Quick Summary of Ratings
We have taken the time to analyze all aspects of erectile dysfunction treatment and have rated the best options. The details below further explain why and how we compared in-person treatment with online options. After doing all the research, we have our top 3 choices listed below.
Why we rated Viking Man our #1
- Initial video doctor assessment to ask any questions you have
- Treatment discussed with you and not for you
- FDA-Approved medication starting at $2/dose
- Unlimited video doctor follow-ups
Why we rated Primary Physician #2
Most online doctors require in-person visit recently
Help rule out any major underlying causes or concerns
Covered by most insurance
Why we rated Roman ED #3
Most medication options for online services
FDA-approved medication sourcing
Free 2-day Shipping
Continued secure messaging with your doctor
“When to See a Doctor for Erectile Dysfunction?”
Although it may seem sort of hard to discuss your erectile concerns and sexual activity with a doctor, it essential and the best way to specifically understand why ED in particular is happening and fix it. Erectile dysfunction affects an estimated 30 million men in the United States and an estimated 140 million men worldwide. Although it is common among so many men, it is not a normal part of aging and growing older. Erectile dysfunction should particularly be checked out by a healthcare professional to find out the exact underlying cause of your ED and treat it once it becomes a problem. It is normal to experience erectile dysfunction from time to time without any major issues. However, when erectile dysfunction begins to become a constant issue or is disrupting your sexual activity on a regular basis, then it is time to reach out to a doctor.
Any doctor that can treat your erectile dysfunction will need your medical and sexual history to get an understanding of what is going on. Although sharing these details may not be comfortable, it is essential to share. Erectile dysfunction can be an indication of a major underlying factor, such as heart issue, diabetes, blood disorder, or nerve damage. Getting to know the root cause of the ED can greatly affect the outcome and the treatment that is needed. It can also save your life if you have a life-threatening underlying issue. Therefore, seeking treatment as soon as ED becomes an issue is the best thing you can do for yourself (and your partner).
“What Types of Doctors Treat ED?”
Many doctors can treat and/or review your symptoms for erectile. Depending upon your symptoms you may generally know which doctor would be the best to visit. However, you may be particularly best served by going to your family doctor first, which can help guide you for any next steps.
Your primary care doctor can for the most part run basic tests and specifically discuss your symptoms, along with provide any referral to a specialist, if needed. The main specialists that you may need to see is a urologist, therapist, or an endocrinologist, depending upon the root cause of your erectile dysfunction.
An alternative option is to visit with an online erectile dysfunction doctor. These types of doctors really are for all intents and purposes best after you essentially have discussed your symptoms, treatment options, and made sure there are no underlying concerns with other physicians first. The worst thing you can do is to ignore the underlying causes of your ED while treating the erectile dysfunction only as the consequences can essentially be fatal.
Urologists
Urologists specialize in urinary and reproductive health, so they are able to diagnose any abnormalities within your reproductive system. Your primary health physician may refer you to a urologist if they have ruled out any other health or mental conditions. If you don’t have any heart disease, high blood pressure, anxiety or depression, then you may need to see a urologist for further examination.
A urologist will most likely check for issues with your prostate gland, nerve damage, and/or diuretics, all of which can cause erectile dysfunction. The easiest to check for is the diuretics – if you are taking a medication or consuming something that is causing you to urinate more frequently. If it is a medication, then your medications may need to be evaluated and possibly changed. If you are drinking a lot of coffee or alcohol then you may need to stop or reduce the amounts you are consuming. A urologist would need to do a physical exam to check for nerve damage or prostate concerns.
Endocrinologists
Endocrinologists are hormone specialists that use blood tests and fertility tests to determine the underlying causes of your erectile dysfunction. Low testosterone is the most common concern that you may have heard about but there are many other hormones that can also cause ED. You would most likely be referred to an endocrinologist after having a blood test come back abnormal or concerning for further review.
Mental health professionals
A mental health professional can help determine if psychological issues are causing or contributing to your ED. A therapist can also help you work through psychological issues during your ED treatment.
Your doctor may refer you to a mental health professional if you are experiencing any of the following symptoms in addition to ED symptoms:
- Eating disorder
- High stress levels
- Relationship problems caused by communication issues
- Symptoms of anxiety (including performance anxiety)
- Symptoms of depression
- Symptoms of a personality disorder
- Symptoms of schizophrenia
A mental health professional will likely have you fill out questionnaires to assess your levels of stress, anxiety, depression, or any other mental health concerns that referred you to them. A mental health professional will also have a conversation with you about how you are feeling and thinking to gain a full understanding of what could be the root cause of your erectile dysfunction. Depending upon what is discovered with the mental health professional you may need regular counseling, lifestyle changes, and/or medication to help treat your ED cause.
“What to Look for When Finding the Best ED Doctor?”
Whether you are searching for an online or in person physician, you will still need to specifically ensure the doctor is qualified to treat your condition. For an in-person physician it really is a bit easier to research their credentials, check their reviews, and read a bit about them before making an appointment. When searching online services, it can be a bit harder to determine because most sites don’t list out their specific doctors.
If you basically are looking for an erectile dysfunction doctor through an online service, such as Viking Man or Hims, you will particularly want to make sure all the physicians within their network are licensed and certified. Since each state kind of has its very own regulations, you will want to definitely make sure that service has a doctor within your state as well.
Another point to consider, is if you are new to erectile dysfunction treatment. This is important as only some online providers actually have a mandatory initial virtual visit with the physician, such as Viking Man. This actually is for all intents and purposes great for someone who is basically seeking ED treatment for the first time. It allows you an opportunity to definitely ask all your questions and discuss medical treatment options.
