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Erectile dysfunction (ED) is one of many health conditions that are hard to talk about, but it’s important that we break the silence. You should know ED is a highly treatable medical condition.
We know ED can impact your confidence in the bedroom and make it more difficult to feel close and connected with your partner. It can also affect other areas of your life. ED is linked to higher rates of absenteeism and lower productivity at work. While distressing enough on its own, ED can also be a symptom of other physical and mental health conditions like diabetes and depression. It’s even considered an early warning sign of cardiovascular disease.
It’s understandable if you’re feeling reluctant about seeking treatment for erectile dysfunction. Specialists like myself are well-equipped to deal with the initial nerves and hesitation. It’s not easy to talk to a stranger about your sex life, but know that help is available and there are many treatment options.
Fenwa Famakinwa Milhouse, MD, board-certified urologist
If talking to a doctor about ED feels too awkward, Hims offers a convenient solution to receive a prescription after filling out an intake questionnaire. Hims provides access to FDA-approved erectile dysfunction medication that can be delivered to your door within days. But is it legit?
After testing the platform and 25 other brands, we think Hims can be a good choice for men who are seeking a convenient alternative to a traditional appointment. But if you’re living with certain health conditions, it’s still preferable to see a doctor for a consultation.
Why HelpGuide cares about sexual wellness
Four out of 10 men in their 40s experience erectile dysfunction (ED), and it becomes more common with age. That means a large number of men don’t feel satisfied with their sexual performance. We know this can lead to performance anxiety, less intimacy, tension in a partnered relationship, low self-esteem, depression, increased stress, and even increased absenteeism at work.
“All of these things have been described in patients that I’ve seen and treated with erectile dysfunction,” says Fenwa Milhouse, a board-certified urologist and CEO of Down There Urology. “Feeling less of a man, feeling less worthy, feeling less like an individual and the person they once were.”
But, there’s nothing to be ashamed about—and you’re certainly not alone. The Handbook Team wants to shed light on this topic, help you feel comfortable addressing it, and encourage you to seek treatment for this highly treatable issue. Ignoring erectile dysfunction means ignoring the impact on your physical and mental health—and the ED may only get worse.
The relationship between these mental health conditions and ED can be cyclical. ED can be a source of considerable anxiety and stress for individuals, leading to a self-perpetuating cycle where the fear of experiencing ED again exacerbates the problem.
Rhiannon John, certified sexologist
Luckily, oral medications for ED, such as Viagra (sildenafil) and Cialis (tadalafil), are now available in generic forms, making erectile dysfunction treatment far more affordable than it was even five or six years ago. The recent popularity of online telehealth platforms also means you can request a prescription for ED medication without having to visit a doctor or pharmacy in person. This is a solution for people who may feel embarrassed discussing their sexual health with a doctor or collecting this prescription at the pharmacy, and it’s also safer than turning to “gas station” remedies. These are unregulated supplements often found in dispensers inside the bathrooms of gas stations, and they have been known to contain hidden ingredients.
But not all of these platforms use the same screening process, charge the same prices, or let you directly message your provider. We don’t want you to feel frustrated by low-quality platforms or misled by false information on the internet.
That’s why we interviewed more than 20 urologists, sexologists, pharmacists, and psychologists, ran a focus group, mystery shopped at over 25 online ED medication platforms, read dozens of academic journal articles, and surveyed 360 real people about their experiences with erectile dysfunction. We got really comfortable with this topic and encourage you to do the same by reading our guides and reviews.
Learn more about our erectile dysfunction review methodology.
HelpGuide Handbook for Hims erectile dysfunction medication platform
If you only learn five things about Hims for erectile dysfunction medication, here’s what you need to know.
Quick questionaire.
No need for a face-to-face appointment in most states.
Convenient and discreet delivery.
Responsive customer service.
$1.33–$8.00 per pill.
Our testing experience
Our Handbook Team was impressed by the user-friendly Hims website and how easy it was to learn about medication options. Of the 26 brands we tested, Hims stood out for the responsiveness of its customer service via messaging and email.
When we surveyed Hims users about how they decided to use the erectile dysfunction medication provider over competitors, the single most important factor they cited was discreet shipping. Most respondents said it was very easy to receive erectile dysfunction medication through the platform, and 76 percent were satisfied with the treatment they received.
Highlights from our testing experience include:
- Ability to learn about common oral erectile dysfunction medications.
- Access to important safety information on each medication.
- Timely and helpful responses from customer service via chat.
Here’s what disappointed us:
- Lack of clear pricing information on the website.
- Quick screening process may miss health concerns.
- Lack of adequate ongoing care.
- Potential risk of delayed diagnosis for another health condition.
The Hims site includes lists of ED medications and we clicked through each to learn more about important safety considerations. On the other hand, it was difficult for us to tell how much each treatment will cost without going through the onboarding process or contacting customer service. This made it difficult for us to compare prices with other platforms.
From our tester
“It’s difficult to compare prices for erectile dysfunction medications, as many platforms do not provide clear information on cost.”
