9.0out of 10
The long one — up to 36 hours, or a daily dose that ends the clock-watching
- Onset
- 30–60 minutes, occasionally up to 2 hours
- Lasts
- Up to 36 hours
Sources linked · Review status shown
Evidence-based reviews of erectile dysfunction treatments
We compare the four prescription medications that treat ED and the telehealth services that sell them — on effectiveness, side effects, and what they should actually cost you.
Last full review of this site’s content:
Review status shown
Articles identify their authorship and medical-review status. New research analyses are AI-assisted and have not been clinically reviewed.
No paid placements
Rankings follow published criteria. Nobody can buy a position, a score, or a favourable line.
Prices shown honestly
We compare the real cost per dose, including the cheaper routes that don't pay us anything.
Before anything else: if you take nitrates for chest pain, ED medication can be life-threatening. And new ED is often an early sign of heart disease.
Read why →Medication reviews
The prescription options
Four PDE5 inhibitors plus one second-line alternative. They differ less in how well they work than in how fast, how long, and how much.
8.4out of 10
The default first try — cheap, predictable, heavily studied
- Onset
- 30–60 minutes
- Lasts
- 4–6 hours
Unscored
An approved ED medicine with strength-specific timing instructions
- Onset
- 100/200 mg: about 15 minutes; 50 mg: about 30 minutes in labeling
- Lasts
- About 6 hours
7.2out of 10
A close cousin of sildenafil, now mostly a second choice
- Onset
- 30–60 minutes
- Lasts
- 4–8 hours
Provider reviews
Where to actually get it
Telehealth services differ mainly in how they price the bundle. We break out what you're paying for the consult versus the pills.
9.0out of 10
CoreAge Rx (4PLAY)
One sublingual dose, four ingredients, ten minutes — the most ambitious formulation in the category
Best for People who want fast onset and long duration from a single dose, and who prefer a sublingual to swallowing a tablet.
Unscored
SuperHealthy Rx
A current-source review of SuperHealthy Rx ED care: the prescription route and the person responsible for follow-up, billing questions and evidence limits.
Best for Readers comparing a clinician-reviewed sildenafil or tadalafil tablet route
Unscored
PlushCare
A video appointment and a pharmacy prescription, with separate membership fees
Best for People who prefer a video consultation and want to choose their dispensing pharmacy.
Guides
Understand the problem first
ED is a symptom. Knowing what's causing yours changes which treatment makes sense — and whether a pill is the right answer at all.
Research11 min readEditorial draft
Sildenafil frequency scores and the meaning of standard errors
A close reading of score averages, uncertainty bars and the questions an individual treatment decision still needs answered.
Updated
Research11 min readEditorial draft
Reading the daily tadalafil trial in percentage points
Follow the arithmetic behind a diary result: starting values, percentage-point changes, weighting, comparison groups and uncertainty.
Updated
Basics8 min read
What actually causes erectile dysfunction
ED is a symptom with a long list of possible causes — vascular, hormonal, neurological, pharmacological, and psychological. Knowing which one you're dealing with changes what treatment makes sense.
Updated
Cost7 min read
What ED medication should actually cost
Generic sildenafil can cost a few dollars a month or several hundred dollars a year for the identical drug. The difference is entirely in where you buy it. Here's how the pricing works.
Updated
Safety6 min read
Erectile dysfunction is a cardiovascular warning sign
The arteries that supply the penis are narrower than the coronary arteries, so they clog first. For many men, ED is the earliest symptom of heart disease — years before anything shows up on a stress test.
Updated
Safety9 min read
Why every ED brand now sells a “custom” blend
Chewables, sublingual drops, four-in-one liquids. The ingredients being added to ED medication mostly are not there for you — they are there because a compounded product cannot be price-checked against a generic, and cannot be a copy of an approved drug.
Updated
Named products · Source dates shown in each review
Read the review for your product.
Ingredients, price and supply details, research limits, availability and follow-up questions for each product. These are public-document reviews, with no firsthand product testing or medical-review sign-off.
Featured products
Ro Sparks
Sildenafil + tadalafil
$48 / 4 doses monthly
Public product listing; individual eligibility and current prescription require confirmation
Read this product review: Ro Sparks →Hims 3-in-1 Hard Mints
Sildenafil + tadalafil + vitamin B12
From $30/month in the ED catalog
Public product listing; individual eligibility and current prescription require confirmation
Read this product review: Hims 3-in-1 Hard Mints →BlueChew GOLD
Sildenafil + tadalafil + apomorphine + oxytocin
Public price examples differ; confirm the selected offer
Public product listing; individual eligibility and current prescription require confirmation
Read this product review: BlueChew GOLD →