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Medications, such as treatment for high blood pressure, can also play a role. These drugs reduce blood pressure by reducing blood flow, which can affect erections. It is not recommended that men stop their blood pressure medications, of course. But some patients can eliminate their need for the treatment through changes in diet and exercise.

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Another second-line therapy is the use of alprostadil, either intracavernosal or intraurethral. Two products are available for direct injection, Caverject (Pfizer) or Edex (Actient). A small needle is used to inject the medication into the lateral aspect of the penis through a small-gauge needle.
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A hollow tube is placed over the penis and the air inside the tube is vacuumed out (manually or battery operated) using a pump. The vacuum pulls blood into the penis, leading to an erection. Once the erection is achieved, a tension ring is placed at the base of the penis to keep the blood in the penis to maintain and erection.
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OverviewWhat is erectile dysfunction?What are the risk factors for erectile dysfunction?How is erectile dysfunction treated?What else should you know about ED?What makes Yale Medicine’s approach to treating erectile dysfunction unique?

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Also use caution if you’re taking alpha-blockers for prostate problems or blood pressure.

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You should not take more than 1 dose in 24 hours. Tadalfil and vardenafil come in tablets of 2.5 mg, 5 mg, 10 mg and 20 mg. Sildenafil comes in tablets of 25 mg, 50 mg and 100 mg.

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    Prescriptions are heavily relied upon, having to be taken 15 minutes to 36 hours before sexual activity is initiated – not only reducing the spontaneity of one’s sex life but oftentimes fostering dependence.

    Erectile dysfunction (ED), formerly termed impotence, is defined as the persistent inability to develop or maintain a penile erection allowing for satisfactory sexual performance.1 ED is an important public health problem and can cause serious distress to men, particularly affecting their masculinity and self-esteem.2,3 The Massachusetts Male Aging Study reported an overall prevalence of 52% for any degree of ED and demonstrated that prevalence clearly increases with age.3 For instance, the annual incidence rate reported was 12.4 cases per 1,000 man-years, 29.8 and 46.4 for men aged 40 to 49, 50 to 59, and 60 to 69 years, respectively.3
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    Nitrates interact very adversely with all phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil. They can cause a FATAL lowering of blood pressure and should NEVER be used together.

    Certain over-the-counter (OTC) supplements may help with erectile dysfunction, such as: L-arginine in combination with pycnogenol Has been shown in studies to improve sexual function in men with ED Korean red ginseng (also called panax ginseng) Studies have shown improvements in erections Yohimbe Some studies have shown it to be slightly more effective than placebo for ED Carnitine (propionyl-L-carnitine) May improve erectile dysfunction Also used to enhance the effectiveness of sildenafil (Viagra) Dehydroepiandrosterone (DHEA) Declines in DHEA are associated with increased incidence of ED DHEA supplements are often promoted to improve sexual health, though more study is needed
    In younger men, the most frequent cause of ED is anxiety due to worrying about causing a pregnancy, nervousness about having sex or about using a condom.

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    Always talk to a Doctor if you suffer from Erectile Dysfunction for more than 3 weeks. It can be a sign of serious health problems. To speak to a doctor in confidence, use our discreet online GP here.

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    It starts with your mind. To get hard, the arteries and tissue surrounding the penis need to be relaxed. But the human body is complex and we have what’s termed a ‘fight or flight response’. This is triggered by the sympathetic nervous system as a result of feeling distressed. Although historically, this was a useful tool for humans vulnerable to attack, these days, the physiological response is often a nuisance.

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Research published in the Journal of Sexual Medicine examined data relating to erectile dysfunction and dietary factors. Researchers found that a dietary pattern that’s high in fruit, vegetables, fish, nuts and whole grains, and low in red and processed meat, is more common in men who aren’t affected by erectile dysfunction. These dietary choices, which fall within the guidelines of the Mediterranean diet, are associated with lower all-cause and disease-specific survival, according to researchers. And in clinical trials, following the Mediterranean diet was more effective in improving erectile dysfunction or restoring erectile function in people with metabolic syndrome or obesity. (21)

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Weight loss programmes, for those who are overweight or obese, can be key to addressing the physical causes of ED. Sexual function can be improved significantly by following a weight loss programme consistently.