What you need to know about ED medications and mental health
Shame is a common barrier to addressing erectile dysfunction. According to our October 2023 survey of 360 men, four in ten struggled with erectile dysfunction for years before seeking care.
Many men in our focus group reported turning to gas station supplements and over-the-counter remedies rather than research-backed treatment options because the conversation was too difficult to broach with a health care provider face to face. One participant who did bring up the topic with their doctor told us, “It was one of the hardest conversations. It was very, very, very awkward to get it going. But once we were done, I thought, I should have done that a long time ago.”
When it comes to ED and mental health, an online provider can empower you to get the support you deserve without the awkward conversation. In many cases, a low-dose PDE5 inhibitor (oral ED medication) can give you a helpful confidence boost and help you begin to recover physically and emotionally.
When we surveyed men on their experiences with online erectile dysfunction medication providers, three in four said they were satisfied with the ED medication they received.
The benefits were clear:
- 67 percent said their mental health improved.
- 75 percent experienced a self-esteem boost.
- 60 percent improved their relationship with their partner.
- 58 percent said they felt more confident sexually.
ED meds can often help overcome anxiety issues in men who can get an erection by themselves but not with a partner.
Karyn Eilber, MD
If you try ED meds through a platform like Hims and they don’t work, reach out for additional support from a primary care physician or a urologist. Dr. Milhouse says she will refer men with psychogenic erectile dysfunction–or ED rooted in the mind–to a sex therapist. Sometimes, couples therapy can help you problem-solve and reconnect with your partner too.
You’re not alone. Don’t feel embarrassed. I know it’s probably hard to talk about it, but it happens.
Focus group participant
Pros/Cons of Hims for erectile dysfunction medication
What we liked
- Convenient and in-depth intake questionnaire.
- Medication can be delivered within days of appointment.
- Access to important safety information on each medication.
- Ordering from the privacy of your home could reduce the burden of stigma.
What we didn’t like
- Brief consultation does not allow for a comprehensive conversation with a provider.
- Lack of continuing care compared to a traditional health care provider.
- Does not accept health insurance.
What is the process like to get medication from Hims?
The consultation is limited to a questionnaire and review by a health care provider. When we tried out the questionnaire, we were impressed by how many follow-up questions we were asked about our health history and medications that could potentially interact with PDE5 inhibitors. But because Hims does not guarantee you will have a conversation with a provider, we were concerned that there could be potential gaps in care compared to an in-person appointment. The experts we spoke with agreed.
As part of our testing, our Handbook Team researched the guidelines from the American Urological Association (AUA) for the gold standard of erectile dysfunction diagnosis and treatment. We compared these guidelines to the prescription process provided on platforms like Hims.
According to the AUA guidelines from the American Urological Association, health care providers should take a thorough medical, sexual, and psychosocial history of men presenting with symptoms of erectile dysfunction, give them a physical exam, and in some cases, do further lab tests. Importantly, prescribers should also let men know that ED can be a sign of underlying cardiovascular disease and other health conditions that need to be identified and treated.
Treatment guidelines note that providers should consider a referral to a mental health professional to ease performance anxiety and address relationship issues. Counseling should also be provided about lifestyle changes that can also help, such as changes in diet and exercise. It’s also important to discuss the benefits and risks of taking PDE5 inhibitors and the best way to take them for maximum effectiveness.
If you’re not living with any major medical conditions like heart disease, and you’re not taking medication that could interact with PDE5 inhibitors, we think Hims is okay to try for ED medication. We spoke with Karyn Eilber, a professor of urology at Cedars-Sinai Medical Center in Los Angeles for her thoughts on Hims.
Hims seems like a legit, good solution for relatively healthy men with straightforward erectile dysfunction.
Karyn Eilber, MD, professor of urology at Cedars-Sinai Medical Center
If you are living with a chronic health condition or taking other prescription medications, we think it’s best to contact a primary care physician or a urologist for a more in-depth consultation and treatment plan. Treating other health conditions like high blood pressure, diabetes, and depression can help reduce your symptoms of erectile dysfunction and increase the effectiveness of PDE5 inhibitors.
If you decide to try something like Hims without a formal workup, you may find yourself back in the same situation if the treatment is not effective. Sometimes PDE5 inhibitors are not enough, and other treatments should be explored with your doctor.
Gustave Weiland, MD, assistant professor of internal medicine at Virginia Commonwealth University School of Medicine
What medications does Hims offer?
Hims provides both name-brand and generic ED treatments called 4 phosphodiesterase type 5 (PDE5) inhibitors. These prescription medications work by inhibiting the action of the PDE5 enzyme to increase blood flow to the penis for a harder and longer-lasting erection.
Prices for Hims medications range from $1.33 per pill to $59 per pill.
Viagra (sildenafil) can work within 30 to 60 minutes and can be effective for 12 hours. That means for the next 12 hours, you can stimulate your penis and the medication will help you get and maintain an erection. You can take it once daily as needed.
