Erectile Dysfunction Treatment

Prescription medication for erectile dysfunction, prescribed online by a US-licensed clinician when it's clinically appropriate for you. The medications are sildenafil, tadalafil and vardenafil preparations — PDE5 inhibitors, a class that treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation — plus Trimix, an injection prescribed when oral medication isn't suitable. Your plan is one fill of a set number of doses every 4 weeks, with your clinician, check-ins and care-team messaging included.

That's a clinical decision. A US-licensed clinician reviews your health history, your heart and blood-pressure history, your medications and the answers you give about your erections, and decides whether ED medication is appropriate for you — it isn't right for everyone. PDE5 inhibitors aren't taken with nitrates, for example, and your clinician weighs other medications and conditions the same way.

One price with provider care included, and nothing is charged at checkout. Plans start at $60 every 4 weeks for 6 doses of sildenafil + pycnogenol or tadalafil + pycnogenol; 12- and 18-dose fills, daily tadalafil, vardenafil troches and Trimix are priced per fill, up to $199 every 4 weeks. The plan you choose is charged once a clinician prescribes and renews every 4 weeks until you cancel — pause, change your dose count or cancel anytime from your portal. If a clinician decides treatment isn't right for you, you're refunded in full.

Complete a short online intake about your goals, your health, your medications and your erections. A US-licensed clinician reviews it and, if appropriate, prescribes the medication, which a licensed partner pharmacy fills and ships to your door in plain packaging. Nothing is charged unless a clinician prescribes; if they decide treatment isn't right for you, you owe nothing.

You tell us your goals, how often you expect to use it and any ED medication you've tried, and we mark a suggestion in the picker — a starting point, not a prescription. Sildenafil, tadalafil and vardenafil are all PDE5 inhibitors; tadalafil is also prescribed as a low daily dose. Your clinician decides which medication and strength, if any, are appropriate for you. The as-needed tablets come in 6, 12 or 18 doses per fill, and you can change the count from your portal.

They're different ways to take the medication. An orally dissolving tablet (ODT) dissolves on the tongue, a troche dissolves between the cheek and gum, and a tablet is swallowed. Your clinician chooses the form and strength that fit you; the medication and how it works are the same class in each case.

Trimix is a compounded injection of three medications — alprostadil, papaverine and phentolamine — injected into the side of the penis before sex. It's prescribed when oral ED medications aren't suitable or haven't been appropriate for you, and only with injection instructions from your clinician. An erection that lasts more than four hours is a medical emergency; your clinician's instructions cover what to do.

Compounded ED preparations — such as the orally dissolving tablets, troches and Trimix — are not FDA-approved. They are prepared by a US-licensed pharmacy for the individual patient when a clinician prescribes them; which forms are compounded is decided per prescription by the pharmacy filling it. That's why every plan starts with a US-licensed clinician who reviews your health history and prescribes only when clinically appropriate.

Tell your clinician everything you take — the intake asks. PDE5 inhibitors aren't taken with nitrates (medications for chest pain such as nitroglycerin, isosorbide mononitrate or isosorbide dinitrate), and your clinician will also weigh alpha blockers, riociguat, HIV antiretrovirals and nitric-oxide supplements. Chest pain during sex, fainting, or vision changes are reasons to stop and seek care.

Usually not. 43 of 50 states are fully asynchronous: you complete the intake online and a US-licensed clinician reviews it by secure message. Arkansas, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, and West Virginia, plus Washington, D.C., require one live video visit to start care — if you live there, you'll schedule a short video visit after your intake.