Supplements: Keep the body well-hydrated to support overall health.
- Sexual Therapy: Counseling to treat psychological causes of ED.
Ginseng is a common ingredient in many male enhancement supplements, but several studies have examined its potential as an anti-inflammatory or antioxidant agent.
- Initial consultation typically involves a detailed medical and sexual history.
- Follow-up appointments assess medication effectiveness and adjust treatment plans.
- Combination therapy (e.g., oral pill + injection) may be used for difficult cases.
- Treatment goals are individualized: restoration of satisfactory sexual intercourse.
- Partner involvement in consultations is often encouraged for better outcomes.
- Monitoring for side effects and drug interactions is an ongoing process.
- Treatment may evolve as health conditions change or new therapies become available.
- A good doctor-patient relationship is key to successful long-term management.
Some of these studies have looked at doses up to 9g daily and showed few-to-no side effects.3 Other studies showed potential benefits at doses as low as 1g/daily.
- Natural doesn't always mean safe; herbal supplements can interact with medications.
- FDA-approved prescription drugs have proven efficacy and safety profiles from clinical trials.
- Over-the-counter "herbal Viagra" products are often adulterated with prescription drugs.
- Supplements are not strictly regulated for purity, potency, or accuracy of labeling.
- Placebo effect can account for perceived benefits from some alternative ED remedies.
- Evidence-based medicine relies on large, randomized, controlled clinical trials.
- Anecdotal reports and testimonials are not reliable substitutes for scientific evidence.
- Consult a healthcare provider before starting any new supplement, especially with heart conditions.
Performer 8, our preferred male enhancement product in terms of safety, utilizes a 6g daily ginseng dose. Stomach discomfort, flushing, and constipation crop up occasionally in the research, but cases are often mild and resolve quickly.4 Another ingredient we like to see in male enhancement products is ashwagandha. There has been a lot of research into ashwagandha’s anxiolytic effects, but other studies looking at its ability to boost testosterone have been promising, as well. Performer 8 utilizes a well-known brand of ashwagandha — KSM-66. It’s not the most potently concentrated form, but it’s been subjected to multiple clinical studies, many of which show comparable rates of adverse effects as those seen in the placebo groups.5 Lastly, when it comes to pills, one occasionally overlooked aspect of safety is the size of the pill itself; many people have difficulty swallowing pills of any size, but especially larger ones.
How do erection pills work?
This reduces the impact of cost and customer service in our final recommendations. You’ll see that Performer 8 outperforms the competition in most categories, with greater doses of ginseng and barrenwort than most competitors. There’s even a certain point of view from which it offers the best cost, which we’ll get into below. Since everyone uses male enhancement pills for different reasons, one remedy might not be as effective for you as it is for others. But we don’t think the answer is to cram a bunch of ingredients into a pill and hope it pleases everybody. If you're one of these people, keep in mind that Performer 8 is a middle-of-the-road size compared to others, while Volume Pills is definitely on the small side. One thing that helps Performer 8 in contrast with others like Semenax, however, is the width — Performer 8 is narrower than some.
| Product Name | Rating (out of 5) | Number of Reviews | Price Range | Notes |
|---|---|---|---|---|
| Viagra | 4.5 | 10,000+ | $30-$50 per pill | Well-known, proven efficacy |
| Cialis | 4.6 | 8,500+ | $35-$70 per pill | Long-lasting effect |
| Levitra | 4.4 | 6,000+ | $30-$60 per pill | Quick onset |
| Stendra | 4.3 | 4,200+ | $40-$75 per pill | Fast-acting |
Considering the practical and potential costs when trying a male enhancement product, we take price into account along with things like shipping costs, money-back guarantees, and bulk purchasing discounts.
How do side effects compare with Viagra, Cialis, vardenafil, and Stendra?
We also order the majority of these products ourselves to test the quality of each company’s website, customer service, privacy experience, and shipping logistics. All told, our team has spent over 200 hours researching the products and services of these companies to provide an accurate, unbiased analysis of how they compare. We reviewed more than 100 scholarly articles pertaining to erectile health and the various ingredients included in common male enhancement supplements. Additionally, like all health-related content on this website, this guide was thoroughly vetted by one or more members of our Medical Review Board for accuracy. We’ll continue to stay on top of new developments in male enhancement and erectile dysfunction treatment to keep this article up to date.
Can you use baking soda for erectile dysfunction treatment?
We had to be very careful in evaluating male enhancement products, as so many contain ingredients without enough clinical research to recommend them in good conscience. Among the products we found suitable, our comparative analysis focused on four key areas the average customer would need to consider before choosing one: effectiveness, safety, cost, and customer service. Effectiveness may be the most obvious, but safety was just as important for us. Those two criteria carried the most weight in our consideration. As you’ll see, these supplements’ prices fall within a pretty limited range; many of them are considerably less expensive than brand-name ED prescriptions but a lot more expensive than generic prescription alternatives. Shipping from all of our recommended companies is free, so let’s take a look at how the other parameters stack up: Male Extra narrowly claims this category thanks to: A tie for the lowest cost per bottle at the highest bulk purchasing level A narrow edge over Performer 8 in cost at the three-month level, which is kind of a “Goldilocks” quantity for many first-time buyers At the three-month amount, however, Performer 8 only costs $10 more than Male Extra.