The Soft Science of Male Enhancement Pills

Huanarpo macho powder, horny goat weed extract and semen ziziphi spinosae.

Those are some suggestively named but purportedly natural ingredients listed on male enhancement supplements widely available in convenience stores and on the Internet.

But in reality, the Food and Drug Administration says many such pills, marketed as natural alternatives to prescription medication like Viagra and Cialis, are actually made with the active ingredients from those very drugs, or slightly altered versions never approved for human consumption.

Many of the supplements are made by fly-by-night overseas manufacturers and imported into the United States by distributors who don’t know or don’t care what’s in them. Experts warn that unintentionally taking Viagra or Cialis without medical supervision can be dangerous, since men don’t know to watch for side effects or to avoid taking the pills with certain other medications. And, doctors say, untested versions of the drugs can have unpredictable consequences.

“Since the FDA can find the Viagra in the pills relatively quickly if they’re looking for it, that’s when [manufacturers] start playing with the chemical formula and coming up with dozens and dozens of brand new chemicals that have never been tested in humans,” said Dr. Pieter Cohen, an assistant professor at Harvard Medical School who’s written about such supplements. “You can have a medication that is very safe and effective, but if you just make a slight adjustment to the chemical structure, it becomes a dangerous compound.”

The FDA has found dozens of male enhancement supplements it says contain “hidden drug ingredients,” and says they are likely only “a small fraction of the tainted over-the-counter products on the market.”

Some pills include other dangerous chemicals as well. One batch analyzed by US Customs and Border Protection was found to contain high levels of lead. In a 2008 Singapore case reported in the New England Journal of Medicine, 150 men were sickened with severe hypoglycemia and four died after taking male enhancement pills containing glyburide, a diabetes drug.

“We’ve already had multiple deaths from these kinds of products, and I’m afraid there’s going to be more because of this completely recklessness with which manufacturers are putting new drugs into sex supplements,” Dr. Cohen said.

In interviews and public statements, several US distributors accused by the FDA of selling drug-tainted supplements placed the blame with overseas companies who actually manufactured the pills.

In June, the FDA warned consumers that Cave Diver and Super Cheetah supplements, both distributed by Chicago-based Boscolini LLC, contained the active ingredient from Viagra.

Boscolini founder Safa Moayyed told me that he started the company with money he saved from years of waiting tables when he learned “the market was hot” for male enhancement supplements. He named the company after his dog, Bosco.

Moayyed said he researched the industry and found a Chinese supplier on Alibaba.com, the Chinese-based wholesale marketplace site. After an exchange of emails, he traveled to Guangzhou, in southern China, to visit the factory and strike a deal for what he was told would be all-natural male enhancement pills.

“They respect you on a whole different, new level when you’re there,” he said. “They know that if you’re going there, you mean business.”

Moayyed said he was escorted into a vast, gated industrial complex, where workers in numerous small factories made products from electronics to ceramic tiles.

“One floor they’re making headphones, another place they’re making pills,” he said.

In a pill factory about the size of a four-bedroom apartment, he saw workers using tabletop machines to put together male enhancement capsules they packaged under various brand names, including some he’d seen in stores, he said.

“They get the capsules from somebody else, they get the ingredients, and they’re punching the pills out,” he said.

Once he returned home, he received a few boxes of pills, then a notice that the rest of his order was being held by US Customs. Soon after, he was visited by the FDA, he said.

“They were very nice,” he said. “I was imagining some big guy with a gun and a badge and stick.”

The FDA agents told him to destroy the pills he had received, including some he had to buy back from retailers, he said. At the FDA’s direction, he cut the pills into pieces and soaked them in bleach. And when he tried to complain to the manufacturer in China, he never heard back.

“They don’t answer any more after I told them about the FDA,” he said. “The website doesn’t exist any more.”

Moayyed said he lost about $8,000 that he sees little hope of recovering.

“I experimented—I lost on this one,” he said. “I just saved up for years, and all of it went down the shit.”

An Alibaba spokesman said the site’s terms of service agreement bans listings for “sexual enhancement foods or supplements” and takes steps to keep them off the site.

“As we are a user-content created platform, however, we also rely on help from visitors and members to identify any suppliers who may be going against any of our listing policies,” spokesman Mark Story wrote in an email.

