Nearly everyone has encountered junk emails advertising supplements that provide benefits below the belt. Aside from the spam problem, these products have another downside that has officials with the Food and Drug Administration (FDA) worried about the health of American consumers. Since 2011, the FDA has issued dozens of public notices related to male enhancement products that contain potentially dangerous unlisted ingredients. Two dozen warnings were issued in 2014 alone, but these products are still available. Due to their status as over-the-counter supplements, the FDA is struggling to crack down on manufacturers and distributors. This regulatory gray area also creates questions about whether a drug lawsuit lawyer can help victims who were harmed by unregulated supplements. With names like Weekend Warrior, Samurai-X, Tiger King, Herbal Vigor Quick Fix and 3 Hard Knights, it would be easy for consumers to believe that these are amusing novelty products based on native botanical remedies. No one expects these products to be laced with sildenafil, the active ingredient in Pfizer's blockbuster erectile dysfunction medication Viagra. One manufacturer even used the name Gold Vigra, which bears obvious similarities to Pfizer's trademark. The presence of so-called hidden drug ingredients concerns doctors and public health officials. The problem also worries any class action lawsuit attorney who is struggling to determine responsibility. Although the FDA regulates pharmaceuticals, it has little control over vitamins and supplements. According to Dr. Drogo K. Montague, director of the Center for Genital Urinary Reconstruction at the Cleveland Clinic, this lack of oversight is part of the problem. He stated that the FDA does not have the level of control over natural and herbal remedies that it should. Heart attack and sudden death are among the risks that Dr. Montague associates with these unregulated medications. Sildenafil is particularly dangerous for anyone with diabetes, high blood pressure, high cholesterol or heart disease and anyone who takes nitrites. When these medications are combined with sildenafil, patients may experience a potentially deadly decrease in blood pressure. Deceptive marketing tactics and claims that consumers can add inches down there also affect purchasing decisions. Science shows that sildenafil improves sexual performance in men who suffer from impotence, but it cannot increase the size of a man's penis. Furthermore, these potentially dangerous products are sold by nutrition stores where consumers expect to find products that will enhance their health. The FDA has warned the public and alerted retailers, but the majority of products are still available. An investigative report published by NBC News in September 2014 found that 18 of the 20 tainted products were still available through domestic and international websites. Tiger King was available on Sears.com 10 months after the warning was issued. Sears only pulled the product, which was sold by a third-party vendor, after the NBC investigation. Another online retailer maintained that they did not receive any notifications from the FDA. An hour after speaking with NBC reporters, company directors said they received an express letter about the issue. This is not the first time that the safety of male enhancement products has been questioned. In 2014, an FDA panel issued a warning about the widespread use of testosterone replacement therapies. A series of aggressive TV commercials urged middle-aged men to consider hormonal therapy that can slow the aging process. Due to the side effects, officials warn that these treatments should only be prescribed to patients with specific ailments that impair hormone production. As more men receive treatment for erectile dysfunction, the population of patients who experience complications increases. Better regulatory oversight and medical recommendations are needed to improve patient safety and prevent the complications that lead injury victims to contact a pharmaceutical lawsuit lawyer.