However, other online treatment service providers do not actually require you to speak with the physician directly like Bluechew or RexMD. This can be risky for those newly seeking treatment as you won’t actually be given a chance to discuss treatment before being prescribed it, which can be dangerous. If you have been taking erectile dysfunction medication regularly for quite some time, you may want to find a doctor who won’t particularly require you to visit but instead can refill your prescription after reviewing your medical history. This is the benefit for many online erectile dysfunction treatment options.
“What Questions Should I Ask an ED Doctor?”
It can seem a bit overwhelming when you first make your appointment, whether online or in-person. You may be nervous what questions you should ask to make sure the doctor is properly treating your ED and the underlying conditions.
Here are the most common questions to ask your doctor:
- What tests do you think I need?
- Do you think my erectile dysfunction is temporary, or will it be a long-lasting problem?
- What do you think is causing my ED?
- How do you think we should treat my erectile dysfunction?
- What are the next steps or options if this initial treatment option doesn’t work?
- Are there any foods, medications, or lifestyle changes I can make to help fix my ED?
- Do you have any brochures or recommended websites for me to check out for education on erectile dysfunction?
- What do I need to look out for with this ED treatment to monitor for any serious health conditions?
- If I need medication, can I take the generic version?
- What are the pros and cons for this type of treatment versus other types?
The best way to ensure you don’t forget a question (or answer) is to write all of your questions down in advance and bring that with you. You can then write the answers the doctor is providing so you can review them later after you have had a chance to allow all the information to sink in. Of course, if you have any questions after or need anything else clarified then you should reach back out to the doctor to make sure you fully understand your treatment and your health needs.
“What Questions Should I Be Prepared to Answer?”
In addition to you asking the doctor questions, you should also be prepared to answer a few yourself. The purpose of the doctor asking the questions is to ensure they are able to review any underlying causes of your erectile dysfunction and able to properly treat you. Even though the questions and answers may make you feel uncomfortable, it is better to be as descriptive and accurate to ensure nothing is missed. Details about your medical and sexual history can provide clues as to what is causing your ED and how it can best be treated.
Some of the questions you may be asked by the doctor:
- Explain your health problems and/or chronic conditions.
- Do you have any other sexual problems?
- Do you have any recent changes in sexual desire?
- Do you still get erections during masturbation?
- Do you still get erections when you sleep?
- When did your erectile dysfunction start?
- How often do you experience ED?
- Does anything help or make your erectile dysfunction worse?
- Do you have any problems with your sexual partner?
- What medications do you take?
- Do you use any supplements, vitamins, or herbal medication?
- Do you consume alcohol, smoke cigarettes, or use illicit drugs?
- Are you currently experiencing any stress or anxiety?
- Have you been previously diagnosed with any mental health problems?
- Have you experienced any trauma, treatment, or surgeries near the penis?
- How often do you maintain an erection long enough for intercourse? When was the last time this happened?
- Are you able to orgasm and ejaculate?
- Does your partner have any sexual difficulties?
“What are the Best Online ED Options?”
There are a lot of erectile dysfunction treatment options available online. Not all are performing reputable business practices. Below we will discuss a mix of good and poor options that can be found online currently. We will breakdown what we are looking for and why we are rating them positively or negatively. Please note these are not all the available options but they are some of the more popular options.
Viking Man
Viking Man is the platform allowing you to speak with a US licensed physician in your state to assist with erectile dysfunction treatment. Viking Man purchases genuine ED medication directly from Verified Accredited Wholesale Distributors which have the highest seal of FDA approved medication sourcing to make sure you are getting safe medication. Viking Man allows you to schedule very your refills either monthly or quarterly, and you full control to stop or start anytime. Viking Man currently provides generic Viagra or Cialis with a plan that is custom made for you.
Viking Man also allows you unlimited follow up conversations via messaging or video with the same doctor. This is vastly important as you don’t want to have to re-explain yourself over and over. Additionally, it provides you a bit of piece of mind as you can discuss any side effects or concerns and help adjust your medications accordingly. Your medications will arrive in discreet packaging and shipped to you for free, so there should be no fear holding you back from seeking out the treatment you need and deserve.
A few concerns for Viking Man are that there are only 2 medication options, so if neither one is working well for you then you will have to start over elsewhere. Another concern is that Viking Man is not currently available in all 50 states – only 31 at this time. However, as long as they are available in your state, Viking Man is our top pick when it comes to online erectile dysfunction treatment.
Hims Ed
Hims provides a tele-health platform for you to discuss all very your erectile dysfunction concerns similar to Viking Man and others. Hims does really provide the most medication treatment options over any other similar online service. However, you do not actually have as much control over your subscription service (and charges) as you do with other similar options. Forhims is available in all 50 US States, unlike some other similar options, and even provides limited offerings in the UK. Provided their ability to provide services within all 50 states and having the most medication options is really great, especially if you aren’t sure which medication option will work best for you.
What hurts Hims, in our mind, mostly is their poor customer service, inability to have control over your subscription service, and the extra costs added to you without fully disclosing them. Hims ED is one of the few services that require a subscription fee on top of paying for the medication treatment. The only way to adjust your subscription (or cancel) is to speak with a customer service representative which seems to be more difficult than it should be.
Roman Ed
Roman provides erectile dysfunction treatment and care directly to you on your time, in the comfort of your own home as well. They provide discreet medications delivered to you with free shipping. You also do get to maintain an ongoing relationship with your doctor via secure messaging, as needed.
Roman does not require video conferencing for your initial visit as some other services do, unless your state requires it. Getroman will reach out to let you know if your state requires a video or phone conference for your consultation visit.
Roman has competitive pricing compared with other similar services. They offer a free initial consultation, free 2-day shipping, and treatment starting at $2 per dose. Roman does not require a subscription fee or have any extra hidden to note. Roman does provide a variety of medication, such as daily erectile dysfunction pills, daily premature ejaculation pills, and as needed medications.
