How can I control my impulses better?

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My ability to control impulses seems to be all or nothing. If I don't want to say something stupid I usually have to avoid saying anything at all. If I want to avoid being rude to someone I have to avoid that person. If I don't want to perv on girls avoid looking at girls at all. The list goes on. Would going on ADHD meds help with this or do I just have to wait until I outgrow this.

Will power.

I used to have some pretty unpleasant habits but I've managed over the years to train them out by using a reward based system. OK, I still slip up now and again but we're all human

You have willpower or you would not ever do anything other than what you would most prefer to do at any given time, which I'm absolutely sure is not the case even though I've never met you and know very lttle about you.
However, willpower is like a muscle in that you have to excercise it for it to become strong.
Right now your will is flabbly, weak, and out of shape, but it exists.
You need to start exercising it.

To shut yourself up, do what I do:
Put your tongue between your teeth and bite down gently.
Seriously, that's what I do to prevent myself from saying things I'm compelled to but know I shouldn't.

As far as rewards go:
Generally speaking only immediate rewards will work and sometimes they even need to be given in advance to be effective and/or to seal the deal.
Autistics have a lot of trouble abstracting so rewards can not be put off till some time in the future, we must be rewarded immediately after, or immediately before, the behavior we're trying to encourage for this type of behavior modification to have any real effect.

If you want a cease-fire from the compulsive, emotional id, you're going to have to learn to negotiate with it.
It/you want(s) things, things you can give it/yourself in return for concessions to the conscious, intellectual ego's wants/needs.
Once you learn to do that, then you have to learn to pick your battles, let the id/compulsions have their way until the point of any deal, and only make deals when it's something that's really necessary.
Make sure you follow through on the deal, whether you get the reward beforehand or after, and don't let either side welsh on the debt.

I've made sort of a standing deal with myself that I will let my obsessions run their course when I'm caught up in them, in return for the ability to then do a large chunk of productive stuff afterwards without having to deal with them.
Basically, I've learned that fighting the obsessions and even making deals to interrupt them is to some large extent counter-productive and that I actually end up getting more done by simply giving in & waiting until I'm ready to be productive.

This is how I've learned, despite paralyzing executive function issues which for many years kept me from really doing anything productive at all, to function & get things done on a fairly regular basis.

The inability to control one's obessions and compulsions is one of the most difficult & frustrating parts of being autistic, imho.
I wish you the best of luck with this.