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
Reviews
Every review, in one place
Two things determine what ED treatment costs you and how well it works: which medication you take, and where you buy it. We review both.
Advertising disclosure: We may earn a commission if you buy through links on this page. Commissions never influence our ratings, rankings, or what we recommend — our scoring criteria are published and applied identically to partners and non-partners. How we make money.
Medications
Prescription treatments
Scored on effectiveness, onset, duration, cost, and side effect profile.
8.4out of 10
The default first try — cheap, predictable, heavily studied
- Onset
- 30–60 minutes
- Lasts
- 4–6 hours
7.6out of 10
Avanafil
StendraThe fast one — and the one least likely to tint your vision
- Onset
- As little as 15 minutes
- 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
6.8out of 10
The second-line option that works when pills don't
- Onset
- 5–20 minutes
- Lasts
- 30–60 minutes
5.0out of 10
Udenafil, mirodenafil, lodenafil
Zydena, Mvix, HellevaReal drugs, real evidence, and no legal way to get them here
- Onset
- Udenafil peaks in about 1–1.5 hours; the others are broadly comparable to sildenafil
- Lasts
- Udenafil remains effective up to around 24 hours; mirodenafil and lodenafil are shorter
3.0out of 10
What men were prescribed before Viagra — and why they stopped
- Onset
- Not an on-demand drug — taken on a standing schedule
- Lasts
- Short half-life, hence the three-times-daily dosing
Treatments
Non-drug treatments
Scored on effectiveness, ease of use, cost, side effects, and the quality of the evidence behind them.
7.7out of 10
The most effective ED treatment there is, and the one nobody advertises
- Cost
- Often $50–$150 per vial, which typically yields many doses — commonly a few dollars per use
7.6out of 10
The end of the road, and the treatment people are gladdest they had
- Cost
- Frequently covered by insurance once conservative treatment has failed; tens of thousands of dollars without coverage
7.4out of 10
Unglamorous, drug-free, and it works when the pills don't
- Cost
- Roughly $100–$500 for a medical-grade device, as a one-time purchase
6.6out of 10
The cheapest thing that works, if your problem is holding an erection rather than getting one
- Cost
- Purpose-built devices run roughly $100–$200; Eddie is priced around $188 for a four-month cycle
6.3out of 10
The first ED treatment you can just buy — and it contains no drug at all
- Cost
- Around $25.99 for four single-use tubes — roughly $6.50 per use
5.4out of 10
Testosterone replacement therapy
Hormone therapyOnly for confirmed low testosteroneSuppresses fertilityReal medicine for a real condition — and the wrong answer for most people who ask about it
- Cost
- Generic injections are inexpensive; gels, pellets, and oral forms cost substantially more, plus ongoing lab monitoring
4.2out of 10
Sold as a cure, priced like surgery, backed by evidence that isn't there yet
- Cost
- Commonly $3,000–$6,000 for a course, paid out of pocket
4.0out of 10
An approved drug — for women. Sold to men by clinics that do not always mention that
- Cost
- Varies widely; wellness-clinic peptide programmes are typically expensive and cash-pay
2.1out of 10
The only category here where the products that work are the ones breaking the law
- Cost
- Commonly $30–$80 a month, frequently more than FDA-approved generic sildenafil costs
Providers
Telehealth services and pharmacies
Scored on signup, price transparency, clinician access, value, and how easy they are to leave.
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.
8.6out of 10
Sesame Care
An actual video visit, an actual prescription, and no subscription attached
Best for Anyone who wants a real clinical conversation and the freedom to fill the prescription wherever it is cheapest.
8.4out of 10
Cost Plus Drugs
Not a telehealth service — a transparent pharmacy for a script you already have
Best for Anyone who already has a prescription and wants the lowest transparent cash price.
8.3out of 10
GoodRx
Not a pharmacy, not a prescriber — just the discount that beats most subscriptions
Best for Anyone who already has a prescription and wants the lowest local cash price without mail order.
8.1out of 10
Lemonaid Health
General telehealth with a flat consult fee
Best for People who want a prescription they can fill anywhere, rather than a bundled subscription.
7.9out of 10
Amazon Pharmacy
A real licensed pharmacy with Prime pricing attached
Best for Prime members who already have a prescription and want it filled cheaply without a separate account somewhere new.
7.4out of 10
Hims
The best-known brand, with the marketing budget to match
Best for People who want the smoothest end-to-end experience, or a less common drug like avanafil.
7.2out of 10
Rex MD
A conventional subscription service that has stayed out of the compounding race
Best for People who want a straightforward subscription for approved generics without being upsold a proprietary blend.
7.0out of 10
Ro
A broader telehealth practice that happens to treat ED
Best for People who want ED treated as part of broader health care rather than as a standalone product.
4.0out of 10
BlueChew
Chewable compounded tablets on a subscription
Best for People who specifically need a chewable format, and who stick to the single-ingredient options rather than the combination products.