Sexual enhancers are drugs which enhance (normal/abnormal) erectile function and aphrodisiacs which increase sexual arousal and desire.
Erectile dysfunction has been a condition affecting men since ancient times. All early attempts to treat erectile dysfunction (e.g. inflatable penis implants and vacuum pumps) failed and it was not until the early 1990s that the treatment of this condition was revolutionized with the discovery of sildenafil (Viagra). This drug was first approved in 1998 and was the first effective oral therapy to treat erectile dysfunction. Due to its popularity two other drugs were approved that work in a similar fashion as sildenafil: Tadalafil and Vardenafil. Together these drugs are referred to as phosphodiesterase type 5 inhibitors (PDE5i). However, as these drugs do not work as aphrodisiacs, and require sexual stimulation, a number of untested drugs have been sold on the illicit market with suggested effects on sexual behaviors. These drugs, such as Melanotan II, supposedly cause spontaneous erections as well as increase sexual desire and arousal.
While little prevalence studies exist, it appears that there is a growing interest in this type of drugs. For instance, this study found that 3% of around 12.000 men (United Kingdom, Italy and Germany) had used sexual enhancers (e.g. Viagra) in the last six months without a prescription. Some even suggest that the consumption of illicit sexual enhancers might ‘dwarf consumption’ of legitimate versions. While sexual enhancers are frequently associated with male users, it has become evident that female users are increasingly interested in this type of drugs to treat low sexual desire.
Studies also indicate that people often use these drugs to increase sexual confidence, prevent premature ejaculation, erection quality and for better sexual performance, amongst other things. Others simply use them to reverse temporary erectile dysfunction caused by, for example, alcohol or other recreational drugs.
PDE5i (Sildenafil, Tadalafil and Vardenafil) have been approved for medical use and are considered safe within their approved indications. However, a particular concern with these drugs is the use of adulterated and untested sexual enhancers bought from the illicit market. In addition, there are an increasing number of (herbal) supplements being sold as sexual enhancers products. The problem with these is that in number of cases these supplements were found contain untested analogues of sildenafil, tadalafil and vardenafil, which were not declared on the label. Finally, the harm of these untested sexual enhancers (e.g. Melanotan II) is that their effects are unknown due to limited testing on humans.
- Both, R. (2015). A matter of sexual confidence: young men’s non-prescription use of Viagra in Addis Ababa, Ethiopia. An International Journal for Research Intervention and Care, 495-508.
- Kapitány-Fövény, M., Mervó,, B., Corazza, O., Kökönyei, G., Farkas, J., Urbán, R., Zacher, G., & Demetrovics, Z. (2015). Enhancing sexual desire and experience: An investigation on the sexual correlates of gamma-hydroxybutyrate (GHB) use. Human Psychopharmacology. 30(4): 276-84.
- Schnetzler, G., Banks, I., Kirby, M., Zou, K.H, & Symonds, T. (2010). Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. Journal of Sexual Medicine, 7(3), 1237-1246.
- Venhuis, B.J., de Vooght, P., Emke, E., Causanilles, A., & Keizers, P.H.J. (2014). Success of rogue online pharmacies: sewage study of sildenafil in the Netherlands. British Medical Journal, 349.
- Yuan, J., Zhang, R., Yang, Z., Lee, Y. et al. (2013). Comparative Effectiveness and Safety of Oral Phosphodiesterase Type 5 Inhibitors for Erectile Dysfunction: A Systematic Review and Network Meta-analysis. European Urology, 63(5), 902-912.
Examples of drugs used to enhance sexual performance:
|Name||How it works||Duration||Route of administration|
|This drug causes spontaneous erections and acts as an aphrodisiac for both men as women. It is suggested that this drugs directly increases sexual desire.||2 hours of half-life||Injection and nasal|
|Melanotan II||This drug causes spontaneous erections and acts as an aphrodisiac for both men as women. This drug is also used for its image enhancing effects (skin tanner), and as a weight-loss drug (appetite suppressant).||Half-life of 1 to 2 days||Injection|
|Sildenafil is one of the most commonly used sexual enhancers. This drug increases blood flow into the penis causing an erection. However, this drug does not function as an aphrodisiac and will not cause an erection unless the user is sexually aroused.||4 hours half-life||Oral|
|This drug is also called the ‘weekend pill’ because it effects can last up to 22 hours. This drug increases blood flow into the penis following sexual stimulation. This helps to maintain an erection.||17 to 22 hours half-life||Oral|
|Vardenafil (Levitra)||This drug increases blood flow into the penis following sexual stimulation. This helps to maintain an erection.||4 to 6 hours half-life||Oral|
|Yohimbe||This drug can increase blood flow and nerve impulses to the penis or vagina. It also helps to counteract the sexual side effects of certain medication used for depression.||1 hour half-life||Oral|
* The duration can vary depending on the type of drugs.