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Erectile dysfunction, also known as ED or impotence, is defined as the inability to maintain a penile erection sufficient for successful sexual intercourse. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles, and blood circulation. If something interferes with this process, the result can be erectile dysfunction.

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Whether you’re suffering from erectile dysfunction, poor erections, or just want to please your partner like no man ever has before, male enhancement supplements can help take your sex life to the next level. However, not all male enhancement pills are created equal and some products don’t even work at all. While some sex pills for men work AMAZING, others don’t have a high enough dosage or the right combination of ingredients in order to be effective. We’ve compiled a list of the best male enhancement pills on the market to help you decide. We evaluated each male enhancer based on its ingredients, dosage, customer reviews, price, and guarantee. If you’re ready to experience more powerful erections, a supercharged libido, and a renewed confidence, here are the best male enhancement pills for 2020: Testogen: Best For Increasing Testosterone Levels Max Performer is the best male enhancement pill on the market and can provide a range of benefits to your sex drive and stamina. It contains a blend of powerful yet natural ingredients that focus on different male sexual health components that may be deficient. Taking this supplement can lead to: Max Performer targets many aspects of your sex drive to produce a well-rounded sex life overall. First, the supplement enhances erections by inhibiting the release of PDE5, an enzyme that reduces blood flow throughout the body. Blocking this enzyme increases blood flow to the penis, which leads to firmer, fuller erections. Max Performer also contains ingredients that restore sexual hormone levels, regulating your sex drive and sperm counts. Some of its components, such as Red Korean Ginseng, also improve alertness to help you perform longer in bed. One of the supplement's most potent ingredients, Cordyceps, increases oxygen uptake to boost blood flow to the genitals. Max Performer contains a supercharged dose of Cordyceps, 1000 mg, to maximize blood flow and erection intensity. Max Performer uses a specially formulated blend of ingredients that work together to maximize sexual function. The formula includes: Though you should see some results after a few days of taking this supplement, you should plan to take one pill daily for 90 days to maximize its benefits. Max Performer is an excellent solution for men looking to enhance their sex lives overall through a blend of tried-and-true ingredients. Vigrx Plus is the best male enhancement supplement for erection strength. This enhancement pill focuses on creating larger, harder, and longer-lasting erections that will enhance sexual satisfaction for you and your partner. Along with improving erection duration, VigRX Plus also gives men better control over their erections, further aiding sexual performance. Dr. Steven Lamm, a medical doctor at NYU Langone Health, has endorsed VigRX in the past. Steven Lamm recommends using this product as an effective way to improve sexual health and fitness. The supplement contains ten potent aphrodisiacs, erection precursors, and libido enhancers that target nitric oxide production in your body. Increasing nitric oxide relaxes the muscle tissue of the corpus cavernosum in the penis, enhancing blood flow to the genitals and producing thicker and fuller erections. VigRX Plus uses a scientifically engineered formula with the perfect blend and dosage of natural, quality ingredients. The supplement contains: BioPerine is an extract that increases the absorption of other nutrients and enzymes. Adding this extract to the mix maximizes the other ingredients' benefits to create a more potent blend overall. The creators of VigRX Plus recommend taking one pill twice a day for thirty days to experience the best results. Some men may also benefit from pairing this supplement with VigRX oil and male enhancement exercises. Overall, VigRX Plus is an excellent natural solution for men looking to enhance their erection size and intensity. Male Extra is the best male enhancer for sexual stamina and lasting longer in bed. This supplement has been on the market for over ten years, and more than 320,000 customers have purchased it since then, making it one of the best sellers in the male enhancement world. Male Extra focuses on enhancing sexual stamina by increasing the size and longevity of your erections. Taking this supplement can provide benefits such as: This supplement contains potent ingredients that target different aspects of sexual performance. Many of its components increase nitric oxide levels, which widens your blood vessels and enhances blood flow and oxygen throughout your body. When your body has access to more nitric oxide, nutrients reach your cells more quickly, delaying fatigue during physical activities such as sex. Additionally, increased blood flow to the penis leads to harder, fuller erections, enhancing sexual stamina. This supplement contains a unique blend of ingredients, including: Male Extra is the only male enhancement supplement on the market that contains pomegranate