Examining the various male-enhancement pills that have been truly known to work closely, it turns out that they usually work through two main mechanisms: either by increasing the level of the user's male hormones, or by decreasing the levels of female hormones in the user. Let us look at each of these at some length.
Starting with the mechanism where male-enhancement pills work by increasing the user's male hormones, it turns out that the size of a man's sexual organ, as indeed most of other so-called 'masculine features' in a man are under the control of these male hormones (also called androgens), especially testosterone whose influence is most pronounced. It follows
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that a man whose male sexual hormones happen to plummet for whatever reason during the crucial stages of his growth, especially during his mid teens to early twenties could find himself experiencing penile size issues later on in life: hence his need for an aid that can help with the problem. Granted, simply pumping testosterone into a grown man is not likely to cause any major male enhancement, but using the male hormones alongside other aids (like small amounts of growth hormones) has shown some success at inducing adult penile growth, and it is this that most male enhancement pills are based on.