Brightly colored packaging, promises of better sexual performance and names like “,” “” and “” make sexual enhancement products difficult to miss. They can be found online, in convenience stores and at gas stations, and some can even be ordered through delivery services.
But what’s inside the package may be considerably different from what appears on the label.
In May 2023, the U.S. Food and Drug Administration a sexual enhancement product called , one of many Rhino-branded products. Laboratory testing had found that it contained two ingredients that did not appear on its label: – the active ingredient in the prescription erectile dysfunction medication – and , the widely used pain reliever also sold as Tylenol.
This finding was not an isolated incident.
, the FDA has maintained an of health fraud scams, including sexual enhancement and energy products found to contain hidden pharmaceutical ingredients.
Today, the sexual enhancement market is still going strong – and still putting out adulterated substances. Seven new products were added to the FDA’s list in September 2026. Recent warnings have involved pills, gummies, , and even marketed as sexual enhancers.
As a who studies substance use and health behaviors with , I see these products as part of a larger challenge created by global supply chains, online commerce and a regulatory system that struggles to keep pace with rapidly changing products.
Supplements are regulated – but not like prescription drugs
In the U.S., the FDA under a different framework than for prescription and over-the-counter drugs. Those drugs undergo a involving three phases of trials that usually take nearly a decade to complete.
Supplements, on the other hand, are regulated under the , which holds manufacturers responsible for ensuring that their supplements are safe and properly labeled. So dietary supplements aren’t completely unregulated, but they generally . This means the FDA does not before they reach consumers, as it does with medications.
That creates an important distinction between pharmaceutical drugs like Viagra and products marketed as dietary supplements, such as many Rhino-branded sexual enhancement products. Viagra is an : Its active ingredient, sildenafil, has been for safety, effectiveness, dosing and manufacturing quality for an approved medical use.
After a dietary supplement goes to market, the FDA periodically inspects its manufacturing facilities and collects and tests some products. But it does not routinely test every supplement on store shelves. Instead, the agency or injuries and those suspected of containing fraudulent, adulterated or .
Hidden Viagra – and much more
Sildenafil and tadalafil, the active ingredients in Viagra and , belong to a class of medications called . They are effective treatments for erectile dysfunction when appropriately prescribed.
But consuming these drugs unknowingly is very different from taking them under medical supervision. They are known to , including nitroglycerin used by some people with heart disease. The combination can produce a .
The Rhino 7S case presented an additional risk: undeclared acetaminophen. It was not clear in the supplement or how it got there. Someone taking the supplement while also using Tylenol, cold medicine or other acetaminophen-containing products could unknowingly exceed recommended amounts. can cause severe liver injury and, in extreme cases, acute liver failure or death.
Research suggests that adulteration is not limited to a handful of recognizable drug ingredients. A 2023 scientific review and related compounds that had been detected as adulterants in sexual enhancement products between 2003 and mid-2023. Adulterated supplements , unapproved analogues and other modified compounds.
A global marketplace
This is not solely an American problem. Studies have identified undeclared erectile dysfunction drugs in supplements sold in Europe, Asia, the Middle East and elsewhere.
In one study of 158 sexual enhancement supplements available in the United Arab Emirates, researchers found in more than 12% of all sexual enhancement products they tested.
The World Health Organization has warned that and the growth of e-commerce make controlling substandard and falsified health products particularly difficult. The makers of these products might source their ingredients from one country, manufacture or package them in another and .
Illicit international pharmaceutical commerce is a major problem worldwide. From December 2024 to May 2025, the international law enforcement body Interpol conducted , in which authorities in 90 countries seized more than 50 million doses of illicit pharmaceuticals. Erectile dysfunction medications were the second-most commonly seized product type, behind , which are drugs that affect how the brain regulates dopamine.
The following year, another international law enforcement operation , social media pages and channels and automated bots connected to illicit medicine sales. Erectile dysfunction medications were again among the most frequently seized products.
Playing catch-up
But identifying one dangerous product does not eliminate the broader market. Packaging can change. Products can disappear and reappear under new names. Sellers can move from one website or social media account to another. Manufacturers can also alter chemical ingredients.
Researchers who from 2007 through 2022 found phosphodiesterase type 5 inhibitors in every version they tested, but the specific adulterants changed over time. Despite warnings and seizures by European food and health authorities, the product was still being sold online at the end of the study period.
Laboratory testing of supplements is therefore essential, but testing alone cannot solve the problem. Even the FDA acknowledges that its public warning list being sold. In other words, a product’s absence from the FDA database should not be interpreted as evidence that it is safe.
An ongoing problem
Words such as “natural,” “herbal” or “dietary supplement” signal to consumers that a sexual enhancement product does not contain pharmaceutical ingredients. But that is not necessarily the case.
U.S. law requires a specific FDA disclaimer when supplement manufacturers make claims about function, but it does not require sexual enhancement supplements to carry a warning explaining that “natural” or “herbal” products may contain undeclared pharmaceutical ingredients. FDA are therefore not designed to warn consumers specifically about hidden drugs in these products.
Online sales add another layer of complexity. Under , some online marketplaces must verify identifying information from certain high-volume third-party sellers and provide consumers with a mechanism for reporting suspicious marketplace activity. But the law does not generally require marketplaces to test dietary supplements for hidden pharmaceutical ingredients or proactively report every potentially adulterated product to the FDA.
The appeal of these products is easy to understand: They offer a private, convenient and widely available solution to problems that many men find embarrassing to talk about. But that convenience can obscure a basic problem — consumers may have no reliable way to know whether the ingredients listed on the package match what is inside.
For sexual health products in particular, reducing that uncertainty will depend not only on regulation and surveillance, but also on making conversations about sexual health feel routine enough that people have safer places to turn for help.
The Conversation reached out to RhinoPills for comment, and they did not respond.
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