Do Gas Station Sex Pills Really Work?
The story America tells about itself is tinged with do-it-yourself principles. In this modern world of doing your own research, over-the-counter (OTC) herbal supplements are especially popular, and there's a certain subset of supplements that flash particularly eye-catching labels in convenience stores—what we'll call gas station sex pills.
Sales of herbal dietary supplements in the United States topped $12.35 billion in 2021, up 9.7 percent from the previous year, according to the American Botanical Council, a nonprofit herbal supplement industry watchdog. That's in addition to the 17.3 percent growth the sector experienced in 2020.
But here, we're specifically talking about supplements that claim to help give you a firmer erection with "all-natural ingredients." Let's examine what exactly goes into these "male enhancement" supplements, what you should know about them, whether or not they work and, especially, whether gas station sex pills are safe.
What are gas station sex pills?
For our purposes, gas station sex pills are any over-the-counter herbal supplements that claim to help men enhance their sexual capabilities. These types of products usually claim to contain ingredients such as Korean red ginseng, horny goat weed, maca root, Yohimbe, amino acids like L-arginine, and sometimes B vitamins.
Often, manufacturers' claims rest on small, one-off studies that may only indirectly suggest one ingredient's effect on circulation, heart rate or blood flow. They then imply that their product formulation can help naturally give you an erection.
Supplement manufacturers are largely unregulated, unlike pharmaceutical companies that are heavily scrutinized. That means they can make a lot of claims that are largely unchallenged.
"There is almost no oversight or monitoring of the industry," said Katherine Rotker, M.D., a urologist with Yale Medicine in New Haven, Connecticut, who specializes in male infertility and reproductive health. "The specific natural supplements that have been looked at have had mixed results in small-scale studies, but in terms of dosing and timing of doses, there's less data to go on. It's similar with our whole vitamin and nutraceutical industry: There's just not that level of regulation."
How are gas station sex pills different from Viagra?
Apart from regulations and stringent testing for efficacy and quality, there are other important differences between OTC supplements and pharmaceutical erection pills.
Part of the complicated process of getting an erection involves the release of a molecule called nitric oxide (NO). Another molecule, phosphodiesterase 5 (PDE5), reverses this process, and PDE5 inhibitors such as Viagra and Cialis block this final step, enhancing the production of nitric oxide, blood flow and, thus, erections.
Nitric oxide is frequently mentioned in male enhancement supplement literature with claims that a company's products naturally enhance it. The thing about these supplements is that "all-natural" is often anything but.
"I have a lot of patients come in and talk about gas station sex pills," said Justin Dubin, M.D., a urologist and men's health specialist with Memorial Healthcare System in South Florida. "Guys tell me sometimes it works, sometimes it doesn't, and they don't know why. It's inconsistent, but it works sometimes. What we know is that most of them are not all-natural. Most of them have Viagra or Cialis in them."
The quality of supposedly "natural" male enhancement pills with PDE5 inhibitors got so bad that the FDA issued a warning about them in 2018. Their list of tainted sexual enhancement products, most of which involve "hidden drug ingredients," currently runs to 42 pages.
"Someone actually had a heart attack taking [a gas station] medication," Dubin said. "Why? These pills were found to have sildenafil or tadalafil at exceedingly high dosages, ranging from 14 to 200 times the regulated dose. So, obviously, people are liking these medications, and they're having good success with them. Although it claims to be natural, it probably isn't."
Quality control of gas station sex pills
The problem with taking PDE5 inhibitors without knowing it is they may create complications for people with existing health conditions. They interact negatively with other drugs, particularly heart medications, and can have serious consequences if the two are taken together.
"One of the biggest contraindications is the use of nitrates because that bottoms your blood pressure out, and you can stroke out and die," Dubin said. "And if these medications are telling you it's all-natural, you're not going to think about the contraindications."
These supplements are often watered down with substances other than PDE5 inhibitors, some of which are perhaps even more troubling.
"They've taken samples that contain gypsum, non-purified talc, amphetamines, commercial-grade paints, paracetamol, so who the hell knows what's in there," Dubin said.
The takeaways
At the end of the day, that's the problem: You just don't know.
On the other hand, if you just talk to your doctor, they may be able to help you with your erection problems and identify an underlying issue and address it.
"What's written on the package, you can't really guarantee that's what's actually in there," Rotker said. "But we have a lot of good treatments and medications, like PDE5 inhibitors, and they have really good safety profiles. We know how they interact with most medications and health conditions, and even if those don't work, we have other options available, like injections and devices that can help.
"There are options out there, including pills and beyond pills, so we don't have to depend on a gas station."