ellagic 40% and L-arginine HCl, which are potent, natural libido boosters. All of its ingredients come from nature, and Male Extra does not produce any adverse side effects. The creators of this supplement recommend taking three pills with food each day for at least thirty days. Over this period, the aphrodisiacs and libido enhancers will build up in your system, maximizing benefits to your sex drive. Men looking to boost their sexual stamina will benefit the most from Male Extra's incredible effects. Best Male Enhancement Product For Lasting Longer In Bed Viasil is the best sex pill for men over 40. Men over the age of 40 often experience lower sex drive and diminished sexual performance. Their bodies tend to produce less testosterone, the male sex hormone, which results in less frequent sexual urges and decreased energy levels. Viasil is a male potency formula that helps middle-aged men fight back against the erectile dysfunction that often comes with age. The supplement is 100% natural and fast-acting, and taking the recommended dose can produce benefits such as: Viasil supports your body's natural processes to return your hormone and energy levels to their formerly elevated state. Its dual-action formula boosts ATP production, the chemical that supplies your body with energy, and nitric oxide levels, the molecule that improves blood flow and erection size. Increasing blood flow throughout your body produces several benefits to your sexual health. Not only does the supplement increase the size of your penis's blood vessels, but it also creates more oxygen and nutrients during sex, which improves stamina and strength. Viasil contains a blend of natural, safe ingredients, including: Its potent contents provide the right mix of nutrients, libido-boosters, and extracts to produce impressive sexual benefits. Confidence is a significant component of one's sexual performance, and Viasil also provides the confidence-boosting effects that many men need to get back into the bedroom. The creators of this supplement recommend taking one Viasil tablet daily to see the best results. Whether they are looking to improve sex drive with a long-term partner or start a new relationship, men over the age of 40 can benefit the most from the impressive effects of Viasil pills. Helps Fight Back Against Erectile Dysfunction Semenax is the best penis enhancement pill for increasing ejaculation volume. Producing massive loads of semen is a surefire way to impress your partner, and this pill does the trick better than any other supplement on the market. This supplement targets four areas of your reproductive system that contribute to semen production: your seminal vesicle fluids, your prostate gland fluid, your seminal plasma, and your bulbourethral gland fluid. As a result, Semenax produces more benefits than other ejaculation-boosters on the market. To show customers the effectiveness of their supplement, the creators of Semenax conducted a double-blind study with 63 men. This study showed that the group taking Semenax increased semen production by 20% or more, as opposed to the placebo group who saw no difference in production. Semenax contains various amino acids and nutrients that promote sexual health, increase libido, and enhance semen volume. These ingredients include: Several of these ingredients also promote sperm health and fertility, which can help couples trying to get pregnant. To see the best results, the creators of Semenax recommend taking four pills twice a day. You may begin seeing the benefits of this pill after less than a week of use. Semenax is an impressive supplement for men looking to improve their sex lives by enhancing the volume of semen they produce during sex. Best Supplement For Increasing Ejaculation Volume Testogen is the best male performance pill for increasing testosterone levels. Your testosterone levels play a significant role in your sexual performance and reproductive health. Testosterone contributes to your muscle size, strength, stamina, energy levels, and libido. When your body decreases its production, you may have a problem performing in bed and pleasing your partner. Testogen is a natural testosterone booster that raises your hormone levels quickly and safely. Boosting testosterone through these supplements can lead to a range of benefits, such as: Because your testosterone levels play a role in more than just your sexual health, taking Testogen can help you feel healthier and more energized overall. Testogen does not contain actual testosterone. Instead, these supplements utilize a unique formula of vitamins, minerals, and amino acids that stimulate testosterone production, helping your body produce the hormone independently. For example, amino acids create luteinizing hormone, which is critical for testosterone production. Its formula includes the following ingredients: Because Testogen contains only natural ingredients, it does not come with the risk factors of many testosterone-boosters on the market. And if you still aren't confident that Testogen can improve your sex life, you can try the product risk-free for 100 days—Testogen will give you a full refund if you are not satisfied with your results. Customers should take four Testogen capsules each morning to best improve their testosterone levels. Men who experience low testosterone levels and struggle with strength, stamina, and