October 31st , 2011

Reginald V. Finley Sr
Critical Thinking
LAI524
Fall 2011
Professor David Terry

A critical review of ExtenZe: Male Enhancement Product

Product Website: http://www.extenze.net/index.php?mode=how-it-works

Fig. 1. (2011), ExtenZe Web Advertisment,

Retrieved from
http://www.discountExtenZeonline.com

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 TABLE OF CONTENTS

INTRODUCTION …................................................................................................. 3

THE SCIENCE HOOK …......................................................................................... 3

THE CLAIMS …....................................................................................................... 4

THE AUDIENCE ….................................................................................................. 6

PROMOTION …....................................................................................................... 7

CLINICAL TRAILS ….............................................................................................. 8

APPEALING TO EMOTION …................................................................................ 10

COMPOSITION …..................................................................................................... 11

NON-SENSE …........................................................................................................... 15

OTHER CRITICISMS ….......................................................................................... 16

DANGERS …............................................................................................................... 17

CONCLUSION …......................................................................................................... 19

REFERENCES …......................................................................................................... 20

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 INTRODUCTION

ExtenZe is a highly promoted product that has been seen on television, paper ads, and the

internet. According to the ExtenZe website (Extenze.net, 2008), their product is a “male enhancement”

pill. The concept of “male enhancement” appears to relate to the claims on their site that their product

helps men maintain erections, improves ejaculate emissions, as well as increases sexual pleasure

(Extenze.net, 2008). This paper is a critical review of the ExtenZe product. We will take a critical look

at many of the various scientific claims that the ExtenZe marketers make as it relates to their product,

as well as, analyze methods utilized to convince the public to buy their product.

THE SCIENCE HOOK

In a description of the product found at the “How it Works” page(Extenze.net. 2008), they use

terminology alluding to the idea that their product is in some way associated with the science of

medicine and has some biologically relevant foundation:

“ExtenZe is a medically created blood flow stimulator which is extremely very safe and most effective and

importantly it is made with all natural ingredients that do not contain any drugs, making most of a man's

natural penile potential. There are three erectile chambers in the male penis that Create the penis body. And

it is only when these penile chambers are sexually aroused that the blood flow does increase and the outflow

decreases. This really produces a big human male erection of the penis. A male's penis becomes much bigger

when more of this blood is pumped into these three penile chambers. ”

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 The very first sentence of the paragraph uses scientific terminology when it states that the

ExtenZe product is “medically created”. Questions to consider: What does this term mean in this

context? Is it created with the intent of being used as a medicine? Was it created using processes known

in medicine production facilities? We just don't really know what is meant by this as the article doesn't

specify. We can infer however that the attempt is to lure/hook those that value science-sounding speak

to purchase the product.

The statement informing us that ExtenZe is a blood-flow stimulator doesn't really tell us very

much. In what ways does it stimulate blood flow to allow a reversal of Erectile Dysfunction(ED)? Does

it narrow the blood vessels thereby increasing the blood pressure? Is it thinning the blood? Is it directly

affecting vascular tissue; but if so, what are the implications of its effect on heart tissue? It seems that

figuring out how it works is left to the reader. Other critical questions that immediately come to mind

are: What chemicals are used in this product? How is it that its alleged “natural” make-up is somehow

better at maximizing an erection? Is it truly a safe product?”

At the end of the paragraph, we are informed about basic penis physiology which could be

interpreted as a way to convince potential buyers that the ExtenZe product makers are knowledgeable

in some way as is relates to ED.

THE CLAIMS

The Extenze.net website makes a wide variety of claims that need to be substantiated. The site states

that their product can:

• Enlarge the penile erection and penis size

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 • Way more larger and frequent erections
• More intense orgasms and cumshots will be experienced
• The penile erection is quicker to obtain and more reliably
• The desire, performance and pleasure is enhanced significantly
• Does improve endurance, sexual pleasure and penile tip sensitivity
• Now can enjoy stronger and longer lasting erections

The use of absolutism in descriptions of the efficacy of the product should alert a buyer right

away. There should at least be a Caveat emptor acknowledging that not all participants will experience

the same results. Even the most irresponsible of late-night infomercial kings will at least provide a

disclaimer. The author's grammar, misspellings, and word-choice as well seem a bit odd for

professionals(see underlined above). These kind of statements and wordings don't reflect a

professional, medical-oriented outlook.