Some drawbacks for Roman ED are the negative customer service reviews, the big price jumps between the medications, and not being able to speak to the prescribing doctor directly. If you happen to live in a state that doesn’t require a conversation with the doctor then you may be prescribed a higher dose of medication than you are expecting (or can afford). Having a doctor make a decision for your medication without speaking to you first is a big red flag to us.
Rexmd
Rex MD is quite similar to Roman ED with its practices. You will complete an online medical history survey and if the doctor has any questions, they will schedule a phone or video conference with you. As discussed prior, this can be tricky, dangerous, or just expensive if you are charged a medication that you cannot take. Especially since there are no refunds for prescription medications.
Rexmd is available within all 50 United States as well and does provide several medication options. The medications seem to be higher priced than other similar services as well which is a big negative for us. What is particularly concerning is that Rex MD doesn’t disclose how they obtain their medications nor that they are using Verified Wholesale Distributors, like other services do. This means they are charging a higher price for medication that could be a lower quality than other similar online service.
Bluechew
What sets Bluechew apart is that their medications are chewable. They are the only online erectile dysfunction treatment service providing a chewable type medication. This can be great if you have a hard time swallowing medication.
Bluechew is very similar to Roman ED services, which may not work best for you. Bluechew may not require a conversation with the prescribing medical professional, depending upon the state in which you reside. To us this is more of a concern as this medication you cannot get elsewhere. We can understand if you have previously taken prescription medication under the guide of a physical doctor and want to switch to online services. In that situation, not having to speak directly to a doctor could be okay as you are familiar with the medication and have been successful using it. However, Bluechew is different and therefore we believe you should want to discuss it with the doctor prior to taking the medication.
There are only two medication options, Tadalafil and Sildenafil, but they are available in a variety of doses. The biggest red flag for us to Bluechew is that neither medication is FDA approved or regulated. These medications have the same active ingredients but the FDA has not tested the chewable format. Also, since the medication is not being regulated it is hard to know if there is something else being added to it that could be potentially harmful to you.
“Do I Get to Keep the Same Online Doctor?”
Once you have gone through the hassle of explaining your full medical and sexual history, you may not want to explain it to someone else. This is why Viking Man and Roman get bonus points because they are the only online services providing follow ups with the same physician you previously spoke with. Viking Man overall wins this as you are able to follow up with the same doctor via messages or video conferencing for free at any point you request. Roman ED only allows unlimited free secure messaging follow up but it is with the same physician so they do get credit for that.
All other online service providers either don’t have a follow up system in place, don’t discuss their follow up system, or don’t allow to message directly with the same doctor.
“What Causes Erectile Dysfunction?”
Erectile dysfunction can be a result from underlying health problems, emotional issues, or both.
Some known risk factors for ED are:
- Being older than 50
- History of high blood pressure
- History of high blood sugar or diabetes
- History of high cholesterol
- History of heart disease
- Lack of exercise
- Large consumption of alcohol
- Smoking
Even though erectile dysfunction is more common in older men, it is still a very serious condition that needs to be fully evaluated by a medical professional. This way the underlying condition, whether physical, mental, or both can be fully treated alongside the erectile dysfunction.
Physical Causes of ED
Physical causes of erectile dysfunction can be a result of a physical injury to the area or an underlying health condition.
Some of the common physical causes are:
- Cancer treatments
- Diabetes
- Direct injury to the penis or pelvic area
- Heart disease
- Medication side effects
- Nerve damage
- Smoking
Emotional Causes of ED
Sex (and erections) are not just a physical act. It is also a mental game and relationship problems or mental stressors can have an impact on the situation.
Some common emotional issues are:
- Anxiety
- Depression
- Relationship stress or conflicts
- Stress from work, home, culture, or religious conflicts
- Worrying about sexual performance
“What ED Treatment is Available to Me?”
The erectile dysfunction treatment that is available to you will depend upon the type of doctor you see and/or the type of online service you decide to use. You may have further limited options depending upon your medical history and if you have any risk factors that would make a particular treatment unavailable to you.
Below we will discuss all known types of erectile dysfunction treatment options but you will need to discuss with your doctor your symptoms to help find the correct treatment for you. Additionally, you may be able to make lifestyle changes to see improvement of your ED rather than only relying upon medical options.
Most health care providers will have you try the most non-invasive treatment options first. However, there are still side effects that you should discuss with your doctor to know which treatment options are best for you.
Typical ED Treatment Options:
- Oral medication
- Testosterone therapy
- Intraurethral medication
- Penile injections
- Vacuum devices
- Surgical options
Oral Medication
Medication known as PDE type-5 inhibitors increase penile blood flow in a pretty major way. These are the only oral agents particularly approved in the U.S. by the Food and Drug Administration for the treatment of erectile dysfunction.
- Viagra (sildenafil citrate)
- Levitra (vardenafil HCI)
- Cialis (tadalafil)
- Stendra (avanafil)
Men who see the most improvement with these medications alone, take the pills about an hour or two before having sex. Of course, men will need to make sure they have normal nerve function and normal blood flow to see improvement with the medications. Men with diabetes or other health conditions are less likely to see significant improvement with these medications alone.
Another concern that should be noted with these oral medications, is if you are taking any nitrates for your heart. You cannot mix nitrates and these PDE5 inhibitor medications as the result can be deadly. Always discuss any concerns you have with your doctor and make sure you are aware of any potential side effects prior to taking any new medications.
Most reported side effects for these oral medications are short-term and mild. However, you should be on the lookout for any of these potential side effects and others:
- Facial flushing
- Headache
- Indigestion
- Muscle aches
- Stuffy nose
In rare cases, Viagra can cause blue-green shading to your vision that can last for a short period of time. Cialis can also cause an increased back pain or aching muscles within the back. These are not all the potential side effects or allergic reactions that can occur with these medications. If you experience any unusual symptoms please speak to your doctor or go to the emergency room right away.
