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Updated October 2026 · 8 US providers reviewed

Best online ED treatments of 2026.

Licensed clinicians, FDA-approved generics, discreet delivery. Compared side by side.

  1. Best OverallHims 9.8
  2. Best for ChoiceRo 9.6
  3. Best ChewablesBlueChew 9.4
See the full comparison

The 2026 comparison

Top online ED providers

Prescription required. A licensed clinician decides whether treatment is right for you. We may earn a commission from listed providers; this can affect placement. Advertising disclosure · How we rank.

  1. 01
    Best Overall

    Hims

    A large US telehealth platform offering branded and generic ED medication after an online consultation with a licensed provider.

    • Free online assessment, no office visit
    • Generic, branded and daily options
    • Unlimited messaging with your provider
    • Auto-refills ship in plain packaging
    • Sildenafil
    • Tadalafil
    • Viagra®
    • Cialis®
    Pricing
    From ~$2/dose (generic sildenafil)
    Formats
    Pills, hard mints (compounded)
    Consultation
    Online questionnaire
    Delivery
    Discreet free shipping
    Insurance
    Not required
    9.8/10Excellent
    Visit Hims Read our review
    Pros & cons
    • Wide range of generic and branded options
    • Ongoing provider messaging
    • Subscription plans with auto-refills
    • Some products need a subscription
  2. 02
    Best for Choice

    Ro

    Telehealth company providing access to US-licensed clinicians and a broad catalogue of ED treatments, shipped in plain packaging.

    • Online visit reviewed by a licensed clinician
    • As-needed and daily treatment plans
    • Unlimited follow-ups with the care team
    • Free two-day discreet shipping
    • Sildenafil
    • Tadalafil
    • Viagra®
    • Cialis®
    Pricing
    From ~$2/dose (generic sildenafil)
    Formats
    Pills, chewable "Sparks" (compounded)
    Consultation
    Online visit
    Delivery
    Free shipping
    Insurance
    Not required
    9.6/10Excellent
    Visit Ro Read our review
    Pros & cons
    • Follow-ups with care team
    • Daily and as-needed options
    • Transparent pricing
    • Consultation required before pricing is final
  3. 03
    Best Chewables

    BlueChew

    Subscription service offering chewable tablets containing the active ingredients of common ED medications, prescribed after an online consult.

    • Chewable tablets with familiar active ingredients
    • Monthly plans at several tablet counts
    • Consultation entirely online
    • Plain-package monthly delivery
    • Sildenafil chewables
    • Tadalafil chewables
    • Vardenafil chewables
    Pricing
    From ~$20/month
    Formats
    Chewable tablets (compounded)
    Consultation
    Online consultation
    Delivery
    Monthly discreet delivery
    Insurance
    Not accepted
    9.4/10Great
    Visit BlueChew Read our review
    Pros & cons
    • Chewable format
    • Simple monthly plans
    • Low entry price
    • Compounded chewables are not FDA-approved products
  4. 04
    Best Value Visit

    Lemonaid

    Telehealth service covering many conditions, including ED, with a flat consultation fee and home-delivered medication.

    • Flat consultation fee, no subscription needed
    • Option to send the prescription to a local pharmacy
    • Covers many other conditions too
    • No office visit required
    • Sildenafil
    • Tadalafil
    • Viagra®
    • Cialis®
    Pricing
    Visit fee + medication
    Formats
    Pills
    Consultation
    Online questionnaire
    Delivery
    Free shipping
    Insurance
    Pharmacy pickup may use insurance
    9.1/10Very Good
    Visit Lemonaid Read our review
    Pros & cons
    • Flat consultation fee
    • Covers many health conditions
    • Pharmacy delivery
    • Fewer specialty formats
  5. 05
    Sublingual Format

    Rugiet

    Offers a compounded sublingual troche combining several active ingredients, prescribed by licensed providers via telehealth.