Other exaggerated claims that any reader should be skeptical of:

“A man's penis will become bigger in just a few short weeks of taking ExtenZe pills”

This is another absolute claim. How can any honest medically related agency make such a claim?

Erectile Dysfunction could be the result of multiple causes such as nerve damage, psychological issues

or major circulatory problems(Lovy, 2011). This being the case, even if ExtenZe has proven some

efficacy, it may not work for all groups of men. With negligent statements like these, they are

promising a 100% success rate, which is medically impossible.

“ExtenZe pills definately help to overcome erectile dysfunction!”

What exactly does, “definately[sic] help” mean? My children can definitely help to wash my car, this

doesn't mean that they'll do a good job or are even successful in washing my car. This ambiguous

language seems to contradict their more absolute stance with regard to their products efficacy.

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 THE AUDIENCE

The promoters of this product appeal to those groups of people concerned with side-effects and

the use of drugs by stating that their product is “made with all natural ingredients”. Firstly, the

statement, “made with all natural ingredients” doesn't necessarily mean that the entire product is fully

“all natural”. It could also mean that the product simply contains some all-natural ingredients. The

suggestion that because their product is natural then it must be safe is a logical fallacy and

irresponsible. Just because something is “all natural” doesn't mean that it is safe. Too much of an “all-

natural” product can kill just as easily as a synthetic product. It appears that dosages and efficacy

should be the concern; however, without valid scientific studies, supplement companies that push

products/drugs such as these can endanger lives. Many natural supplement companies don't reveal

exactly how much of a substance you are getting and this can be extremely dangerous.

The promoters argue that the ExtenZe pill isn't a drug; yet, it contains “natural ingredients” that

produce a desired effect. Any chemical placed in the body that produces an altered desired effect is in

fact a drug (Drugs, n.d.). A normal effect of aging in a number of men is to suffer a form of erectile

dysfunction (Erectile Dysfunction, n.d.); thus, it could be argued that manipulating one’s natural system

to reverse this effect via chemical use, is in fact taking a drug. The ExtenZe marketers make no

distinction between natural drugs and synthetic drugs. The reason is speculative but readily apparent as

they may wish to avoid the stigma of placing drugs in the body; though this is exactly what would be

occurring if ExtenZe is to effectuate a result.

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 PROMOTION

The promoters of this product market their product as safe. They continuously discuss it's safety

via their ads by pushing it's alleged “natural” make-up, of which we analyzed earlier and will again in

the Composition section (p. 11). Conducting a search for the “truth of Extenze” reveals a number of

sites that do nothing more than further promote the product without any evidence of its claims. One

website, ExtenZetruth.com for instance, is obviously a marketing arm for their product. Another site

DiscountExtenzeonline.com has a similar design and feel as the Extenzetruth.com site. It also seems

rather apparent that this is another marketing arm for the ExtenZe product line. TryExtenze.com comes

up when you google search “Extenze composition”. Extenze.ws intercepts you when you google

“Extenze dosage” and is once again a marketing arm for the product. The information is sometimes

copied and pasted from site to site. A search for “chemical analysis of ExtenZe product” brought up a

site that is an obviously fake review of the product as it's filled with a plethora of marketing buzz

words: http://home.actlab.utexas.edu/mediawiki/index.php/User:Extenze .

While conducting my research I did finally bump into a site by a blogger who took ExtenZe for

a month and decided to post his results (Dyrko, 2008.). He reports no significant change; that it's “a

failure”. Unfortunately, blogs like his get drowned out by the plethora of promotional sites that

ExtenZe has built up. The internet researcher would have to search for “Extenze Scam” or “Extenze

fraud” to find contradicting information.

With so many sites making a concerted effort to market ExtenZe, it becomes uncomfortably

obvious that ExtenZe is designed to be a money making machine by any means necessary. Every

ExtenZe site I analyzed lacked scientific rigor, and promoted gross irresponsibility when it came to

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consumer safety. Every site reviewed boasted a 95 to 100% efficacy and 0% risk or side effects.