Psychological Counseling
Mental health services can be beneficial in treating erectile dysfunction either alone or with other treatment options. Therapy can be great for lowering stress, anxiety, and fixing relationship problems that could be impacting your ED. If your mental health isn’t treated then you can have a reduced self-esteem or more emotional stress that can make your erectile dysfunction even worse.
One study in 2019 found that stress was one of the main erectile dysfunction predictors. The study also found anxiety and depression associated with ED and that chronic stress can affect testosterone levels and cause sleep deprivation. Another study from 2014 found that attending a stress management program while taking erectile dysfunction medication helped improve ED more than medication alone.
A recent 2021 research review found that psychological interventions were effective when paired with ED medications. The research found the most common types of psychological interventions were individual cognitive behavioral sex therapy (CBST), group therapy and counselling, couple CBST, and internet-based interventions.
Another study in 2018 found that mindfulness-focused group therapy framework may also improve erectile dysfunction and sexual satisfaction as well. These studies are proof that by fixing the mental blocks or issues that are impacting your erectile dysfunction, you are able to potentially fix your ED with therapy alongside your medications.
A 2016 study points out the relationship between the sexual partners contains shared health issues. This means that for couples who are dealing with erectile dysfunction, they should both attend education, counseling, and therapy together to help fix the ED as a unit since both partners are affected. The same study found that when both partners are not involved with erectile dysfunction treatment, the outcome is low to unsatisfactory recovery from ED.
Lifestyle
Depending upon your current lifestyle choices your doctor may recommend making a few necessary changes. Make sure you discuss any supplements, vitamins, or over-the-counter medications that you are currently taking. Of course, with all changes, make sure you make them gradually so you aren’t hurting yourself or putting more stress on your body than necessary.
Some common lifestyle changes are:
- Alcohol or drug use reduction
- Dietary changes
- Getting regular exercise and physical activity outside of sex
- Sleeping more
- Stopping smoking
Eating a balanced diet may help maintain your sexual function and can decrease your risk for developing ED. A 2020 study found that men who more closely followed a Mediterranean diet had a lower chance of developing erectile dysfunction. In particular, the men ate less red or processed meats and primarily consumed fruits, vegetables, legumes, nuts, and fish. Similarly, research from 2017 found that consuming more fruits, vegetables, and flavonoids lowered the risk of erectile dysfunction in men from ages 18 to 40.
Similar to eating healthy and maintaining a balanced diet, research has found that limited alcohol consumption can help erectile dysfunction. A 2018 study found that erectile dysfunction was more common with men who have alcohol dependence syndrome. This study from 2020, found smoking, alcohol, and drug usage to be risk factors for erectile dysfunction. The study also found that a healthy diet, physical activity, and intimacy helped to protect against ED. The Centers for Disease Control and Prevention (CDC) recommends as a general guideline that men should drink 2 or less drinks per day for optimum health.
A 2018 research study found moderate-to-intense exercise for 40 minutes a day, four times per week, for 6 months helped reduce erectile dysfunction. The exercises that seem to provide the most benefits are bicycling, brisk walking, running, swimming, or skiing. Physical activity helps to improve blood flow, lower stress, and raise testosterone levels which can all help with ED.
It is also important to be sure you are getting enough sleep each night. A 2017 study found that men who are working night shifts and reported worse sleep quality had a higher risk for erectile dysfunction. Additionally, a 2015 study found that people with a sleeping disorder had a greater risk of developing erectile dysfunction than the general population. Another study, shows a link between obstructive sleep apnea and an increased chance of ED. This means that the amount of sleep you receive and the quality of it can affect your erectile dysfunction.
Maintaining a healthy weight can also help with erectile dysfunction. A 2020 research study found that ED was significantly more common in men who were overweight, obese, or had a larger waist circumference. A study in 2014, found that men who had gastric bypass surgery improved their blood vessels and erectile dysfunction in extremely obese men. A similar research study conducted in 2017 found improvement in ED after bariatric surgery for weight loss.
Lastly, for maintaining a healthy lifestyle you should quit or reduce the amount of smoking you are doing each day. According to this research study from 2015, more-frequent and smoking more did increase the risk of developing erectile dysfunction. The study also determined that heavier smoking created more severe ED and was not reversible even after quitting smoking. Although quitting smoking can be difficult, if you are interested and having a hard time you should speak to your doctor as they have resources that can help you stop smoking.
Testosterone Therapy
If you find yourself with a generally low sex drive and a blood test proves that your testosterone levels are lower than normal, then your doctor may recommend testosterone therapy. Testosterone therapy may fix your erectile dysfunction on its own once your hormone levels are back to normal or may be combined with oral medications (PDE type 5 inhibitors).
Vacuum Erection Device
If medications aren’t appropriate for you, or you cannot take them due to taking nitrates, then your doctor may have you use a vacuum device. A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube creates a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis to hold the blood in the penis (and keeps it hard) for up to 30 minutes.
Self-Injection Therapy ICI
If you cannot take oral medications due to nitrates or other medical concerns, then injections may be needed. Alprostadil is injected into the side of penis with a very fine needle. You should be given the first shot in the doctor’s office so they can show you exactly how to properly self-inject this medication.
Alprostadil can also be used as a mixture with other medications if needed. Based upon your doctor’s recommendations and what your medical needs are will determine if you need to mix Alprostadil or use it as a standalone drug. Please note that only Alprostadil is FDA approved to treat erectile dysfunction. Your health care physician can decide which medications are best for you and show you how to use them correctly.