    • Dissolves under the tongue
    • Combines several active ingredients in one dose
    • Telehealth visit with a licensed provider
    • Discreet packaging
    • Rugiet Ready (sublingual)
    Pricing
    Varies by plan
    Formats
    Sublingual troche (compounded)
    Consultation
    Online visit
    Delivery
    Discreet shipping
    Insurance
    Not accepted
    8.9/10Very Good
    Visit Rugiet Read our review
    Pros & cons
    • Dissolves under the tongue
    • Single combined dose
    • Compounded, not FDA-approved
    • Higher price per dose
  6. 06
    Easy Onboarding

    MEDVi

    Telehealth provider with a short intake process, offering generic ED medication prescribed by licensed clinicians.

    • Short online intake form
    • Generic and combination options
    • Licensed clinicians review every request
    • Home delivery
    • Sildenafil
    • Tadalafil
    Pricing
    Varies by plan
    Formats
    Pills, combination formulas (compounded)
    Consultation
    Online intake
    Delivery
    Home delivery
    Insurance
    Not accepted
    8.7/10Good
    Visit MEDVi Read our review
    Pros & cons
    • Quick intake form
    • Generic pricing
    • Smaller product range
  7. 07
    Budget Pick

    Direct Meds

    Online provider focused on low-cost generic ED medication, prescribed by licensed physicians after a remote consultation.

    • Low-cost generic sildenafil and tadalafil
    • Rapid-dissolve tablet option
    • Remote consultation with a licensed physician
    • Fast free shipping
    • Sildenafil
    • Tadalafil
    Pricing
    Low-cost generics
    Formats
    Pills, rapid-dissolve tablets (compounded)
    Consultation
    Online consultation
    Delivery
    Free shipping
    Insurance
    Not accepted
    8.5/10Good
    Visit Direct Meds Read our review
    Pros & cons
    • Low generic pricing
    • Straightforward ordering
    • Limited branded options
  8. 08
    Men's Health Focus

    PeterMD

    Men's health clinic offering telehealth visits, lab-based assessments and ED treatment plans from licensed clinicians.

    • Lab work to check hormones and underlying causes
    • Telehealth visit with a licensed clinician
    • ED care alongside testosterone and wider men's health
    • Home delivery
    • Sildenafil
    • Tadalafil
    Pricing
    Varies by plan
    Formats
    Pills
    Consultation
    Telehealth visit + labs
    Delivery
    Home delivery
    Insurance
    Not accepted
    8.3/10Good
    Visit PeterMD Read our review
    Pros & cons
    • Lab-based approach
    • Broader men's health care
    • Higher cost than basic generics

At a glance

Side-by-side table

ProviderTreatmentsFormatsConsultationPricingAvailabilityScore
Hims Sildenafil, Tadalafil, Viagra®, Cialis®Pills, hard mints (compounded)Online questionnaireFrom ~$2/dose (generic sildenafil)Most US states9.8
Ro Sildenafil, Tadalafil, Viagra®, Cialis®Pills, chewable "Sparks" (compounded)Online visitFrom ~$2/dose (generic sildenafil)All 50 states9.6
BlueChew Sildenafil chewables, Tadalafil chewables, Vardenafil chewablesChewable tablets (compounded)Online consultationFrom ~$20/monthMost US states (not ND)9.4
Lemonaid Sildenafil, Tadalafil, Viagra®, Cialis®PillsOnline questionnaireVisit fee + medicationMost US states9.1
Rugiet Rugiet Ready (sublingual)Sublingual troche (compounded)Online visitVaries by planMost US states8.9
MEDVi Sildenafil, TadalafilPills, combination formulas (compounded)Online intakeVaries by planMost US states8.7
Direct Meds Sildenafil, TadalafilPills, rapid-dissolve tablets (compounded)Online consultationLow-cost genericsMost US states8.5
PeterMD Sildenafil, TadalafilPillsTelehealth visit + labsVaries by planAll 50 states8.3

How it works

From questionnaire to doorstep

01

Online consultation

Answer a medical questionnaire. A US-licensed clinician reviews your history, medications and symptoms.

