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While public health officials don’t know the extent of the problem, they agree that incidents are vastly underreported, with national tracking systems capturing perhaps as little as 1 percent of them.

Victims may be embarrassed, and doctors rarely ask about supplements.

The AP often couldn’t determine from records whether incidents reported to tracking systems of the federal Food and Drug Administration and state poison control centers involved mixing herbal alternatives with nitrates.

Some men in their 30s who went to emergency rooms after taking herbal sex pills were presumably otherwise healthy, but they showed the transitory side effects of the active ingredients in regulated impotency pharmaceuticals, such as difficulty seeing clearly or severe headaches, records show.

Emergency rooms and poison control hot lines are starting to log more incidents of the long-ignored phenomenon.

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“A Web site can look sophisticated and legitimate, but actually be an illegal operation.” In many cases, the ingredients used to alter herbal pills come from Asia, particularly China, where the sexual enhancers are cooked up in labs at the beginning of a winding supply chain.

The company said that 69 percent of 3,400 supplements it purchased in China contained sildenafil citrate, the main ingredient in Viagra. law, because such pills are “dietary supplements,” they’re far less regulated than pharmaceuticals and face few barriers to market.

Pfizer didn’t check for the patented ingredients of its rivals. Viagra, by contrast, underwent years of testing before it was publicly available.

when she bounced a little too high, and crunched Ray's erect penis. and "blood was everywhere." Ray says he immediately passed out from the pain. and underwent emergency surgery to close the wound and repair a "slight tear" in his urinary tube.

explaining how he was having sex with his GF, who was "on top" ...

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