For most ICI therapies, men will get an erection that will end with climax after about 20-30 minutes. However, it is possible to maintain your erection after orgasm as it is not being controlled by your nerves but is medically controlled. If you experience a prolonged erection, which is an erection that is lasting longer than one hour, you should reach out to your medical professional. Your doctor should be able to give you another injection that can help your erection go away. If your doctor is not available or if your erection is lasting more than two hours you should go to the emergency room right away. Maintaining a prolonged erection without proper treatment can lead to permanent penile damage and worsen your erectile dysfunction.
Intraurethral (IU) Therapy
If you don’t want to give yourself shots in your penis then you can try IU therapy. This requires a tiny medicated pellet of the drug, Alprostadil, to be placed in the urethra (the tube that carries urine out of the body). Unfortunately, this may not work as well as the shot version but should be tested in the office so you can be properly shown how to use this the correct way.
The most common side effect of IU alprostadil is a burning feeling in the penis. As with the injectable Alprostadil, if you have a prolonged erection, you should seek medical treatment right away to prevent further damage.
Surgical Treatment
Although there are surgical options to help reconnect nerves, the most common surgical treatment for erectile dysfunction is the penile implant or prostheses. Surgery is typically a last resort option once everything else has failed to work. Of course, all surgery comes with risks, but penile surgery is typically the most successful for all erectile dysfunction treatment options. It is also a permanent solution to your erectile dysfunction and allows for spontaneity, which some treatment options don’t allow.
There are two types of penile implants, the bendable semi rigid implant and the inflatable implant.
Semi Rigid Implant (Bendable)
The simplest kind of implant which is made from two easy-to-bend rods, that are most often made of silicone, is the semi rigid implant. These silicone rods give the man’s penis the firmness needed for sexual penetration. The implant can be bent downward for peeing or upward for sex. The semi rigid implant is always firm which does make it harder to conceal. It does have less of a mechanical failure but is less rigid and natural compared to an inflatable implant.
Inflatable Implant
With an inflatable implant, the fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and has a natural feeling for your partner. With the implant, men can control firmness and, sometimes, the size of the erection. Implants allows a couple to be spontaneously intimate and there is generally no change to a man’s feeling or orgasm.
What is the Surgery Like?
Penile implants are most often placed when a man is under general anesthesia. If a patient has a skin or urinary tract infection, the surgery should be postponed until all infections are treated and dissipated. If a man is on blood thinners, then he may need to talk with a medical expert about stopping the medications prior to preparing for the elective surgery and healing process.
Most of the time one small surgical cut is made, either above the penis where it joins the belly or under the penis where it joins the scrotum. No tissue will be removed and any blood loss is typically small. A patient will typically either go home the same day or spend one night in the hospital recovering.
After the surgery, there will be some pain, discomfort, bruising, and swelling that can last for a few weeks. Typically, the surgeon will prescribe a narcotic for pain-relief during the first week or two. However, by week two most men are able to use over-the-counter pain medication instead of narcotics. During the first month, men will need to limit their physical activity. The surgeon will review how much exercise is allowed during the healing process. As long as there is no pain or swelling, most men can start enjoying sex again after 8 weeks of recovery.
If there is any infection or complication, then the implant is likely to be removed. If the implant has any mechanical malfunction, then it will likely need to be surgically replaced. If the implant needs to be removed for any reason, other non-surgical treatments for erectile dysfunction may not work.
Clinical Trials
There are some ongoing trials to try and improve erectile dysfunction with other methods. These options are currently not approved by the FDA and will not be covered by any government or private health insurance benefits. Patients who are interested in the clinical trials will need to discuss it with their doctor to discuss the risks, benefits, and see if they are eligible.
Some of the current clinical trials for ED:
- Extracorporeal shock wave therapy (ESWT) which is a low-intensity shock wave to help fix the erectile tissue and restore natural erections.
- Intracavernosal injection autologous platelet rich plasma (APRPR) which helps tissue regrowth in cavernous areas.
- Intracavernosal injection of stem cells which helps cavernous tissue regrowth.
Supplements
Supplements are typically more popular, generally cheaper than prescription drugs, and easier to obtain for erectile dysfunction treatment. However, supplements have not been tested to see how well they work or if they specifically are a safe treatment for ED. Many of these types of medications have unnamed ingredients within them so you aren’t really sure what you are taking. As such, you could be taking a medication that you are allergic to or may have a reaction with another medication you are already taking. Since these medications are not being regulated, the FDA has issued many consumer warnings of these types of products. Therefore, they should be avoided at all costs.
“What Medications Are FDA-Approved for ED Treatment?”
We have been discussing many of the medications that are not FDA approved so it is good for you to know what has been specifically approved by the Food and Drug Administration (FDA) as erectile dysfunction treatments in the United States.
The only 4 approved currently are:
- Avanafil (Stendra)
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
Viagra
Viagra, or Sildenafil which is the generic name, is typically the first medication prescribed by doctors. Viagra has been on the market the longest so the side effects and interactions are the most well-known.
The FDA states that the recommended dose of Viagra is 50 milligrams (mg), which you should ideally take about 1 hour before sexual activity. However, it should be effective anywhere from 30 minutes to 4 hours before sex. Most men state that it starts working in about 30 minutes to 2 hours. When taking Viagra, you should not consume alcohol and you should not take it with food, as this can slow down the absorption rate and delay the effects.
Cialis
As per the prescribing information for Cialis, the initial dose should be 10 mg, and a person can take it as necessary for sexual activity. They can decrease the dose to a minimum of 5 mg or increase it to a maximum of 20 mg, depending on what they need and tolerate under the guidance of their physician.
Cialis, or Tadalafil, behaves slightly differently than other ED medications. It does not break down as quickly, so it stays in the body for longer. Most men prefer taking Cialis for this reason because they are able to be more spontaneous than with Viagra.