02

Clinician decision

If treatment is appropriate, a prescription is issued. If not, you won't be charged for medication.

03

Discreet delivery

A licensed pharmacy ships your medication in plain packaging, often within a few days.

The basics

What is erectile dysfunction?

Erectile dysfunction (ED) is trouble getting or keeping an erection firm enough for sex. Occasional difficulty is normal; ED is when it happens regularly. It is one of the most common health conditions in men: the landmark Massachusetts Male Aging Study found some degree of ED in about half of men aged 40 to 70, and an estimated 30 million men in the US are affected.1,2

ED is also a useful health signal. Because erections depend on healthy blood vessels, ED can appear years before heart disease is diagnosed, which is why clinicians often check blood pressure, cholesterol and blood sugar.3

Common symptoms

  • Trouble getting an erection
  • Trouble keeping an erection during sex
  • Erections that are less firm than before
  • Reduced sexual desire, sometimes alongside ED

Symptoms can come and go. If ED appears suddenly or with chest pain or shortness of breath, see a doctor in person.

Why it happens

Possible causes of ED

ED often has more than one cause, and physical and psychological factors can feed each other.2

Physical health

  • Heart disease and clogged arteries
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Obesity and metabolic syndrome
  • Low testosterone and other hormone disorders
  • Nerve conditions (MS, Parkinson's, stroke)
  • Prostate surgery or pelvic injury

Mental health

  • Stress
  • Performance anxiety
  • Depression
  • Relationship problems
  • Low self-esteem

Lifestyle

  • Smoking
  • Heavy alcohol use
  • Recreational drug use
  • Lack of physical activity
  • Poor diet
  • Poor sleep

Medications

  • Some antidepressants (SSRIs, SNRIs)
  • Some blood pressure drugs (e.g. thiazide diuretics, certain beta-blockers)
  • Antipsychotics
  • Antiandrogens
  • Opioids

Never stop a prescribed medicine on your own; ask your doctor about alternatives.

Know the options

ED medications compared

All four are PDE5 inhibitors, the first-line treatment for ED recommended by the American Urological Association. Doses and timing are typical ranges; your clinician sets yours.4,5

MedicationTypical dosesStarts workingLastsFoodGood to know
Sildenafil
Viagra®		25, 50, 100 mg as needed30–60 minAbout 4–6 hoursHigh-fat meals delay itMost studied; cheap generics widely available
Tadalafil
Cialis®		10–20 mg as needed, or 2.5–5 mg daily30 min–2 hoursUp to 36 hoursNot affectedDaily option removes the need to plan; also treats enlarged prostate symptoms
Vardenafil
Levitra®, Staxyn®		5, 10, 20 mg as needed; 10 mg dissolving tablet30–60 minAbout 4–5 hoursHigh-fat meals delay itOrally dissolving version available
Avanafil
Stendra®		50, 100, 200 mg as needed15–30 minUp to about 6 hoursMinimal effectFastest onset; brand-only, so usually pricier

How ED pills work

During arousal, the body releases nitric oxide, which relaxes the smooth muscle in the penis so blood can flow in. An enzyme called PDE5 then breaks down the chemical messenger (cGMP) that keeps those muscles relaxed. PDE5 inhibitors slow that breakdown, so blood flow is stronger and lasts longer.

They are not aphrodisiacs and do not raise testosterone: you still need sexual stimulation for them to work. Studies show they help roughly two-thirds to three-quarters of men, and it is worth trying a medication several times, at the right dose, before deciding it doesn't work.4

Generic vs. brand vs. compounded

Generics contain the same active ingredient as the brand, meet the same FDA standards and cost far less. Compounded products (chewables, mints, troches, combination formulas) are mixed by pharmacies for individual patients; they can be convenient but are not FDA-approved, so their quality and effectiveness haven't been reviewed by the FDA.6

Beyond pills

Other ED treatments

If pills don't work or aren't safe for you, there are other proven options. Supplements and devices vary widely in evidence.

