ExtenZe for erectile dysfunction (ED): does it work?

Sexual enhancement may be one of the least controversial concepts in the world—what human being would pass up an opportunity for better sex? 

Unfortunately, the off-the-charts marketability of the phrase “sexual enhancement” has given rise to some products that are controversial––and even potentially dangerous. Certain male enhancement products—particularly those available without a prescription—fall into this category, including pills that promise a bigger member. 

ExtenZe is one such supplement that claims to alleviate erectile dysfunction (ED), but it may not be all it’s cracked up to be. Here’s why. 

You may have seen ExtenZe advertised on TV or in a magazine if you have access to a time machine and are reading this from 2005.

ExtenZe is an herbal dietary supplement marketed for “natural male enhancement," including a larger penis and better sex. The product's website claims it will give the user harder, more frequent erections, as well as enhance pleasure and produce more explosive orgasms.

The ingredients of ExtenZe include yohimbe, L-arginine, horny goat weed, zinc, red ginseng, pregnenolone (a hormone produced by the adrenal gland), and dehydroepiandrosterone (DHEA), among others. Some of these ingredients on their own are also used to help with ED, although research on most is scant.

Erectile dysfunction (ED) can include anything from softer erections to erections that don't last as long, less frequent erections, or a lack of morning wood. It's also very common. Most guys will experience ED at some point, and it's estimated that more than 30 million American men have some form of it (Nunes, 2012). 

ExtenZe claims to reduce symptoms of ED by encouraging more blood flow into the penis, producing an erection. There are no studies yet that specifically examine the health benefits of ExtenZe, although there has been some research on the product’s individual ingredients. For example, studies have found that damiana, horny goat weed, and muira puama extract may have sexual health benefits, including an increased sexual drive. 

It cannot––at least not permanently. No pill can, and here's why.

The penis contains two tubes of spongy tissue called the corpus cavernosum. During an erection, this tissue fills with blood, causing the penis to stiffen and enlarge. When the blood drains out, the penis softens and shrinks. The amount of spongy tissue in your penis is set once puberty ends. That's what determines the size of your erection, and there's nothing a pill can do to create more of it.

Some male sexual enhancement products like ExtenZe contain ingredients that may help you get more in the mood for sex, get an erection faster, or achieve one that's a bit firmer than usual. But a dietary supplement can't enlarge the corpus cavernosum and make you permanently bigger. 

The same goes for any cream, gel, mousse, or frappé that claims to enlarge your penis via topical application.

Biotab Nutraceuticals, the company that makes ExtenZe, has been subject to lawsuits for deceptive marketing. In 2011, Biotab paid $6 million to settle a class-action lawsuit that accused the company of false advertising. 

Ads for ExtenZe once described the product as a capsule that can “make a man larger” and is “scientifically proven to increase the size of a certain part of the male body." Five guesses as to what that certain body part is? 

But the language that got them sued was vaguer than what prompted another lawsuit in 2006. Biotab was fined $300,000 for unfair business practices and false advertising in California over claims that ExtenZe could enlarge a man’s penis by 27%.

Today, the company has tampered down its marketing campaigns, merely promising that ExtenZe will give you "the manhood you've always wanted." Okay, false advertising is one thing, but does that mean it’s unsafe?

In 2018, the U.S. Food and Drug Administration issued a warning not to purchase or use Extenze. The agency's lab tests found that the product contained sildenafil, the active ingredient in Viagra (FDA, 2018). 

"This undeclared ingredient may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels," the FDA stated. "People with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates."

It’s extremely dangerous for anyone taking nitrates to take ED medication at the same time as the two can react and cause a potentially deadly drop in blood pressure. Viagra and other ED drugs are known as PDE5 inhibitors, which work by widening blood vessels. Nitrates also widen blood vessels, and taking them in conjunction with a PDE5 inhibitor can widen them too much, leading to serious adverse health effects. 

Other possible side effects of ExtenZe include (Coon, 2012; Kearney, 2010; NIH, 2020; Smith, 2021): 

• Nausea 

• Cramps 

• Diarrhea 

• Headache

• Trouble sleeping 

• Stomach aches

• Breast development in men (gynecomastia)

• Seizures

Oh, and at least two of ExtenZe's ingredients (DHEA and pregnenolone) are considered performance-enhancing drugs and are banned by professional sports. 

Another thing to keep in mind: ED can be a sign of a potentially serious health condition. Symptoms of ED could be an early indication of heart disease, high blood pressure, diabetes, depression, hormone imbalance, and more. That's why it's important to consult a healthcare provider at the first signs of ED. If you're taking ExtenZe to address erectile dysfunction, you might be overlooking a bigger problem.

If you're experiencing ED, talk with a healthcare professional. They might suggest that you make some easy lifestyle changes, including getting more exercise and managing stress. 

You might also be prescribed ED medications, such as sildenafil (brand name Viagra), tadalafil (brand name Cialis), vardenafil (brand name Levitra), or avanafil (brand name Stendra). They all pretty much work the same way: by widening arteries and encouraging more blood flow to the penis. 

It bears repeating: certain medications also increase nitric oxide, which is why taking ED meds at the same time as other prescription drugs can be dangerous. If you're experiencing ED, there are medically proven steps you can take instead of using a nutritional supplement. 

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Current version

December 15, 2021

Written by

Michael Martin

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.