Though it's rarely male enhancements, it's mostly skin creams and health supplements, as if anyone on this website would care about that
This has been suggested before, and the general consensus was that the sheer volume of new users, nevermind new posts, on this site is way too high for the relatively small team of staff members to handle.
Maybe with enough Patreon backers, we'll have enough money to employ a couple people in different time zones to be full time spam busters
This has also been suggested before, and Costello said that they have a lot of anti-spambot measures in place that we might not notice, and the remaining spammers are most likely real people paid to spam, and that if they disallowed URLs in titles, the spammers would just change up their posts to bypass the filter and it would inconvenience legitimate users.
Which I agree with, there doesn't really seem to be any easy way to block spammers permanently, it's like Nintendo trying to patch all the hacks, they may be one step ahead but the hackers are never far behind and always find a way around it eventually.
There isn't a whole lot of it, but if you're up at the times when the staff is usually asleep you start to see a pattern. The spammers always seem to post around the same time, knowing that the staff is likely asleep. It doesn't happen every day, but it always happens around the same time.
Getting a new staff member in a different time zone might help. They tend to post at nighttime/early morning in Europe and USA, so maybe get a staff member in Australia/NZ.