Proven

Topical gel

Eroxon is a gel applied to the penis that works through a cooling and warming effect. It is FDA-authorized and available without a prescription. Effects are modest compared with pills.7

Proven

Vacuum erection devices

A cylinder and pump draw blood into the penis, and a ring at the base holds it. Drug-free and reusable; remove the ring within 30 minutes.

Proven

Penile injections

Alprostadil or combination drugs injected into the side of the penis work for most men who don't respond to pills. A urologist teaches you how to self-inject.

Proven

Urethral suppositories

A small alprostadil pellet inserted into the urethra. Less effective than injections but needle-free.

Proven

Penile implants

A surgical option for men when other treatments fail. Satisfaction rates are high, but surgery is permanent.

Proven

Testosterone therapy

Only helps ED when blood tests confirm low testosterone. It is often combined with a PDE5 inhibitor and needs monitoring.

Emerging

Shockwave therapy

Low-intensity sound waves aim to improve blood flow. Early results are promising for mild vascular ED, but it is not FDA-approved for ED and the AUA considers it investigational.4

Supportive

Counselling & sex therapy

Very effective for stress, anxiety or relationship-related ED, and helpful alongside medication.

Limited evidence

Supplements & vitamins

L-arginine, L-citrulline and vitamin D are studied, with mixed results. They are not substitutes for treatment, and the FDA warns that many "male enhancement" products contain hidden drugs.8

Safety first

Side effects & who should avoid ED pills

Common side effects

Usually mild and short-lived: headache, flushing, stuffy nose, indigestion, dizziness and back or muscle aches (more with tadalafil). Sildenafil can cause a temporary blue tint to vision.

Do not take PDE5 inhibitors if you

  • Take nitrates (e.g. nitroglycerin for chest pain) or use "poppers"
  • Take riociguat for pulmonary hypertension
  • Have been told sex is unsafe because of heart problems
  • Have very low blood pressure or recently had a heart attack or stroke

Tell your clinician about alpha-blockers, some antibiotics and antifungals, and HIV medicines, which can interact.

Get emergency care for an erection lasting more than 4 hours, chest pain, or sudden loss of vision or hearing.5

Long-term outlook

Can ED be cured?

Sometimes. ED caused by lifestyle factors, medication side effects, stress or low testosterone often improves or goes away once the cause is treated. ED linked to long-term vascular disease or nerve damage is usually managed rather than cured, and modern treatment works for most men.

Habits that help

  • Exercise regularly: aerobic exercise improves erectile function
  • Eat a Mediterranean-style diet
  • Lose excess weight
  • Stop smoking and limit alcohol
  • Sleep 7–9 hours
  • Manage stress, and talk to your partner

In depth

Full provider reviews

#1 · Best Overall

Hims review

Affordable, discreet ED treatment with the widest catalogue

9.8/10Excellent

Hims is one of the best-known names in men's telehealth. You fill in a medical questionnaire, a US-licensed provider reviews it, and if treatment is appropriate a prescription is filled by a partner pharmacy and shipped to your door.

Its catalogue spans generic sildenafil and tadalafil, branded Viagra® and Cialis®, and compounded "hard mints" that combine active ingredients. Multi-month plans bring the per-dose price of generics down sharply.

Best for: Men who want a choice of generics and brands in one place, with low per-dose pricing.

Pros

  • 100% online consultation
  • FDA-approved generic and brand options
  • Fast, discreet shipping
  • Provider follow-ups through the app

Cons

  • Lowest prices require multi-month plans
  • Compounded mints are not FDA-approved
  • Insurance not accepted
Visit Hims

#2 · Best for Choice

Ro review

A polished platform with strong clinician follow-up

9.6/10Excellent

Ro (formerly Roman) runs a full telehealth practice and its own pharmacy network. After an online visit a clinician recommends a plan and stays available for follow-up questions or dose changes at no extra cost.