Levitra
Levitra is the brand name of Vardenafil. The FDA recommends 10 mg as an initial dose, which a person should take about 1 hour before sexual activity. The maximum dose recommended is 20 mg, with the minimum being 5 mg based on your tolerance and reaction to the medication.
Your doctor may adjust the dosage depending on the medication’s effect. A person should take Levitra no more than once per day, with or without food.
Staxyn is a dissolvable tablet that contains vardenafil. However, according to the FDA, it is “not interchangeable” with Levitra as it has a stronger effect on the body. Staxyn comes in 10-mg tablets that dissolve on the tongue. A person can take the tablet with or without food about 1 hour before sexual activity, but it is important to take it no more than once a day.
Stendra
The FDA has approved three doses of Stendra: 50-mg, 100-mg, and 200-mg. A typical dose of Stendra, or Avanafil which is the generic form is taken about 30 minutes before sexual activity. The starting dose is often 100 mg, but a person can either increase it to 200 mg or decrease it to 50 mg, depending on how they respond to treatment.
“What is the Difference Between Generic and Branded Options?”
Brand name medications are typically better known than their generic counterparts due to advertising that is done. Since the brand name medications appear on the market first, this gives them the advantage. Brand name medications typically are more expensive than the generic equivalent. Newer medications may not have a generic version for a while because the release of their patent rights takes time.
Generics are a copy of the branded equivalent. A generic form of medication works in the exact same way as the branded drug, shares the same side effects, and dosage instructions. A person’s insurance company may substitute a generic version of the branded equivalent to save money.
You should always make sure you are purchasing generic or branded medication from a reputable pharmacy. Please note that erectile dysfunction medications are only available with a prescription. If you find any ED medications online or in person without a prescription you should not purchase them. These pills are not regulated, come from an unreputable manufacturing source, and may contain dangerous ingredients.
“What Medications Can Be Prescribed Online for ED?”
Most of the online erectile dysfunction treatment options have a variety of medications available. What needs to be examined carefully is where the medications are coming from. Some of the online services state they are using Verified Accredited Wholesale Distributors which have the highest seal of approval and FDA approved medication sourcing, such as Viking Man and Roman ED. However, there are other companies that won’t state where the medications are coming from or are using the medications in a way that is not FDA approved and regulated. This is where you can find yourself taking medication that you aren’t sure what is fully in it and/or having a reaction that is unexpected.
Not all medications are provided by all online services, but the typical medications that are available are:
- Viagra
- Sildenafil (Generic Viagra)
- Cialis
- Tadalafil (Generic Cialis)
- Stendra (Avanafil)
- Sertraline
- Paroxetine
“How Much Does Erectile Dysfunction Treatment Cost?”
Erectile dysfunction treatment costs do vary depending upon the type of treatment. Most ED treatment is not covered by health insurance, but it is important to check and discuss your medical or financial concerns with your doctor. Depending upon the underlying conditions for your erectile dysfunction, some treatments could be covered with insurance.
Only services are not typically covered by insurance but they do claim to have a low price on their prescriptions. It is good to note which services are offering the best prices so you do not find yourself overpaying for the same medication.
Forhims
Hims is a subscription-based service and all medication prices do not include the subscription price. You will also get a one-time $5 fee added to your first purchase and shipment. Additionally, your medications cannot be adjusted (type or frequency) without a doctor’s approval. This can result in unwanted medication being sent if you aren’t able to get the system updated in time before the next shipment.
Hims ED provides medication you can take as you need prior to sex or pills you can take daily so you can stay more focused in the moment. The prices do vary based on which medication you choose and if you would rather take generic medication or not.
As Needed Medication:
- Sildenafil Citrate (Generic for Viagra) – starting $4 per dose
- Viagra – starting $70 per dose
- Stendra (Avanafil) – fast acting pill can be effective in 15 mins – starting $59 per dose
Daily ED Pills:
- Tadalafil (Generic Cialis) – starting $99 per month
- Cialis – starting $525 per month
Daily PE Pills:
- Sertraline – starting at $24 per month
- Paroxetine – starting at $24 per month
Viking Man
Currently, Viking Man only provides two options, Sildenafil and Tadalafil. However, both are obtained with the highest seal of approval from the FDA approved medication sourcing. Viking Man is currently charging $2 per dose for either medication. Viking Man is the only online service charging the lowest starting price with no subscription or extra fees added on.
Roman ED
Roman ED provides a variety of options that you can take daily or as needed for the duration of your erectile dysfunction treatment. Roman also uses the FDA approved medication sourcing to ensure proper pills are being prescribed.
As Needed Medication:
- Sildenafil – starting at $2 per dose
- Generic Viagra (Sildenafil) – starting at $34 per dose
- Branded Viagra – starting at $70 per dose
- Generic Cialis – starting at $11 per dose
- Branded Cialis – starting at $17 per dose
Daily Erectile Dysfunction Pills:
- Generic Cialis – starting at $8 per dose
- Branded Cialis – starting at $13 per dose
Daily PE Pills:
- Sertraline – starting at $24 per month
Bluechew
Bluechew is providing a prescription chewable tablet in Sildenafil or Tadalafil. They do offer different packages based upon how many tablets you need and at which dosage is needed. The medication prices do not reflect the shipping or tax that will be added later. Bluechew is the only online company currently offering a chewable form of ED treatment, but as discussed prior this method is not FDA approved or regulated.
Sildenafil:
- 30MG x 6 – $20
- 30MG x 10 – $30
- 30MG x 17 – $50
- 30MG x 34 – $90
- 45MG x 6 – $30
- 45MG x 10 – $40
- 45MG x 17 – $65
- 45MG x 34 – $120
Tadalafil:
- 6MG x 4 – $20
- 6MG x 7 – $30
- 6MG x 14 – $50
- 9MG x 28 – $90
- 9MG x 4 – $30
- 9MG x 7 – $40
- 9MG x 14 – $65
- 9MG x 28 – $120
Rexmd
Rex MD US-licensed physicians can prescribe a variety of medications based upon your symptoms and concerns. They do offer a pill you can take daily for your ED, as needed medication, and premature ejaculation medication as well.
