Sexual Health

Prescription tablets to help you get and keep an erection firm enough for sex, prescribed online by a US-licensed clinician when it's clinically appropriate for you. The medications are sildenafil and tadalafil — PDE5 inhibitors, a class that works by increasing blood flow to the penis during sexual stimulation — taken as needed, or tadalafil as a low dose every day. Your plan is a 30, 60 or 90-day supply, 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 sildenafil or tadalafil 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. The lowest-cost plan is a 90-day supply of 18 tablets of sildenafil or tadalafil for $75 — $25 a month; a 30-day supply of six is $49. Supplies run 30, 60 or 90 days (the daily tablet 30, 90 or 180, from $25 a month), each priced per supply, up to $210 for the largest. The supply you choose is charged once a clinician prescribes and renews on the same schedule until you cancel — change your supply 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 what you'd like help with, 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.

Sildenafil and tadalafil are both PDE5 inhibitors. Both are taken as a tablet before sex; tadalafil is also prescribed as a low dose taken every day. Which medication and which regimen are appropriate for you is your clinician's decision — the intake asks what you'd prefer and marks a suggestion from your answers, and that is a starting point, not a prescription.

You tell us how often you expect to use it, and the picker sizes three supplies — 30, 60 or 90 days — with the number of tablets each holds and the price per tablet. A longer supply costs less per tablet and is billed less often. You can change your supply anytime from your portal, and your clinician decides the strength.

Sildenafil and tadalafil tablets are filled by US-licensed pharmacies; which preparation your pharmacy dispenses is decided per prescription. The tadalafil + sildenafil combination tablet is compounded — prepared by a US-licensed pharmacy for the individual patient when a clinician prescribes it — and compounded preparations are not FDA-approved. 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.

Sildenafil and tadalafil are prescribed for erectile dysfunction — trouble getting or keeping an erection firm enough for sex. They don't increase desire and they don't work without sexual stimulation. If you're not sure whether what you're experiencing is erectile dysfunction, the intake's questions about your erections are the ones clinicians use, and a US-licensed clinician decides whether medication is appropriate for you.

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.