Beyond generics and brands, Ro offers Sparks, a fast-dissolving compounded format. Pricing is clearly listed before checkout, though your final plan depends on the clinician's decision.

Best for: Men who value ongoing access to a care team and clear pricing.

Pros

  • Strong clinician follow-up
  • Daily and as-needed plans
  • Available nationwide
  • Clear pricing pages

Cons

  • Final plan depends on the consultation
  • Compounded products are not FDA-approved
  • Insurance not accepted
Visit Ro

#3 · Best Chewables

BlueChew review

Quick, chewable ED support delivered entirely online

9.4/10Great

BlueChew pioneered the chewable ED tablet. Its chewables contain sildenafil, tadalafil or vardenafil, the same active ingredients found in Viagra®, Cialis® and Levitra®, and are made by compounding pharmacies.

Plans are billed monthly by tablet count, which keeps the entry price low. Because the tablets are compounded, they have not gone through FDA approval as finished products.

Best for: Men who prefer a chewable to swallowing a pill and like a simple monthly subscription.

Pros

  • 100% online consultation
  • Chewable tablets with proven active ingredients
  • Low starting price
  • Discreet monthly shipping

Cons

  • Not available in North Dakota or outside the US
  • Compounded, not FDA-approved
  • Does not accept insurance
Visit BlueChew

#4 · Best Value Visit

Lemonaid review

Straightforward care with a flat visit fee

9.1/10Very Good

Lemonaid is a general telehealth service that treats ED alongside conditions like hair loss, depression and birth control. You pay a flat consultation fee and a clinician reviews your answers, sometimes following up by phone or video.

You can have medication shipped from Lemonaid's pharmacy or send the prescription to a local pharmacy, which may let you use insurance.

Best for: Men who want one visit and a prescription without a subscription.

Pros

  • Flat, upfront visit fee
  • Local pharmacy option
  • Broad telehealth service

Cons

  • Fewer specialty formats
  • Visit fee charged separately from medication
Visit Lemonaid

#5 · Sublingual Format

Rugiet review

A combined sublingual dose for men who want speed

8.9/10Very Good

Rugiet's main product, Rugiet Ready, is a compounded troche that dissolves under the tongue. It combines more than one active ingredient so you take a single dose rather than several pills.

Sublingual absorption is marketed as faster than swallowed tablets, but combination compounded products are not FDA-approved and cost more per dose than standard generics.

Best for: Men who have tried standard pills and want a combined, dissolvable format.

Pros

  • Sublingual, no swallowing
  • Single combined dose
  • Fully online

Cons

  • Compounded, not FDA-approved
  • Higher price per dose
  • Narrow product range
Visit Rugiet

#6 · Easy Onboarding

MEDVi review

Fast sign-up and simple plans

8.7/10Good

MEDVi keeps onboarding short: a brief intake form is reviewed by a licensed clinician, and approved medication is shipped to your home.

It offers generic sildenafil and tadalafil plus combination formulas. The range is smaller than the largest platforms, but the process is quick.

Best for: Men who want the quickest path from sign-up to prescription.

Pros

  • Quick intake
  • Generic pricing
  • Home delivery

Cons

  • Smaller product range
  • Combination formulas are compounded
Visit MEDVi

#7 · Budget Pick

Direct Meds review

Low-cost generics with a simple order flow

8.5/10Good

Direct Meds focuses on keeping generic ED medication affordable. A licensed physician reviews your consultation remotely, and approved orders ship free.

Alongside standard tablets it offers a rapid-dissolve compounded option. Branded medication choices are limited.

Best for: Budget-conscious men who are happy with generics.