sex drive can benefit the most from taking Testogen pills. Male enhancement pills increase sex drive and enhance sexual performance in several ways. Many of the supplements above increase nitric oxide production, the substance that boosts blood flow and widens your blood vessels. Stimulating blood flow to your genitals increases the size and duration of your erections and improves stamina. Increased blood flow overall augments your energy levels so that you last longer in bed. These pills also boost testosterone levels, which is the male sexual hormone that plays a primary role in reproduction and sexual development. As a result, men who take male enhancement pills with testosterone also experience increased strength and stamina, which can benefit their performance in the bedroom. The male enhancement pills above are 100% natural and safe, so they do not come with the risk factors and adverse side effects that more potent enhancement pills produce. These natural products are effective and can benefit your sexual function immensely. Things to Look for When Buying the Top Male Enhancement Supplements You can find dozens of male enhancement supplements on the market today, but not all of these products come with the same level of safety and effectiveness. To identify the best, safest supplement options, keep an eye out for these factors: The best male enhancement pills utilize high-quality ingredients. You would not want to put something cheap and ineffective into your body, and because enhancement supplements have such high and frequent dosages, you want to make sure their ingredients are top-quality. All of the brands we reviewed above utilize safe, quality ingredients. Some male enhancement supplements do not list the exact dose of each ingredient in their formulas. This practice, known as proprietary labeling, is often a red flag for low-quality, unsafe supplements. If a company is not forthcoming about the ingredients it uses, it probably has something to hide. Even worse, if you do not know the dose of nutrients and amino acids you ingest, you could end up overdosing on one. Steer clear of supplements with proprietary labels and look for ones that clearly and directly state their formulas. Companies only offer money-back guarantees if they are confident that their products will work. If they were unsure, they would not risk losing money by refunding their customers. All of the products we reviewed above offer a generous money-back guarantee that takes the risk out of buying them. As a result, you can be sure that they utilize effective, results-driven formulas that you can trust will support their claims. Customer reviews offer valuable information about the effectiveness and safety of a product. However, many websites post positive reviews purely as a marketing tactic to persuade people to purchase their products. To gain the most accurate understanding of a supplement's reviews, you should Google the product's name and read customer reviews on several different websites. The male enhancement supplements with the most positive reviews across the web are likely the highest-quality, most effective options. The Food and Drug Administration sets health and safety standards that United States-based supplement companies must adhere to. If a company produces a supplement outside the United States, it may not meet the safety requirements of the Food and Drug Administration, so you cannot be sure of its safety. Look for male enhancement supplements made in the United States to ensure that they will be safe for consumption. Male enhancement pills can produce a wide range of benefits for male sexual health. A few primary advantages of these supplements include the following. Erectile dysfunction is a common sexual problem that many men face. Male enhancement pills can reverse the effects of erectile dysfunction by producing harder erections and making your penis look and feel bigger. As a result, men taking these pills get erections faster, last longer during sex, and please their partners better. Many men have trouble staying erect and aroused as long as they would like to during sex. Male enhancement pills increase your stamina and performance, allowing you to please your partner longer and keep your penis erect throughout intercourse. One side effect of erectile dysfunction is a lack of interest in sex. Many men want to please their partners but have trouble getting and staying aroused enough to have sex. Male enhancement pills reverse this effect by increasing your libido and allowing you to become aroused more frequently. Many men experience premature ejaculation during sex or would like to perform longer before they reach orgasm. Male enhancement pills give men better control over when they ejaculate and how much semen they produce, benefiting their own and their partner's sexual experience. Even men who are satisfied with their sex lives can benefit from the more intense, pleasurable orgasms that male enhancement pills produce. Many of these products boost blood flow to the penis, resulting in longer, more frequent, and overall better orgasms. Testosterone contributes to sex drive, physical strength, muscle size, and reproductive health. When your body becomes deficient in this hormone, you may experience lower sexual arousal, difficulty building muscle, and diminished energy levels. Several male enhancement