Another site discovered is Extenze.com. On their how it works page, it is much shorter, makes less

claims, provides less scientific sounding descriptions and doesn’t mention any ingredients. This is a

very smart move by the ExtenZe franchise; however, since their .net domain still has the bulk of the

information that we are reviewing, we will maintain our analysis on the information maintained at the

ExtenZe.net site.

CLINICAL TRAILS

Extensive internet and database searches for any clinical studies for this product reveal only one

alleged clinical study(ExtenZe Clinical Study, 2004), which doesn't typically fit the profile of respected

clinical trials that are posted online. It uses buzz words and marketing jargon to describe the product.

The sample size was extremely low (just 20 participants) and the results of the product was based on

alleged consumer feedback. This alleged clinical study is hosted by a web marketing company located

at http://www.mvsp.biz. The only evidence for the efficacy for this product are via anecdotal or

personal testimonies for how this product has changed peoples lives. Again, these studies are unreliable

due to experimenter bias. The study in Section A of the results states:

“The increase in sexual thoughts and fantasies rose with statistical significance in all participants taking

ExtenZe once a day.”

Of course it did. The subjects are talking ExtenZe pills daily with the belief that it will enhance

performance. Was that statement even needed? Certainly, it is feasible that as a result of using and

believing in ExtenZe, that one can develop positive psychological and possibly physiological effects, at

least in the short-term(Placebo Effect, 2011). This however is a far cry from stating that the ExtenZe

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product itself contains any actual elements that improve sexual performance. Just believing that it will

work alone may account for the alleged positive effects of the drugs. Also, however, the actual

testimonies themselves could have been contrived. There is really no real reason for the causal

investigator to believe the testimonies.

The study ends with this statement:

“This study shows that the all natural pro-sexual herbal and male pro-hormone sexual nutrition

supplement ExtenZe boost sexual desire, sexual energy and sexual passion. The study reveals

that sexual power, sexual pleasure and sexual performance are significantly enhanced by taking

ExtenZe for at least eight weeks. Taking ExtenZe for eight weeks revealed a highly significant

overall sex life improvement. Based on the encouraging positive outcomes of this study, a double

blind placebo-controlled clinical trial is currently in progress. ExtenZe promotes better sex. In our opinion,

better sex promotes a healthier and longer life.”

Notice that this study reflects many of the same kinds of marketing jargon as in previous examples . It

also contains many uncommon referents that we are supposed to take for granted, such as, “sexual

power” and “pro-sexual”? The authors have concluded that “better sex”, resulting from ExtenZe, can

increase one's life span; however, nothing in the study even advances support for such a claim. Lastly,

the article was at least honest in admitting that there is no double-blind, placebo controlled clinical

study. But even that statement is suspicious in that if one does a google search for “double-blind,

placebo-controlled clinical trial, ExtenZe”, the study is in the top 5 results. The ExtenZe camp are

marketers. I don't think the entry into the paper about a double-blind placebo controlled clinical trail

was an accident. Those searching the net for evidence but are unfamiliar with real clinical studies may

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think that the glorified ad for ExtenZe was a true scientific study.

Lastly, it was discovered that one of the experimenters and authors of the “study”, a Dr. Stein, is

one of the founders of the ExtenZe product and has a personal and financial interest in ensuring the

viability of this product. Though he died in April, 2011, the ExtenZe camp is still using his visage to

attract customers without even a mention that he is dead. Out of his own mouth at the

http://www.mvsp.biz/extenze website, he claims that he “has researched the ExtenZe formula” and

found that it can make the male penis larger. Unfortunately for Dr. Stein, the “research” in question

contained no critical elements and lacked scientific rigor. The “study” was also done improperly at best.

The only study which could have provided scientific evidence for the efficacy of ExtenZe has been

revealed to be useless. At this point, there is no scientific evidence.

APPEALING TO YOUR EMOTIONS

The ExtenZe.net site appeals to emotions by attempting to bring you down in the hopes of

building you back up. This is seen in many self-improvement style commercials on television. As an

example, there's a particular product I remember seeing on television that's suppose to get rid of

“unwanted” body fat. Before providing you with the miracle savior to rescue you, they break you down

first, reminding you of your perceived flaw(s). “Over the years, fat collects in this troublesome area and

it just gets worse. Our product can stop this.” The ExtenZe promoters do something similar. They tear

you down first, then they build you back up with a convenient crutch which is the savior of all your

erectile ills:

“Most erectile dysfunction treatment remedies have been really carefully created to help any men of all ages

and to put an end to this quite embarrassing condition for good.” &

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 “A man can definately learn everything he needs to know about putting a stop to their devastating erectile

dysfunction today.”