Pros

  • Low generic pricing
  • Simple ordering
  • Free shipping

Cons

  • Limited branded options
  • Rapid-dissolve tablets are compounded
Visit Direct Meds

#8 · Men's Health Focus

PeterMD review

A lab-led approach to men's health

8.3/10Good

PeterMD is a Florida-based men's health telemedicine clinic best known for testosterone therapy. Its ED care starts with a telehealth visit and lab work, which can help spot hormonal or metabolic causes.

That depth costs more than a simple generic subscription, but suits men who want to look at the bigger picture.

Best for: Men who suspect low testosterone or want ED looked at alongside overall health.

Pros

  • Lab-based assessment
  • Broader men's health care
  • Available nationwide

Cons

  • Higher cost than basic generics
  • Lab work adds time
Visit PeterMD

Buying guide

How to choose an online ED provider

Licensed clinicians and pharmacies

A legitimate service always requires a medical consultation and uses US-licensed prescribers and pharmacies. Be wary of any site that sells ED drugs without a prescription.

FDA-approved vs. compounded

Know whether you're buying an FDA-approved generic or brand, or a compounded product. Both may be prescribed, but only the first has been reviewed by the FDA.

True cost per dose

Compare the price per dose, not the monthly headline. Check whether consultation fees, shipping and follow-ups are included, and how easy it is to cancel a subscription.

Ongoing support

Good providers let you message a clinician to adjust your dose or switch medication at no extra cost.

Privacy

Look for plain packaging, discreet billing names and a clear privacy policy explaining how your health data is used.

FAQ

Quick answers

All questions
What is erectile dysfunction (ED)?

ED is the ongoing difficulty getting or keeping an erection firm enough for sex. It is common, becomes more likely with age, and can be linked to heart health, diabetes, blood pressure, medications, stress or lifestyle factors.

Do I need a prescription for ED medication?

Yes. In the United States, ED medications such as sildenafil and tadalafil require a prescription. Every provider listed here requires a consultation with a licensed healthcare professional before any medication is prescribed.

Does Men's Vitality Hub sell or prescribe medication?

No. Men's Vitality Hub is an independent comparison website. We do not sell, prescribe or dispense medication and we do not provide medical advice. Treatment decisions are made between you and a licensed clinician.

How do online ED consultations work?

You typically complete a medical questionnaire that a US-licensed clinician reviews. Some services may request a video or phone visit or lab work. If treatment is appropriate, a prescription is sent to a pharmacy that ships the medication to you.

What is the difference between generic and branded ED pills?

Generic sildenafil and tadalafil contain the same active ingredients as Viagra® and Cialis® and are FDA-approved generics. They usually cost much less than the branded versions.

Are compounded or chewable ED products FDA-approved?

Compounded medications, including some chewables and sublingual troches, are prepared by pharmacies for individual patients and are not FDA-approved products. Ask your clinician about the differences before choosing.

Who should not take ED medication?

ED medicines can be unsafe with nitrates (often used for chest pain) and certain other drugs, and may not suit people with some heart, liver or kidney conditions. Always give your clinician your full medical history.

Is my information private?

Men's Vitality Hub does not collect medical information. Providers you visit have their own privacy policies and handle health data under applicable US law. Read each provider's policy before sharing information.

Sources

References

  1. Feldman HA, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Journal of Urology, 1994;151(1):54–61.
  2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Erectile Dysfunction.
  3. Mayo Clinic. Erectile dysfunction: symptoms and causes.
  4. Burnett AL, et al. Erectile Dysfunction: AUA Guideline. Journal of Urology, 2018;200(3):633–641.
  5. U.S. National Library of Medicine, MedlinePlus. Sildenafil and Tadalafil drug information.
  6. U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers.
  7. U.S. Food and Drug Administration. De Novo classification of Eroxon (MED3000) for erectile dysfunction, 2023.
  8. U.S. Food and Drug Administration. Tainted Sexual Enhancement Products.

This page is general information, not medical advice. Speak with a licensed clinician about your situation.

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