supplements contain natural testosterone-boosters as a way to promote sexual health and wellness. Natural male enhancement pills contain vitamins, minerals, amino acids, and extracts that benefit your sexual health. A few popular ingredients in these pills include the following. Horny Goat Weed is a medicinal herb that treats erectile dysfunction problems. Researchers believe that icariin, the active component in the herb, inhibits the release of PDE5 to increase blood flow to the penis. Panax Ginseng is a root that contains high amounts of ginsenosides, substances that can increase alertness and concentration. Enhancement products include this root to boost sexual desire and endurance during intercourse. Saw Palmetto is a fan palm extract that excites testosterone pathways. People have used this plant for hundreds of years to treat erectile dysfunction and support a healthy sex life. L-Arginine is an amino acid that supports erection quality and male performance. Your body uses this amino acid to produce nitric oxide, which widens your blood vessels and boosts blood flow to the penis. Ginkgo Biloba is an ancient Chinese herb that acts as an antioxidant in your body. Taking this herb increases blood flow throughout your central nervous system and your penis, augmenting erection size and length. Tribulus Terrestris is a plant that many people use to support heart health and regulate blood sugar levels. Having high blood sugar and cholesterol can reduce sexual desire, so this plant balances your levels to enhance sexual performance. Zinc is an essential mineral that plays a significant role in testosterone production. Many men experience deficiencies in this mineral due to an unhealthy diet and can develop health problems as a result. Enhancement supplements contain Zinc to regulate libido and promote overall health. Taking male enhancement pills effectively enhances sexual function, but some men may prefer to go a different route. Thankfully, several alternatives to supplements exist that can also enhance your penis. Jelqing is a penis enlargement exercise that gently stretches the length of the penis. Over time, your penis develops microscopic tears from the stretching technique that heal by forming new tissue cells. The new cell growth increases penis size and length permanently. Jelqing uses the same concept as penis extender devices but is not nearly as effective. However, it may be a practical solution for men who want to achieve minor penis enlargement for free and without a device. Penis extender devices effectively increase your penis size and length. These products fit over your shaft and apply gentle tension to your penis that you increase weekly. Your penis will develop small tears from the pressure, causing your body to produce new cell tissue to heal the tears. Unlike jelqing, penis enlargement devices apply uniform pressure for an extended time—several hours a day—to maximize results and reduce risk. Research has supported these products' effectiveness in increasing penis size, straightening curved penises, and reducing erectile dysfunction. Doctors often recommend them to patients with these issues. Many men use penis pumps to treat erectile dysfunction. These devices help you get and maintain an erection by pulling blood into your penis and then restricting blood flow away from the shaft, keeping your penis erect during sex. Penis pumps come with a plastic tube that fits over your penis, a battery-powered pump, and a constriction ring. To use this product, place the plastic tube over your penis and then use the pump to create a vacuum inside the tube. The vacuum will pull blood to your penis, creating an erection. Once your penis is erect, slip the constriction ring around the base of your penis to cut off blood flow. Doctors often recommend erection pumps as safe, practical solutions to patients with sexual dysfunction. Surgery is a last-resort option for men who struggle with sexual performance or experience erectile dysfunction. Though surgery can produce beneficial results, it also comes with many risks. Some surgery patients experience erectile dysfunction during their lengthy recovery, and sometimes, they lose sexual function permanently after the surgery. If you are considering surgery for severe sexual dysfunction, we recommend trying other solutions first. If nothing else works, discuss the advantages and drawbacks of surgery with your doctor. You may be wondering whether you should purchase male enhancement supplements or invest in a penis enlargement device. Though these two products offer some overlapping benefits, they work in different ways and produce varying results. Male enhancement pills focus on the internal mechanisms of your sex drive. They regulate hormones, increase blood flow, and give you energy, all of which are essential factors in maintaining a healthy sex life. These supplements produce physical results through internal means. Penis enlargement devices, on the other hand, are external, non-invasive products that work to improve your penis as a way to enhance sexual performance. These products change the physical structure of your penis to promote self-confidence in bed, allow you to please your partner better, and improve your physical sensations during sex. Each of these products can work wonders for your sex life. To determine the right one for you, consider