Often labeled as dietary supplements, male enhancement pills claim to boost sexual performance by increasing testosterone levels, improving erections, enhancing the libido, and more. This sounds like it would be good news when it comes to getting your partner pregnant.

However, there is some evidence that these supplements — or even prescription medications like Viagra — can have a negative effect on fertility. Here is what you should know about male enhancement pills and male fertility, including which common ingredients in erectile dysfunction supplements can be damaging and which are sperm-safe.

Takeaways:

• Male enhancement pills may boost sexual desire and performance.
• Herbs like ashwagandha, maca root, and fenugreek may positively impact both libido and fertility.
• Some male enhancement supplements contain testosterone, which can negatively impact fertility by lowering sperm count and concentration.
• While Viagra may help users maintain erections, there is conflicting evidence on how the drug affects fertility.

What is a male enhancement pill or supplement?

Male enhancement pills are supposed to increase blood flow to the penis to help users get and maintain an erection, consequently boosting sexual desire and performance. Some formulations also claim to support proper testosterone levels, which may be helpful for men with a low libido. Ingredients range from herbs like ashwagandha and ginkgo to vasodilators like sildenafil citrate and tadalafil.

Herbal male enhancement supplements

There are a wide range of herbal supplements used to male sexual performance and pleasure. These include maca root, gingko, ashwagandha, ginseng, and more. Some herbal supplements do have clinical data to back them up, such as this 2003 study that linked maca to increased sexual desire in men, and this 2012 Korean study that showed the efficacy of panax ginseng in treating erectile dysfunction.

However, not all herbal supplements are as effective or even safe. The FDA is consistently updating a list of tainted sexual enhancement products that contain hidden ingredients that may be harmful or have contraindications with other medications. (Remember, herbal supplements — unlike most medications — do not have to be approved by the FDA, or have data to back up their use, in order to be sold.)

Viagra, Cialis, and Levitra

The active ingredient in Viagra is sildenafil citrate. Sildenafil, tadalafil (the active ingredient in the drug Cialis), and vardenafil (the active ingredient in the drug Levitra) are known as vasodilators and phosphodiesterase-5 inhibitors. These drugs target and inhibit a specific enzyme in order to open (dilate) the blood vessels and increase blood flow to the penis. This makes it easier for users to obtain and maintain an erection.

Why do people use male enhancement pills?

People use male enhancement pills to address a lack of libido, low sexual stamina, or erectile dysfunction. These medications are fairly common. In a 2017 study out of Saudi Arabia, 52% of respondents used sex-enhancing medications to treat erectile dysfunction, while 69% reported that they used the pills “recreationally” for an “enhancement of erections.”

Some find that issues with libido, erection, or ejaculation are not just affecting their own sexual satisfaction and that of their partner, but also their ability to conceive a child naturally (which requires sexual intercourse and ejaculation). Experts estimate that up to half of infertile men experience low sexual desire and lack of sexual satisfaction; around one in 6 report erectile dysfunction or premature ejaculation; and 10% experience orgasmic dysfunction (the inability to reach orgasm).

Do male enhancement pills affect male fertility?

Because some people experience difficulty conceiving as a result of erectile or orgasmic dysfunction, male enhancement pills may help, because they allow a couple to have intercourse to ejaculation. However, ingredients in some male enhancement pills may have negative effects on fertility. This is especially true for drugs that contain testosterone and PDE5 inhibitors like Viagra.

Testosterone

Taking testosterone to enhance sexual performance or pleasure seems to make sense. After all, research indicates that the symptoms of low testosterone include decreased libido, erectile dysfunction, and decreased energy. Many men are prescribed testosterone replacement therapy for these symptoms.

However, taking testosterone or medications that increase testosterone can have lasting effects on male fertility. A 2016 study found that anabolic steroids inhibit the secretion of both follicle-stimulating hormone and luteinizing hormone, which are both crucial to producing sperm.

When these hormones are inhibited, the body is not able to properly produce sperm, resulting in lower sperm count and concentration. In another study of male bodybuilders, decreased fertility was one of the most significant long-term adverse effects of taking testosterone over a two-year period.

Erectile dysfunction medications

There is conflicting research around these drugs’ effects on male fertility. One 2017 meta-analysis found that taking PDE5 inhibitors like Viagra, Cialis, and Levitra boosted the number of motile sperm as well as normally shaped sperm. However, an earlier 2007 study indicated that, while such drugs do improve sperm motility, they can negatively impact the acrosome reaction, the process by which sperm bonds with the egg during fertilization.

Until more research confirms the safety and efficacy of Viagra and other erectile dysfunction medications, experts recommend that users who are trying to conceive reconsider their intake, especially those who use it recreationally and are able to get or maintain an erection without.

Herbal male enhancement supplements

There are a range of herbs used in male enhancement pills. Certain herbal supplements used to increase libido may actually have a positive impact on sperm health. Here is what the research says.

• Ashwagandha: A 2013 study showed that three months of ashwagandha supplementation increased sperm counts by 167%, motility by 57%, and semen volume by 53%. Ashwagandha has also been proven to increase seminal concentrations of testosterone, LH, and FSH.
  
• Fenugreek: Studies show that fenugreek also improves testosterone levels, with increases of up to 46% after three months of supplementation. This is shown to benefit sperm parameters such as count and morphology, while also boosting libido.
  
• Maca root powder: Research from 2011 found that in addition to “significantly” improving libido, maca root also increased sperm count and sperm motility. 

View our guide to male fertility supplements.

What’s actually in your herbal supplements?

Making matters complex is the fact that supplements are not regulated or routinely tested in the United States. Periodic analyses have shown that some “natural” male enhancement supplements, such as ExtenZe, can contain testosterone-boosting hormones such as DHEA that are known to adversely affect sperm count and quality — potentially long term.

Additionally, the FDA has found that a number of sexual enhancement supplements that are marketed as “herbal” or “natural” actually contain sildenafil or other active ingredients from prescription erectile dysfunction medications. (If it works like Viagra, it’s probably actually Viagra.) While the dosage is likely far lower in these supplements than if someone was using prescription medications, it’s still possible that these active ingredients could impact male fertility in the same way Viagra, Cialis, and Levitra do.

The bottom line: Male enhancement pills can enhance sexual desire and performance, but the ingredients in some formulations may end up harming fertility.

If you are considering taking a male enhancement pill to improve sexual desire or performance, pay attention to the ingredients to avoid potentially harmful effects on fertility, and choose a legitimate manufacturer (avoiding those on the FDA’s bad list).

In addition to choosing herbal supplements supported by clinical data, following a healthy lifestyle is important. View our guide to sperm improvement for lifestyle tips to support sexual and fertility health.