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About Erectile dysfunction

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Erectile dysfunction is a condition that occurs when you are unable to achieve and maintain an erection firm enough for sexual activity. In some cases, men who experience ED are unable to get an erection at all, while others are unable to get or maintain an erection firm enough for sex. Many people will experience difficulties with their erections from time to time; however, you should seek help from a medical professional if it is a frequent and ongoing issue. Erectile dysfunction may also be a sign of an underlying health problem or a risk factor for heart disease.
Common Medication
Treatment Options

Below is a list of common medications used to treat erectile dysfunction, which a doctor or provider can prescribe to you for just $5 through SesameRx.

Note that all prescriptions are at your provider's discretion.

In addition to oral medication, there are other treatment options for erectile dysfunction.
FAQs

Erectile Dysfunction / ED

What is erectile dysfunction?

Erectile dysfunction (ED) is a common form of male sexual dysfunction tin which men are unable to get or maintain an erection firm enough for sex. A recent study by the National Institute of Health (NIH) concluded that about 30% of men are affected by erectile dysfunction.

In many cases, erectile dysfunction is a natural product of aging or stress. It is normal to experience difficulty maintaining an erection every now and then. However, ED can also signify underlying health problems that need to be addressed. If you experience persistent ED, it is recommended you consult a doctor.

What are types of sexual dysfunction?

Most types of sexual dysfunction can be broken into four groupings, depending on the causes and symptoms of the sexual problem. Here's an overview of sexual dysfunction classes:

Desire disorders: Desire disorders are characterized by a lack of sex drive or desire for sexual intercourse. Desire disorders may be caused by low hormone production (low testosterone levels or low estrogen levels), pre-existing psychological conditions (such as depression/ anxiety), or medication usage (antidepressants known as SSRIs can cause low libido as a side effect).

Arousal disorder: Arousal disorders are characterized by an inability to become physically aroused enough during sexual activity. In male sexual dysfunction, arousal disorders usually show up as erectile dysfunction, or the inability to get or keep an erection for sexual intercourse. In female sexual dysfunction, this may cause dryness and lack of lubrication in the vagina.

Orgasm disorders: Orgasm disorders occur when an individual either has a delayed orgasm or experiences no orgasm at all during sexual activity. In men, orgasm disorders can also show up as premature ejaculation. In women, orgasm disorders often occur after menopause. With the hormonal changes brought on by menopause, women may experience difficulty having an orgasm during sexual activity.

Pain disorders: Sexual pain disorders occur primarily and women, and result in pain during intercourse. The two common conditions that cause intercourse are known as dyspareunia (lack of lubrication in the vagina during intercourse) and vaginismus (painful spasms in the vaginal muscles and pelvic floor during intercourse). There are several physical and psychological causes behind these conditions, including previous sexual trauma or changes in hormone levels.

Can doctors fix erectile dysfunction?

If ED is affecting your sex life? Causing you relationship problems? The best treatment for ED is to not stress about it. Most cases of ED are easily treatable with some ED medication and a few lifestyle changes. Erectile dysfunction is one of the most common men's health conditions, with nearly 1 in 3 men experiencing some form of ED during their lifetime. Men often experience ED as a result of aging or stress, or as a side effect of health problems such as cardiovascular disease, high blood pressure, and heart disease. If you book an ED consult visit with a primary care provider or men's health specialist (such as a Doctor of Urology), they can provide medical advice and treatment options such as:

Physical activity: Moderate to vigorous exercise can help increase blood flow and lower cholesterol. Blocked blood vessels and poor cardiovascular health are some of the most common causes of ED. Because of this, physical activity is one of the most effective and commonly prescribed erectile dysfunction treatments offered by doctors. Adopting a regular exercise routine can help fix ED, and improve mental health at the same time.

Counseling/ Sex therapy: ED can be caused by mental health conditions such as depression, anxiety, and stress. Talking to a licensed mental health professional, such as a psychologist or sex therapist, can help address stress management, performance anxiety, and other factors affecting your sex drive.

Prescription medication: Oral medication that relaxes blood vessels and increases blood flow to the penis can be used to treat persistent ED. Drugs such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) are approved by the FDA to treat erectile dysfunction and premature ejaculation. When diagnosing and treating sexual dysfunction, doctors prescribe these drugs to patients of all ages, not just older men.

Injections: For persistent cases of ED, doctors may recommend a penile injection of alprostadil to relax muscles and increase blood flow to the penis during sexual activity. Alprostadil can also be released into the body by a tiny suppository inserted into the urethra before sex. If ED is being caused by hormone conditions such as changing testosterone levels, an endocrinologist may recommend a hormone injection to boost low testosterone.

Mechanical aids: Devices such as penile implants, or vacuum erection devices (penis pumps) can help stimulate blood flow during sex. Penile implant surgery is usually reserved for patients who have severe conditions that prevent erections (such as Peyronie's disease). Penile implant surgeries are usually performed at health care centers such as hospitals or urology clinics.

There is no one cause of ED, just like there are many treatment options. Talk to a primary care doctor or urologist if you experience persistent erectile dysfunction, as ED can often signify other health conditions. Don't wait to get control of your sexual health. Book a virtual erectile dysfunction consult on Sesame to discuss your symptoms and treatment options that might be right for you- all at affordable cash prices up to 60% less than what you'll find through insurance networks.

Can doctors on Sesame diagnose erectile dysfunction?

Yep! Doctors on Sesame can diagnose ED during a video ED consult. Video visits on Sesame are 100% HIPAA compliant, meaning that your consult is totally confidential. All you need is a stable internet connection, a private space, and camera access on your device.

