Is male enhancement possible with natural herbs and nutrients as opposed to a drug? It depends how you define it. If the term refers to an increase in penis size, then the answer would be that the effect of any male enhancement herb on penis growth would be minimal if at all. However, if you define it in terms improvement in overall sexual performance, stamina, engorgement and sensation, there there is no doubt that there are many male enhancement pill herb products that really do work. There are several products that claim to lead to such an effect, that is growth of penis size. Some of these are promoted on TV or through magazine ads. We have seen no proof that such a product leads to a bigger penis.

Dietary supplements that are useful or do not work
In our experience, we have not found arginine to be an effective amino acid for such purposes, at least in the short term and in dosages smaller than 5 grams.

There are quite a number of major areas involved in male enhancement

Psychological / mental
The causes of psychological male enhancement dysfunction and low libido are numerous, and it is difficult to list them all, but most often low libido is related to depression, performance anxiety, marital stress or relationship problems, life crisis, financial difficulties, religious repression, or some type of mental illness. Sexual enhancement is possible through various forms of therapy, stress release, vacation, etc.

2. Hormonal influence on male enhancement -- Androgens, such as testosterone, are a major component of libido. Testosterone levels decline about 1 percent each year in men, which may contribute to lower male libido with aging.  Women who have had surgical removal of the ovaries notice a drop in sexual interest. Sexual enhancement through replacement of androgens can be helpful in those with age related sexual dysfunction. Testosterone is available by prescription only. An over the counter hormones, such as DHEA, converts into testosterone and thus has a positive influence on libido. Pregnenolone is another over the counter hormone that may increase testosterone levels and thus lead to sexual enhancement. However, hormones may not be safe to use for sexual enhancement, therefore aphrodisiac herbs are a great alternative.

3. Vascular effect on male enhancement -- Alterations in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For instance, medical conditions such as atherosclerosis (hardening of the arteries), high cholesterol, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection or genital swelling. Proper diet and exercise can reduce the risk. Additional factors that can impede blood flow include penile injury, surgery in the pelvic or abdominal area, and sitting on a bicycle too long. Men who log several thousand miles a year on their mountain bikes suffer scrotal damage that could reduce their fertility.  Some of these health problems, if treated appropriately, can lead to sexual enhancement.

Neural effect -- Nerve damage from disorders such as diabetes, multiple sclerosis, Parkinson’s disease, and stroke affect the brain’s ability to respond to sexual stimulation. In women, abdominal or pelvic operations can occasionally lead to nerve damage. Sexual dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer. 

Chemical influence on male enhancement -- Some chemicals involved in the human sexual response and libido include dopamine, acetylcholine, and nitric oxide. Sexual enhancement is quite likely through manipulation of these brain chemicals by using natural herbs and supplements.

Medical diseases
Certain medical conditions reduce libido, performance, or enjoyment. These include hypertension, diabetes, high cholesterol, cardiovascular disease, peripheral vascular disease, and neurologic disorders, and insomnia.

Drugs that interfere, interact or inhibit
Drugs that interfere with libido or sexual function include some anti-hypertensives, SSRIs, sedatives, sleeping pills, and beta-blockers. Alcohol's negative affect on libido increases with age. Smoking can reduce genital blood flow.

Male Enhancement drug and medication
There are several sexual enhancement drugs including Viagra, Cialis, and Levitra. These drugs work very well in dilating blood vessels leading to a strong erection, however they do little else for sexual enhancement, such as libido, sensation, and sexual stamina. Plus, they have side effects. It has been reported that Viagra in rare cases can cause permanent blindness. Sexual enhancement supplements are, as a rule, much safer. Which is the best sexual enhancement drug? This is difficult to say since each person has their own preference.

Research review
Exercise and weight loss may lead to sexual enhancement in obese men, researchers in Italy report. In a new study of more than 100 obese men with erectile dysfunction, nearly a third regained normal sexual function after participating in an intensive weight loss program.

Emails
Q.  Have received Spam mail and seen on web sites male enhancement pills or male enhancement product supplements that the vendors say are guaranteed to increase the size of your penis.  The ingredients seem to be the common supplements spoken about with regard to penile health.  Is there any substance to these claims and these pills lead to sexual enhancement?
     A. We have gotten similar emails. We are not aware of any male enhancement pills that permanently increase the size of a penis.

Q. Does exercise lead to male enhancement?
     A. Perhaps not directly, but indirectly exercise can help you sleep deeper which does wonders. Exercise also makes you feel better about your body, and this could also have an influence on your libido.

Q. I bought a male enhancement supplement and took one pill in the evening and I couldn't sleep all night.
     A. Many male enhancement supplements have ingredients that cause alertness so most of them are better taken in the morning as soon as you get up.

Q. I was looking on line for a free sample of male enhancement, a free male enhancement pill. I called one site and gave them my credit card since they said they needed it to cover the 5 dollar shipping charge. A month later they charged my credit card 39.95.
   A, Be very careful about getting a free sample of a male enhancement pill. Never give your credit card number if they are offering a free male enhancement pill.