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Perhaps even more dangerous than the counterfeit PDE-5i that is marketed as legitimate pharmaceuticals, however, are those marketed as “natural” supplements. Microbial growth analysis of phosphodiesterase-5 inhibitors (PDE-5i) products (29). PDE-5i products purchased from Internet pharmacies rarely contain the stated amount of active ingredient (17). The best male enhancement pills combine various ingredients to improve sexual function, virility, and libido. Others among our top picks offer 67- or 100-day guarantees, which are admirable but can’t compare to the lifetime promise. In the customer service department, Performer 8 is the only company offering a lifetime guarantee on its product. We had to be very careful in evaluating male enhancement products, as so many contain ingredients without enough clinical research to recommend them in good conscience. The focus of the research was also to gain more details on how the use of ginseng would affect a male patient’s mind. 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