The rather inconspicuous message here is that you aren't really quite a man until you take care of your

problem by purchasing this product. Here's another one:

“... their inate ability to achieve an erection and to have good sex I...”

I really don't know why the authors of this page didn't use spell-check, but I digress. The

message is clear here. 'Good sex' is dictated by achieving an erection. The authors have just defined

“good sex” for their readers. Who wouldn't want good sex right? Final example:

“A man will not be paying anymore attention about their erection problems. Men who have used some cheap

impotence cure at home do say that this treatment option is so powerful, just like a health crash course - but

they get hard once or rock hard and just from getting smiled at by a somewhat pretty girl!

Was this really necessary? Of course the message here is essentially, “Yeah, we may be a tad bit

more expensive than those other guys, but at least pay for something that works right?”. They are

appealing to our common sense here but the comment about the pretty girl once again wasn't indicative

of professionals. There are mixed messages here about who the product is supposed to be for. The way

the ad reads is almost as if they are trying to appeal to teenagers.

COMPOSITION

ExtenZe is a proprietary blend (Brink, 2007), as a result of this, no individual ingredient

amounts are shown on the label. How can consumers make good decisions about what they are buying

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or even if it's safe if there are no dosage information per ingredient? Even a physician couldn't tell you

what is safe or not without knowing the exact amounts you are ingesting. The ExtenZe site gives an

alleged list of various chemicals that is contained in their pills. They state:

“The following are herbal extracts for people taking alternative remedies for erectile dysfunction (contained

in ExtenZe):”

Please notice that last statement in parenthesis. It is obvious that the reader is suppose to believe

that firstly, all of the ingredients they list do help with Erectile Dysfunction and two, that ALL of the

those ingredients are in ExtenZe. Of course, since ExtenZe has all of these ingredients, the buyer

should expect major results, right? I will go down the list itemizing a few ingredients and fact checking

their claim:

1.) Yohimbe: It does appear that there are studies which show some positive benefits by using

Yohimbe but the results are not consistent and minimal effects have been observed(Saenz de

Tejada, 2000) .

2.) Gamma-Butyrolactone (GBL). They say,“GBL is found in products marketed for improving

sexual function (Verve, Jolt).” This is a truly a smart move by their legal team. Indeed, it is

marketed as such by some other companies, but this doesn't mean that it works. Every scientific

website I have read about the product shows that it is extremely dangerous, especially when

mixed with Alcohol (Zvosec. Et al, 2001).

3.) Gingko. Ginko Biloba is an extract derived from a tree found primarily in Asia. It appears that

that there is some evidence that Gingko may assist with memory and dementia but not so much

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 for Alziehmers (Gingko, n.d.). Including Gingko into the formula (or at least listing it)probably

had nothing to do with sexual performance but more about riding the wave of popular

supplements.

4.) L arginine (also called arginine). Arginine is an amino acid, that when exposed to the proper

enzymes, can be broken down into Nitrous Oxide, a potent vasodilator (Rajfer et al, (1992).

Nitrous Oxide causes dilation of the arteries in the penis, thus establishing and maintaining an

erection. This is actually how Viagra, Levitra, and Cialis works (Lovy, 2011). We have used

Arginine with some success on certain conditions of spasms of the arteries that lead to the heart.

When exploring the topic on pubmed (medline's database), the use of Arginine as a single

Nitrous Oxide donor did not lead to a significant change in erectile dysfunction(Klotz et al,

1999, Chen et al, 1999). Some subsequent studies did show some success, but this was

combined with other chemicals that activated the conversion to NO (Nitrous Oxide). In most

renowned systematic reviews of erectile dysfunction, the use of Arginine is not even mentioned

as an acceptable or viable treatment option. This is probably due to a study which showed that

high levels of Arginine was only effective at providing an erection in subjects with abnormal

nitric oxide metabolism, such as those associated with cardiovascular disease (Freeman, 2010).