As Needed Medication:
- Sildenafil (Generic for Viagra) – starting $10 per dose
- Viagra – starting $90 per dose
- Tadalafil (Generic Cialis) – starting $10 per dose
- Cialis – starting $29 per dose
Daily ED Pills:
- Tadalafil (Generic Cialis) – starting $3 per dose
PE Pills:
- Sertraline – starting at $24 per month
“Is Online Erectile Dysfunction Treatment Legit?”
The answer is it can be. There are definitely some websites that aren’t providing FDA approved medications. There are also sites that are only relying on a quick survey to determine what medications are best for you without speaking to you. This can be dangerous to you and your health to have a doctor prescribe you medications without speaking to you directly.
Additionally, there are sites that do not have a way to follow-up with the doctor and discuss any side effects or medication changes. This is also a negative and can be dangerous as well, if you are stuck taking medication that isn’t helpful. Additionally, without the ability to follow up you may be charged and continue to receive medication that is not helpful to you as well.
However, even though there are some bad players in the game, there are definite legit online erectile dysfunction treatment options. The best online treatment options that are providing FDA approved medications, video conferences prior to prescribing medications, and follow-up services are:
- Viking Man
- Roman ED
“How Do We Rate Erectile Dysfunction Services?”
Overall, we take into consideration all aspects of the journey for erectile dysfunction. We analyze the amount of time you need to devote for treatment, the cost of treatment, accuracy of treatment, treatment options, reviews and customer service, and continued treatment options. We particularly analyze each piece described above for each doctor type and online service to find the best options for you.
Amount of Time
This one is a bit tricky because no one really likes to waste time. Additionally, most people don’t have extra time to waste either. The fastest option that can generally be the most convenient is the online erectile dysfunction treatment option. The downside to this actually is that many online treatment options also require a recent in person physical to ensure there are no deadly underlying conditions.
Since a physical visit is required for most of the online treatment services, this is a pretty clear winner. The best option is to go to your primary physician to discuss your symptoms and concerns to know and understand if you need further evaluation from a specialist. You will spend more time having to make an appointment, drive to the appointment, and get evaluated in person but this really is the best option to really help rule out any dangerous underlying conditions, which can be fairly significant.
Once you have been evaluated and treated by an in-person physician, then you are capable and able to switch to online erectile dysfunction treatment if you so choose. This is the best course of action because you can then take control of your treatment plan. By discussing the treatment options with an online doctor and choosing how frequently you will receive the medication discreetly to your door.
Cost of Treatment
What we check here is the overall cost. In person visits for ED can be covered, depending upon your insurance coverage. However, most of the medications for erectile dysfunction really are not covered. This is another reason that it is beneficial to go for in-person testing first and then switch to online treatment for maintaining your ED treatment. Many online treatment options have much cheaper medication options than the typical pharmacy down the street. Additionally, you are getting your medications shipped discreetly to you so you don’t have the embarrassment of going in person to the pharmacy or taking more time out of your schedule.
Accuracy of Treatment
Depending upon where you are on your erectile dysfunction treatment journey, will generally depend which option is the absolute best for you. For overall accuracy of treatment, it really is best to go to a doctor in person. This generally is the only true way to get evaluated for all the underlying causes of erectile dysfunction. Since many of the underlying causes of erectile dysfunction can be very dangerous this needs to be diagnosed to be properly treated. It can be dangerous and deadly to treat the erectile dysfunction without treating the underlying causes.
Treatment Options
An in-person doctor has many more options than those that are online. With that said, most people generally are able to treat their erectile dysfunction with oral medication. Online treatment options, exclusively provide medication treatment and is typically cheaper than most other pharmacies. This generally makes online treatment options a great choice, unless you have a major underlying condition that needs much more than medication.
Reviews and Customer Service
Customer reviews is important because you should evaluate how others in your same situation have been treated by that particular brand before. For local doctors, you can check the Better Business Bureau, Trust Pilot, or Google Reviews. This will allow you to see how others feel about a particular doctor if you have several in your area to choose from. Depending upon your area, you may not have many options and will just need to visit the doctor that is available to see you in a reasonable amount of time.
However, we have reviewed and gathered the online companies’ data to help rate them from the best to the worst. Here is the information we found on the online erectile dysfunction treatment reviews.
Rated best to worst:
- Viking Man – having no reviews seems to be the best. This means there are no disgruntled customers and no one to complain about the service.
- Rexmd – has the highest overall rating among all the companies with a 4.58
- Hims – Overall average of 3.94
- Bluechew – overall customer satisfaction of 2.55
- Roman – overall customer happiness of 1.73
Viking Man
Viking Man has zero Trustpilot or Better Business Bureau reviews. Both profiles have been claimed since early 2021, so it is a good sign that there are no reviews in nearly a year as it seems most of the reviews come from negative customer experience when compared to other similar businesses.
Rex MD
The reviews for Rexmd are quite mixed. The website shows 457 out of 476 as a 4- and 5-star review with an overall 4.84 out of 5-star rating. Trustpilot has a similar rating of a 4.6 out of 5 with 1,767 total reviews. What seems concerning is that the majority of the positive reviews are for customer service, which is great. However, it looks like each time there is a negative review then several positive customer service ones appear as to push down the negatives. This could be happening organically or the company could be incentivizing some customers to leave the positive reviews. The negative reviews state over and over that it is very easy to get the prescription, your credit card is then charged, but nothing is actually shipped. Additionally, several customers note canceling or pausing their subscription and still being charged for the medication with no refund possible. Several other customers note that the price is much higher with Rexmd ED pills than with other comparable services.