At the time Story sent the email, searches for keywords like “penis” and “erection” in the site’s supplements category each turned up a few dozen hits. When shown the listings, Story confirmed they were “exactly the types of products that our policy is intended to prohibit,” and they were quickly removed. Others remain at the time of publishing.

Dr. Cohen speculated that Chinese manufacturers of counterfeit Viagra, often sold prescription-free over the Internet, are also behind some of the faux-natural supplements.

“There’s a huge black market of the prescription meds already out there, “ he said. ”They have huge factories already producing these chemicals, [which] leads them to saying,  ‘Well, we have some extra chemicals, why don’t we see if we can sell some of them as natural supplements?’”

Brand name over-the-counter supplements have also been counterfeited by overseas manufacturers using prescription drugs instead of natural ingredients.

In August, Shuja Ali Syed, a 52-year-old New Jersey businessman, pleaded guilty to a federal charge of trafficking in counterfeit goods after prosecutors said he imported more than $1 million in bogus trademarked supplements that actually contained Viagra and Cialis.

According to federal prosecutors, Syed, who is now awaiting sentencing, sold some of the pills to an undercover federal agent and delivered others to a Brooklyn dollar store wholesaler. As part of a plea deal, he agreed to forfeit more than 600,000 male enhancement pills along with other “counterfeit and/or prohibited items,” including condoms, baby oil, and cold medicine, according to court documents.

And in July, Shem Weissman, a 24-year-old Long Beach, California man, was sentenced to 10 months in prison after pleading guilty to a similar charge. Authorities said he ordered more than 22,000 counterfeit Extenze male enhancement pills from a Chinese vendor he told investigators he found through Alibaba. The pills, which he had sent to a mailbox rented with a fake ID, were found to contain Cialis and dangerous levels of lead, prosecutors said.

“Weissman [told Customs agents] that the purpose of the rented mailbox was to avoid consequences, that he ‘did not want this to bite me,’ and was concerned that the Extenze tablets he purchased were counterfeit and that he would be the subject of a lawsuit from the Extenze company,” according to an investigation report.

He told the agents that he had sold 400 to 500 packets of 30 counterfeit pills each on eBay, according to the report. He paid between $3 and $5 per packet and sold them for $15 each.

The number of male enhancement supplements has increased in recent years, FDA spokeswoman Shelly Burgess said in an email. The FDA “is working closely with US Customs and Border Protection to develop a more effective network to successfully screen and stop these shipments from entering US commerce,” she said.

But in the meantime, questionable supplements are easily found in convenience stores, gas stations and even through third-party vendors on major e-commerce sites.

Until recently, it was possible to buy a product called “African Superman Top-Class Permanence Tablet” on Sears.com through a third-party vendor. Shoppers could even add the tablets to their wedding registries, and shoppers who looked at the listing could find Sears ads for the tablets following them across the Internet.

The supplement’s packaging shows a grinning, dark-skinned man embraced by smiling women and claims it “solves impotence and the early ejaculation” when taken “10 minutes before the nexual [sic] intercourse.” The label includes a South African flag but lists a manufacturer’s address in Tibet. Listed ingredients include “scalper’s penis,” “pilose antler of young stags” and “buffalo’s penis penis etc.”

Inside the box, a pamphlet tells the story of an office worker named King who took the pills, then accidentally brushed up against his female employer.

“What the hell is that?” the boss asked, surprised by his enhanced manhood.

“So she seized every single chance to have some chit-chats with King, and they eventually got together and had the most amazing sex,” according to the story. “King was continuously promoted and salaried by the satisfied female boss, and made the sweetest love every night with the boss, who’s also a hot woman!”

The listing for African Superman, which had been placed by a California auto parts supplier, violated Sears policy and the listing has been removed, a company spokesman said in an emailed statement.

“Marketplace sellers go through a registration process and agree to our Marketplace terms,” according to the email. “If a problem occurs, we take appropriate action.”

Even with swift removal of online listings, the market for male enhancement pills isn't shrinking any time soon. Burgess said that while the FDA "uses all of its enforcement powers" to crack down on illicit supplements, consumers' best course of action is to use common sense. If the claims made by supplements with names like Cave Diver or Lightning ROD sound too good to be true, they probably are.

"The critical issues are that FDA doesn’t approve dietary supplements prior to going to market," Burgess said. "When consumers see claims that something works as well as an erectile dysfunction medicine, or works within minutes of sexual activity, they need to stay away from the product."