Frequently asked questions

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.

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.

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.

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.

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.

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.

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.

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.

We assess licensed clinician access, treatment range, pricing transparency, delivery, customer support and ease of use. Commercial relationships may influence placement; see our Advertising Disclosure for details.

Seek in-person care if ED appears suddenly or comes with chest pain, shortness of breath or other new symptoms. An erection lasting more than 4 hours is a medical emergency.

Most ED pills are taken 30 to 60 minutes before sex. Sildenafil works best on an empty stomach, while tadalafil is less affected by food. Your clinician will advise on timing for your prescription.

Do not combine ED medications or take more than prescribed unless your clinician tells you to. Mixing PDE5 inhibitors raises the risk of low blood pressure and side effects. Never combine them with nitrates or recreational "poppers".

No oral ED medication is FDA-approved for over-the-counter sale in the US. Supplements sold as "male enhancement" are not proven to work, and the FDA has found many contain hidden prescription drugs. Eroxon, a topical gel, is FDA-authorized without a prescription.

Most online ED services are cash-pay and do not bill insurance. Some let you send a prescription to a local pharmacy, where your insurance may cover part of the cost. Generic sildenafil and tadalafil are often cheaper than an insurance copay.

Waking with erections or getting erections during masturbation but not with a partner can point to a psychological cause such as stress or performance anxiety. Gradual onset, especially with risk factors like diabetes or high blood pressure, suggests a physical cause. A clinician can help work it out, and often both play a role.

Often, yes. PDE5 inhibitors improve blood flow regardless of the cause, and successful experiences can ease performance anxiety. Counselling or sex therapy works well alongside medication for stress, anxiety or relationship-related ED.

Yes. ED can be an early warning sign of heart disease or diabetes, and ED drugs interact with some medications, including nitrates and certain blood pressure drugs. Keeping your doctor informed keeps your care safe.

It depends on the cause. ED linked to lifestyle, medication side effects or stress often improves or resolves once the cause is addressed. ED from long-term conditions is usually managed rather than cured, and treatment is highly effective for most men.