what problem you are trying to solve. If you want to increase your sexual arousal and performance during sex, enhancement supplements may be best. If you would like to improve your penis size and enhance pleasurable sensations permanently, a penis enlargement device may be better. Most men can benefit from taking male enhancement pills. Even if you are satisfied with your sex life, you can utilize these supplements to make sex even more pleasurable by enhancing orgasm intensity, semen volume, and overall arousal. However, men who serve to benefit the most from enhancement pills are those who experience a deficiency in their sexual performance. These supplements can provide the boost some men need to get their sex life back on track without producing adverse side effects or necessitating surgery. Male enhancement pills are safe and typically do not produce any side effects. They contain all-natural ingredients, so as long as you take the recommended dose, you can expect to experience results without any drawbacks. Men who have underlying health problems may want to talk to their doctor before taking male enhancement pills. Additionally, if you take other supplements, you should be sure that you do not exceed the recommended dose of a specific vitamin or mineral. For most men, male enhancement pills are safer than prescription products and surgery. With so many male enhancement products on the market, you may find it challenging to determine which ones are legitimate and which are scams. Here are some tips to avoid fraudulent male enhancement supplements: Avoid Free Trials: Many companies that offer free trials try to trick customers into paying for their product after the trial ends. They may also lack sufficient support for their claims that would convince buyers to purchase their products. If a male enhancement supplement offers a free trial, it may be ineffective or a scam. Avoid Viagra Alternatives: Several Viagra alternatives exist on the market with claims to provide similar results to the name-brand version. However, "herbal Viagra" supplements can produce adverse side effects, such as dangerously low blood pressure, and often contain undeclared prescription medications. Avoid these options and look for safe natural supplements instead. Avoid Unrealistic Claims: No male enhancement supplement can increase your penis size overnight or help you ejaculate on command. If a product seems too good to be true, it probably is. Avoid Unsolicited Email Advertisements: Some companies resort to unsolicited communications because they cannot sell their products any other way. If you receive an email advertisement about a product without giving your contact information, you can assume it is a scam. Frequently Asked Questions Can You Buy Penis Enlargement Pills Over the Counter? You may be able to find a few penis enhancement pills in stores in your community. However, these products do not always work as well as online options because they tend to have a lower potency of ingredients. For the best results, consider purchasing one of the online products we reviewed. Books and movies sometimes indicate that male enhancement pills have immediate, powerful effects. In reality, most of these pills require several weeks of daily ingestion before you will see any noticeable results. Some users report experiencing benefits after a few days, but you likely will not notice any difference in sexual function for some time. Can Male Enhancement Pills Increase My Penis Size Permanently? No, male enhancement pills cannot increase penis size. They can increase the length and girth of your erection during sex, but this change will only be temporary. To permanently increase your penis size, you will need to use a penis enlargement device or undergo surgery. Taking male enhancement pills is a natural way to treat erectile dysfunction. These supplements increase blood flow to the penis and enhance arousal before and during sex. Men experiencing erectile dysfunction often try natural supplements before resorting to more severe treatment options. Each of the enhancement supplements we reviewed can produce incredible results. However, the most effective pill by far is Max Performer. This pill contains the perfect blend of potent ingredients to maximize your sex life benefits without producing any side effects. It also targets several areas of sexual performance, as opposed to products that only benefit erection length or testosterone. If you aren't sure which product to try, you can't go wrong choosing Max Performer. Male enhancement pills can produce a wide range of benefits for your sexual health and performance. These products can improve orgasms, increase stamina, enhance erection length, and help you please your partner better—all of which are effects that can benefit anyone. Because enhancement pills do not produce any side effects, and most come with a money-back guarantee, you can try them risk-free. However, once you see the incredible benefits they can deliver in the bedroom, we think you'll be a customer for life. Tags: SPONSORED Local journalism is information. Information is power. And we believe everyone deserves access to accurate independent coverage of their community and state. Help us keep this coverage going with a one-time donation or an ongoing membership pledge. 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