What started as a quick fix to improve his sexual performance turned into a medical emergency for Sizwe Mthembu (42) in November 2025. After taking two sex enhancer pills he bought for R15 from a street vendor on Victoria Street in Durban, he developed a prolonged and painful erection that lasted more than 24 hours.
“I was terrified,” he says. “That’s when I went to a doctor and was diagnosed with priapism, a condition I did not know anything about before.”
Dr Ntlotleng Mabena, a medical practitioner, explains that taking such pills without proper medical assessment can be especially risky for individuals with underlying health conditions or those taking other medications.
These products can result in complications such as severe headaches, dizziness, dangerously low blood pressure, and, in some cases, a prolonged erection known as priapism, which requires urgent medical attention.
“Priapism is caused by high dosages of these unregulated pills. When someone experiences this kind of erection, blood flow is restricted, preventing oxygen from reaching tissues. Over time, this can cause tissue damage,” she explains.
Some immediate at-home remedies for priapism include stopping any sexual stimulation, walking around, or applying an ice pack to the inner thighs (but not directly on the genitals) to relax blood vessels. However, if these methods do not work and the erection persists for four hours or more, it’s crucial to seek medical help immediately.
“These pills are dangerous because we do not know how they are made or what dosages they contain,” she says. “Sometimes manufacturers use excessively high or low dosages, which can lead to serious complications such as strokes or heart attacks.”
Increasing demand
Mthembu hasn’t used any sexual performance enhancers since. But others swear by these products.
At spaza shops, taxi ranks and informal markets, men regularly purchase products that promise enhanced sexual performance.
Mbongeni Mazibuko (52) tells Health-e News that he began using sex enhancement pills four years ago after starting a relationship with a woman half his age.
“I wanted to perform better and not lose her. I used to buy these pills for R20 to R30 each from a street vendor at Durban Station every time I knew she was going to visit me,” he says. “The results were amazing; I could achieve an erection that lasted longer than before.”
But Mazibuko’s story didn’t have a happy ending.
“Everything changed when she found the pills and confronted me; that is when she broke up with me.”
Pharmacist Nomzamo Matosse says many male customers frequently request sexual enhancement products without prescriptions or proper medical guidance. She explains that unregulated sex pills can lead to serious side effects due to unknown ingredients, which may sometimes be present in high doses.
“In many cases, customers come to the pharmacy seeking stronger enhancers because they claim that herbal or natural products they tried did not work,” she says.
Dennis Friday, who owns a spaza shop in the Embo area, confirms that he sells these products and that demand is particularly high from Friday to Monday. He says popular products include Red Cobra and penis-shaped cobra tablets.
He claims that most of his customers, typically aged between their early thirties and late fifties, seem to be well-informed about how to use the pills, including their instructions and potential side effects. However, he says that customers rarely ask questions about safety when purchasing these products.
Although he would not disclose where he sources the pills, Friday insists that the products he sells are regulated.
The South African Health Products Regulatory Authority (SAHPRA) did not respond to our enquiries, but has previously warned consumers not to buy illicit and dangerous sexual enhancer medicines sold online, at health shops, retail pharmacies and markets. Medicines such as Viagra, Dynafll, and Avigra are approved by SAHPRA and must be prescribed by a doctor.
Despite the risks, some users continue to rely on these products. Sthembiso Mlaba* (42) from KwaNyuswa, weighing 102 kg, says he uses these products occasionally to ensure his weight doesn’t impede his sexual performance. The products he uses include a liquid substance that he applies to his genitals.
“I make sure I follow instructions, even though I buy from different vendors,” he says. “I haven’t experienced any problems so far.”
Matosse emphasised that what may seem like a quick solution could lead to serious long-term consequences; she urged the public to seek professional medical advice and avoid unregulated sex pills, warning that sexual health should be approached with proper care, not quick fixes.
But why take the risk?
Clinical psychologist Anele Siswana says the increasing use of unregulated sex pills is also driven by psychological and social pressures. Many men feel pressured to meet unrealistic expectations about sexual performance.
“People are navigating a culture that equates sexual performance with worth, masculinity, and success,” he says.
He adds that reliance on sex pills can lead to psychological dependency, performance anxiety, and reduced self-confidence.
“When someone begins to rely on a pill to feel capable, it can erode their confidence and create the belief that they cannot perform without it,” he explains. – Health-e News
*Not his real name