One downside: For the best results, you should take it on an empty stomach or with food but avoid heavy, high-fat meals. These can hamper the absorption of the medication and could make it work less effectively for you. The need to have an empty stomach in anticipation of an intimate night or risk poor sexual performance is one of the most common reasons Viagra doesn’t work for some people, notes Jonathan Davila, MD, a New York-based urologist.
You can get a prescription for generic Viagra on Hims for $6.50 to $8 per pill, depending on the dosage. It’s available in counts ranging from 4 to 16 doses per month.
Unlike Viagra, Cialis (tadalafil) can be taken any time with or without food. It takes about an hour or two to work, but it can be effective for 36 hours. You can take Cialis daily or as needed.
Research suggests that it works just as well either way. With your provider’s help, you may decide on one approach over the other based on which approach suits your lifestyle and comes with the least side effects. For example, if you plan to have sex multiple times a week, you may choose to take Cialis daily. If you plan to have sex less frequently, an as needed dosage may make more sense for your needs.
Cialis can also be used to treat conditions that can come with ED like an enlarged prostate (benign prostatic hyperplasia), chronic prostatitis, or chronic pelvic pain syndrome.
You can get a prescription on Hims to take Cialis daily or as needed. If you’re interested in taking it on a daily basis, you can get a 30-day supply of generic Cialis for $99, or $3.30 per pill. Another option is a prescription plan where you take it as needed 4–16 times per month at $1.33–$7.50 per pill.
Stendra (avanafil) is the fastest-acting erectile dysfunction medication, but it also has the shortest window of effectiveness. Stendra can work in as little as 15–30 minutes and can be effective for the next six hours. Like Viagra, it’s best to avoid a high-fat meal for maximum effectiveness.
The biggest downside of Stendra is the cost: At $59 per pill, Stendra is far more expensive than generic Viagra or Cialis. There’s no generic option for Stendra available on Hims.
Who should not take PDE5 inhibitors?
According to research, oral ED medications might not be safe or effective for you if you take:
- Nitrate medications like nitroglycerin (such as Nitro-Dur or Nitrostat), isosorbide mononitrate (Monoket), or isosorbide dinitrate (Bidil).
- Alpha-blockers like tamsulosin (Flomax), doxazosin (Cardura), and terazosin.
- Medicines that block an enzyme called CYP3A4 such as itraconazole (Sporanox, Tolsura), ketoconazole (such as Extina or Ketozole), or ritonavir (Norvir).
They also may not work or be dangerous if you’re living with any of the following:
- Very low blood pressure or uncontrolled high blood pressure.
- Severe liver disease.
- Kidney disease that requires dialysis.
- Recent heart or blood vessel problems like a heart attack, stroke, or serious heart rhythm disorder.
- An inherited eye disease that affects the retina.
What are the side effects of Hims medications for ED?
Side effects of erectile dysfunction medications are generally mild, per the Mayo Clinic. You may experience:
- Skin flushing.
- Headache.
- Upset stomach.
- Visual changes, such as a blue tinge to vision, sensitivity to light, or blurred vision.
- Stuffy or runny nose.
- Back pain.
- Dizziness.
In rare cases, more serious side effects can occur, such as:
- Hearing loss or vision loss.
- An erection that doesn’t go away on its own.
If you experience any of the above, seek immediate medical support.
Key features of Hims for ED
Convenient and in-depth intake questionaire.
Discreet delivery within days of consultation.
Responsive customer service.
Access to generic Viagra and Cialis.
Compare the best erectile dysfunction medication platforms of 2023
The cost of erectile dysfunction treatment can vary depending on your dosage and plan. Beyond ED medication providers, there are also GoodRx coupons and online pharmacies like Mark Cuban Cost Plus Drugs you can use to save, notes Dr. Davila.
Here’s how Hims compared to other ED medication providers and online pharmacies.
Our final verdict
If you’re otherwise healthy and suspect you may have erectile dysfunction, Hims is worth a try. If you take multiple prescription drugs, you should talk to your doctor or healthcare provider first about possible interactions. And if your problem doesn’t go away, your ED could be a symptom of something else or require another approach. Should this happen, you shouldn’t suffer in silence. Schedule an appointment to see a provider in person for an exam, conversation, and personalized treatment plan.
Frequently asked questions
Hims medications including Cialis (tadalafil), Viagra (sildenafil), and Stendra (avanafil) can be an effective treatment for erectile dysfunction.
Most erectile dysfunction treatment options on Hims are FDA-approved including Cialis (tadalafil), Viagra (sildenafil), and Stendra (avanafil). Hard mints, which may combine medications and are produced in a compounding pharmacy, are not FDA-approved. Other Hims products may also not be FDA-approved.
Hims provides Cialis (tadalafil), Viagra (sildenafil), and Stendra (avanafil) for erectile dysfunction. Generic Viagra and Cialis are also available on competitor websites like Roman and Lemonaid Health, but only Hims offers Stendra.
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