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Rather, those products are produced in clandestine underground laboratories lacking the necessary knowledge or equipment to produce these compounds in adequate quantity and quality, as also described by other authors [26, 35, 38]. Substandard and counterfeit products found in our systematic review were most likely produced by manufacturers not in line with good manufacturing practices (GMP’s) . Many users report positive experiences with specific products, often citing improvements in libido, stamina, and overall sexual satisfaction. Some formulations may contain undisclosed or harmful ingredients, making it vital for consumers to research products thoroughly before use. Common ingredients found in these supplements include ashwagandha, ginseng, L-arginine, and yohimbine, among others. By grounding our discussion in scientific evidence, we strive to empower readers with the knowledge necessary to make informed decisions regarding their sexual health. 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