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The study included several ingredients found in Volume Pills. Promising everything from enhanced libido to increased stamina, these products are marketed as the ultimate solution for those looking to reclaim their youthful vigor. MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. All authors had full access to all the data in the study and can take responsibility for their integrity and the accuracy of the analysis. Moreover, other RCTs on the various EIs are needed, improving the number of included patients and the inclusion criteria, in order to have more solid evidence on single molecules. Finally, it is also important to underline that unverified ingredients may be present in some DSs. 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A similar situation has been seen in the USA, with 45.5% of adulterated dietary supplements being marketed for sexual enhancement, according to a warning released by the FDA, from 2007 to 2016 . Previously, we reported that 85% of safety alerts launched from the USA, EU, and Asia Pacific from 2010 to 2016 consisted of recall or warning information about food products containing undeclared medicinal ingredients . Therefore, we have been working to disseminate public notices and safety alerts issued around the world through the online database, “Information system on safety and effectiveness for health foods (Japanese only)” [3,4]. Consumers expect to gain health benefits from these supplements, but there are inherent risks of adverse effects caused by the ingredients themselves and interactions with medicinal drugs . 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The patients who underwent this treatment claimed various justifications for wanting to enlarge their penile circumference. Nonetheless, testosterone is currently, and frequently, prescribed off-label for the treatment of low sexual desire in women, and the idea of testosterone as a cure-all for female sexual dysfunction remains popular. One study found no change in plasma levels of testosterone after sexual intercourse (Lee et al., 1974), and two subsequent studies found testosterone increased around times of sexual activity. In 1970, an anonymous researcher published a case study in Nature in which he demonstrated that anticipation of sexual activity could increase testosterone levels in men, as measured indirectly by beard growth. Testosterone and sexual activity and increased testosterone levels may enhance sport performance. 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