In addition, as is the issue stated earlier, we are not given any information in the ingredients

regarding the proper dosing of Arginine.

5.) Astragalus is an amazing plant with some great potential in cellular manipulation research, but

it is potentially dangerous as it increases blood pressure and blood sugar levels. Some species

are neurotoxic(Astralagus, n.d.).

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There are many more ingredients apparently

within this product. The pattern of dangerous

side-effects repeat over and over again with

each ingredient. If it's not dangerous, it's

simply another bandwagon ingredient that is

marketed to treat other ailments. In searching

for the actual ingredients inside ExtenZe, I

managed to find a Supplement Facts label, as

opposed to Nutrition Facts apparently.

Thanks to another one of their marketing sites

buyExtenze.com, we are provided a label to

scrutinize (see right):

It appears that they have no qualms about revealing to us that DHEA and Pregnenolone is in the

product which we will cover in the Dangers section. Vitamin amounts in mcg's are given. Notice that

the term “Active Ingredients” is no where on the label. Also, each individual amount of the ExtenZe

blends are not listed. Notice that the Sexual Response Enhancement Blend is claiming that you are

getting 600mg per serving of a variety of chemicals. The consumer could in fact be getting 599mg of

Deer Antler and 1mg total of everything else. The consumer has no way of knowing. Many of the other

ingredients listed, allegedly increase libido, heart rate, cause erections, sex drive etc. The assumption

that they wish for the consumer to have is that, if one were to ingest a mix of all of these beneficial[sic]

ingredients, then something positive must happen! In fact however, the ingredients themselves could

interfere with each other or increase certain reactions with other prescription medications.

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 NON-SENSE

Some things said on the site just don't make any sense. We will take a short tour through a number of

contradictions and ridiculous claims:

“ExtenZe pills today are the best natural formula making it THE most effective and normal way to get an
increase on a man's penis size and to enhance overall sexual desire along”

If you are taking pills to fix a problem, how can it be normal?

“The more angles you do attack your erectile dysfunction with, then the more likely you are really going to

put an end to your condition sooner and for good this time. Vitamins, herbs, supplements, dieting, breathing

techniques are definite things not to avoid.”

This is dangerous non-sense. As mentioned earlier, mixing all of these “natural solutions” could

contraindicate. It's irresponsible to tell anyone to try multiple methods to achieve a similar goal when it

involves ingesting chemicals to generate a physiological response.

“Natural remedies are a proven method that is guaranteed to work. No side effects. These remedies offer a

sure and safe and permanent solution to stop this erectile condition permanently. You will then definately not

become very dependent on any type of drugs. Will definately not affect other used medications that are taken.

No weekly drug bills. A man can definately learn everything he needs to know about putting a stop to their

devastating erectile dysfunction today.”

At this point, it should be more than obvious to the casual reader and critical thinker what's wrong with

the above paragraph. I have underlined the statements and phrases I find troubling. Advocates for

consumer awareness and for the protection of consumers are assuredly as disturbed as I upon reading

15
such carelessness. I find it despicable that supplement providers can get away with making so many

harmful claims. The passage speaks for itself at this point. I don't think there's a need to go over every

point. The passage above reflects, once again, the pattern of reckless absolute claims, dangerous

claims, and lack of scientific evidence. The old adage, “If you say it enough times people will start to

believe it's true”, unfortunately, is probably true.

The grammar and English of this article is atrocious. The author of the ExtenZe how-to page

doesn't appear to have a good grasp of the English language. This isn't an attack on the intellect of the

author, but rather the professionalism that a company should exude if they are trying to convince you to

swallow a pill that can alter your bio-chemistry. There are a multitude of egregious spelling and

grammatical errors that could have been fixed via a simple word processing program.

OTHER CRITICISMS

The webpage at http://en.wikipedia.org/wiki/Extenze has a decent review of the ExtenZe

product and brings up a number of legal issues that the company owner has faced due to false

advertising and a lack of proof that the product works.

Dr. Stephen Barrett revealed that the ExtenZe manufacturers have already lost prior lawsuits in

which the Orange County District Attorney's Office (OCDA) in California obtained a $1.75 million

settlement against Biotab Nutraceuticals (Barrett, 2011) . Not surprisingly, the lawsuit involved false

advertising which involved the lack of a scientific basis for their claims about penis enlargement.