The Better Business Bureau are the worst for Rex md, rating them a 1 out of 5 with 6 customer reviews. The company has a C rating and states it is not a BBB Accredited business. There have also been 21 complaints closed in the last 12 months with the BBB. The negative reviews are about the way Rexmd operates by charging your credit card and then either not delivering the product or charging even after cancellation and refusing to refund. The complaints are also involving the same type of situations, customer was prescribed and charged but then a month (or more) time passes and they don’t receive the prescription. Several customers state that calling the support line or creating a support ticket does not seem to help either.
Hims
Overall, Hims has a bit of a mixed rating but mostly trending negatively. The Better Business Bureau has Hims rated 1.19 out of 5 with 86 reviews. The primary concern from the reviews is how difficult it is to cancel their subscription, change medication, follow up with doctors, extra items being added to their subscription without permission, and the difficulty to get customer service to reply.
Trustpilot has a higher rating for Hims at a 4.2 out of 5 with 910 reviews. However, it does state the reviews were merged but doesn’t specify with which company. Therefore, it is hard to know if the reviews are truly accurate. Most of the negative reviews mention the poor customer service, no ability to pause or cancel the subscription, doctor’s not caring or putting in time to get to know the patient, getting multiple doctors, and being prescribed incorrect products.
Bluechew
Bluechew customer reviews aren’t very good across Trustpilot and the BBB. Trustpilot has one 1-star review from a customer who states the product did not work for him. Overall, Trustpilot has rated Bluechew at a 3.2 out of 5 with the one review.
The Better Business Bureau rates Bluechew at a 2.33 out of 5 based on 3 customer reviews. 2 of the reviews state the pills are not working and/or the production is not being closely monitored because they are sometimes getting real pills that work and sometimes just getting sugar pills. There have also been 5 complaints filed with the BBB in the last 12 months. Most of the complaints are from customers stating they paid for and never received the products but were also denied refunds.
Roman
Roman ED reviews are positive on their website, showcasing their best reviews from 2018 and 2019. However, when reviewing other sites, it is a bit of a different story. The Better Business Bureau shows a rating of 1.5 out of 5 with 10 customer reviews. All of the customer reviews are a one star, except for one 5-star review. The negative reviews note the doctors prescribing you something and then being charged without a chance to review or accept that medication, being overcharged, not being able to cancel auto-renewals without customer service, paying and not receiving medication, and being hung up on by customer service after waiting an extended period of time to talk with someone.
Trustpilot rates Roman at a 2.9 out of 5 with two 1-star reviews. However, one of the reviews is about the hiring practices and not the customer service experience. The one review for the company customer service notes the price for Roman is much higher than other companies.
Continued Treatment Options
For this section, online treatment options really win hands-down. Many online options provide free follow up with the same doctor or another physician through their portal. In person treatment, however, requires a physical appointment which will cost more money (and time). That is why the online treatment option wins for continued treatment as the best option.
Conclusion Section
Erectile dysfunction is a fairly common condition and one that’s usually easily treatable. However, you should discuss your symptoms and concerns with your doctor right away due to the potentially dangerous underlying conditions. Your primary care physician should be your first stop to check on your ED and see if you need a referral to a specialist or more extensive testing. Oftentimes, erectile dysfunction treatment can be quite simple and easy to manage. The first step toward your recovery is talking openly and honestly with your doctor to help pinpoint the root cause of your ED.
Overall, your erectile dysfunction can be caused by a physical reason, mental, or both. That is why it is important to know the different types of doctors you may encounter during your ED treatment. Although you have the option to speak with a doctor in person or online, we believe it is best to seek in person treatment first. Once you have ruled out any major medical concerns, then it is best to transfer to an online service that may save you both time and money.
Other Concerns About Erectile Dysfunction You May Have
“Can erectile dysfunction treatment be without medicine?”
There are many natural treatments for ED. They range from lifestyle changes like modifying your diet and exercise to getting mental health or relationship counseling. It is always best to speak with your doctor before trying any new treatment. Not all erectile dysfunction can be treated without medication, but if your doctor gives you the okay then you could try the following suggestions.
- Alcohol reduction
- Changing your diet
- Increasing the amount of exercise
- Losing weight
- Psychotherapy treatment
- Sex therapy or couples counseling
- Sleeping better or more
- Smoking cessation
- Stress reduction
“Are there any drawbacks to using natural remedies for ED treatment?”
Although lifestyle changes can be effective for improving erectile dysfunction and your overall health, it may not be enough. Some of the necessary changes may be difficult to achieve or take such a long time to see the effects and changes to your erectile dysfunction. Additionally, some natural remedies, like losing weight or eating healthier, may need time for your body to adjust to these changes so you may not see any improvement of your ED without other necessary treatments. Make sure you don’t use products that are marketed as natural alternatives for erectile dysfunction, specifically pills, as they are likely containing dangerous ingredients.
It is also important to note that not all underlying causes of erectile dysfunction can be cured with natural remedies. If you have experienced any trauma to your penis or pelvic area, have nerve damage, or have undergone prior surgeries or treatments that are causing your ED, then you may need medical intervention to assist with your ED recovery.
“How can I find erectile dysfunction doctors near me?”
You can easily Google Map erectile dysfunction doctors close to you. However, we recommend that you reach out to your primary health care first. If you don’t yet have a primary doctor then this is a great time to get one established. They will be able to run all the basic diagnostic tests while utilizing your health insurance. Once the test results are back your primary doctor will know if you need a referral to a specialist. They will be able to verify if the specialist accepts your health insurance and/or find a specialist that does accept your health insurance. Alternatively, you can check with your insurance provider to get a list of all doctors that accept your health insurance in your area. This can be less frustrating than just Googling and then trying to see who accepts your health insurance.
