This study focuses on popularized representations of sexual enhancement medication (SEM) use. Relying on online forums, a discourse analytic approach (i.e., treating talk as action and as identity practice; Wetherell & Edley, 2014) examines how these portrayals are positioned within dominant discourses about male sexuality and masculinity. Intending to examine both SEM user testimonials and health expert advice about recreational SEM use, we found that men who have sex with men (MSM) user narratives were virtually nonexistent; only men who have sex with women (MSW) user narratives were locatable. SEM experiences of MSM are consistently filtered through health advocacy warnings about risks, in both mainstream and queer sites. Two prominent discourses emerged: SEM among MSW—legitimacy, heteronormativity, and relationship preservation and SEM among MSM—recreation, risk, and excess. The skewed representation of SEM used by MSM in empirical literature and sexual health advice and the omission of MSM from mainstream marketing, is shaping health discourses that link recreational uses of these drugs with gay men and risky sexual behavior (Wentzell, 2011). This reflects a broader cultural rhetoric that associates the sexuality of MSM with sexual health risks and concurrent illicit drug use.