Another lawsuit involved a class-action lawsuit against Biotab for massive frauds against the people

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(Williams, E. et al vs Biotab, 2009). The defendants needed to substantiate their claims that ExtenZe

improves penis size and male sexual prowess which it could not. Dr. Barrett points out that apparently

ExtenZe at one time referred to their products as "ambesium labidrol" and "aunctus philtrum". These

products were fictitious nomenclatures created to sound like scientific terminology!

Family Practitioner, Dr. Jon Lovy in a phone interview with me dated 10/27/2011, stated:

“First off, lets start with the actual problem of sexual/erectile dysfunction. Bear in mind that this is a

syndrome, and not a disease. The difference is that a syndrome is a constellation of signs and symptoms that

point to a pathology, without actually addressing what the specific cause of the pathology is. A disease is the

actual tissue diagnosis that is causing the pathology or syndrome. ED can have a wide variety of causes or a

specific cause that taking a pill may not fix. Claiming an almost 100% success rate is irresponsible.”

DANGERS

The ExtenZe site takes some time to describe the various chemicals that are in its product and

their supposed medicinal application. Let's remember that the Extenze creators have stated that with

their product, “.. there are no negative side effects”. Let's address two chemicals “Pregnenolone and

DHEA. Pregnenolone has no evidence of efficacy in treating ED. Pregnenolone is a chemical in the

body that is used to make all steroid hormones. Cholesterol is converted to Pregnenolone and

Pregnenolone can be converted in turn into DHEA (Walter, 2002). There are are no clinical studies that

I have been able to find that substantiate the idea that Pregnenolone alone has anything to do with

staying erect. I'd argue that this is simply another attempt at jumping on the supplement bandwagon as

Pregnenolone is very popular among bodybuilders. There is some evidence that the use of DHEA in

17
patients who are found to have a low level of this hormone in the blood had some beneficial effects on

erectile dysfunction; however, due to long-term concerns about safety, most experts do not recommend

its use(Lovy, 2011). In any case, the claims that there are zero side effects or drug interactions are

highly deceptive because of the known effects of DHEA on acne, liver disease, hair loss, palpitations,

hormone sensitive cancers, mood disorders, abdominal pain, and cardiac arrhythmia(Lovy, 2011). As

Pregnenolone frequently converts to DHEA, the consumer may inadvertently receive a higher dose of

DHEA than expected.

There are other dangers associated with ExtenZe that aren't related to just health. Career and

reputation could be tarnished as well taking ExtenZe . In April 2010, LaShawn Merritt, an Olympic

gold medalist was banned from competition for taking ExtenZe, due to the DHEA in the formula. Of

course DHEA (Dehydroepiandrosterone) is a steriod that is banned from athletic competition. Merritt

attempted to explain that he was unaware that it contained the chemical but was still banned (Shipley,

2010).

From the ExtenZe website, it provides a brief disclaimer but of course understates its

significance:

“In a man, some Occasional erectile dysfunction is quite normal. But if this erectile dysfunction keeps

happening for longer than two months or is a very recurring problem, please see your doctor for a physical

re-evaluation. Also please discuss with the professinal doctor any male enhancement questions in regards to

using herbal supplements. Then he or she will for sure help you weigh the obvious pros and cons of any

herbal treatments for erectile dysfunction based on your medical history.”

This statement is quite misleading in that it’s assuming that a doctor would actually recommend herbal

treatments, especially the likes of ExtenZe, for “male enhancement”. They wish for the reader to

18
assume the same.

CONCLUSION

The available evidence leads to the conclusion that this product probably doesn't work. A lack

of scientific rigor supporting the products efficacy, contradicting evidence regarding product safety, and

rampant absolute statements disallows this product as meeting the standards of conducting good

science. Good science provides a level of falsifiability, structured analysis, and honesty. Good science

also provides peer-reviewed studies that other scientists can replicate (What is Good Science?, n.d). We

see all of that and more lacking with the Extenze product. Though there is plenty of science wording in

the Extenze promotional efforts, there is really no science at all in their methods. As there are no

scientific methodologies employed in the ExtenZe product, one should be cautious if considering

partaking in this product. I am not a physician; however, based on the evidence, I would never

recommend Extenze to anyone.

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