During your ED consult, you'll be asked about your medical history and any symptoms you have been experiencing. Doctors may request to perform a visual exam, so it is best to do your consult in a private and safe space. After assessing your symptoms and health history, doctors can help create a treatment plan that's right for you. Urologists and primary care providers on Sesame can prescribe medication and offer referrals if further testing is necessary.

Don't stress about ED. Book a video ED consult on Sesame to get quality care from the comfort of your home. The best part? Sesame works directly with doctors- not insurance companies- so you can get the best men's health care available without premiums or copays. Save up to 60% when you book an ED consult on Sesame and start getting treatment right away- no insurance needed.

What kind of doctor should a man see for erectile dysfunction?

Primary care providers (sometimes known as family doctors), as well as Doctors of Urology, are capable of diagnosing and treating erectile dysfunction. It's generally recommended that you speak to a primary care provider (PCP) first to help determine if any underlying conditions or health problems are causing your erectile dysfunction. From there, your PCP might refer you to a urologist or endocrinologist, based on your medical history and symptoms.

Urologists specialize in the urinary tract and reproductive systems of both men and women. A urologist can conduct urine tests, as well as penile ultrasounds to check for conditions such as kidney disease, STIs, or blood flow issues that might be causing erectile dysfunction.

Endocrinologists specialize in the diagnosis and treatment of conditions related to hormones and the glands that create them. You may be referred to an endocrinologist for ED if your primary care provider thinks that your sexual health is being caused by low testosterone or other hormonal issues.

Are ED consults on Sesame private?

Absolutely. All video visits on Sesame are HIPAA compliant and 100% private. Doctors on Sesame understand that ED can be a sensitive issue and are fully committed to your privacy.

Sesame connects you (the patient) directly with real, quality doctors Sunnyvale, CA, so you can feel totally confident that a video ED consult booked on Sesame is confidential. Book a visit at your convenience, and talk to a doctor about any questions regarding erectile dysfunction you may have.

Do I need to turn on my camera for an ED consult?

If you book a video ED consult on Sesame, your doctor will assess any symptoms you may have related to your erectile dysfunction. In some cases, a physical exam may need to be performed. It is crucial that your provider can speak to you face-to-face (even over video), to help get a sense of your general health and wellness. If you are experiencing anxiety, or do not have a camera on your device, call the provider you have booked an appointment with. They will be able to answer any questions you may have about the visit and can discuss options with you if video doesn't seem like the right choice for you.

All platforms on Sesame are 100% confidential, and HIPAA compliant. That means your payment and medical information is absolutely safe and secure. You can read about our privacy policies here.

Erectile dysfunction can complicate sex. It may also signify underlying health concerns that you want to address ASAP. ED is a common occurrence in men, especially in men over the age of 50. If you are experiencing persistent ED, or if ED is regularly disrupting your sexual activity, regain control of your sex life with a video ED consult on Sesame. 15-minute visits start at just $35.

How does a urologist diagnose erectile dysfunction?

Urologists or primary care providers diagnosing erectile dysfunction will use a number of tests and exams to determine the cause of ED and develop a treatment plan that meets your needs. During an ED consult, doctors will:

Ask questions: You will be asked about your medical history and lifestyle choices. Poor diet, tobacco smoking, and substance abuse may cause erectile dysfunction. Underlying health conditions such as heart disease, diabetes, and prostate cancer can also affect your ability to keep or maintain erections. It's important that you are upfront and honest about your lifestyle, medications you take, and health conditions you have to help doctors create the best treatment plan for you.

Perform a physical exam: Doctors will perform a physical examination of the penis and testicles to check for abnormalities or nerve damage. You may have your blood pressure taken and your pulse checked to test blood flow.

Take a blood test/ urine sample: If your doctor suspects that you are experiencing ED as a side effect of undiagnosed heart disease, diabetes, or kidney disease, you may be asked to have your blood drawn.

Urine Tests: Additionally, urine tests may be conducted to check for kidney function or urinary tract infections.

How does a video ED consult work?

Sesame offers convenient and affordable 15 minute ED consultations with real, quality health care providers in Sunnyvale, CA. All you will need is a stable internet connection, a private space, and a camera on your device. ED consultations are quick and painless sessions between you and a primary care provider to discuss symptoms you may be experiencing and treatment options that might be right for you.

Your doctor will start by asking you questions related to your medical history, and the symptoms you are experiencing. It is recommended that you are upfront about any drug, alcohol, or tobacco use - as this information helps doctors get a clear picture of your general wellness.

You will be asked questions about your ED symptoms, including:
- How long have you been experiencing ED?
- Do you experience loss of sex drive or libido?
- Do you have problems with ejaculation?
- Are your erections painful? If you experience pain during an erection or notice a lump in your penis, your primary care provider may refer you to a urologist to screen for Peyronie's disease (segments of scar tissue in the penis).


Your doctor will then ask to perform a physical exam, via your device's camera. You may be required to expose your genitals during this exam, as doctors may need to screen for cancer or trauma to the area. Video consultations on Sesame are HIPAA compliant, which means your privacy is guaranteed during these video visits. Physical exams help providers check for disease and injury to your groin, both of which are possible causes of erectile dysfunction.

If the questionnaire/ physical exam is inconclusive, or if further testing is needed, your doctor may refer you to a urologist or endocrinologist. A urologist can perform blood work and urine samples to help screen for cancers or underlying causes of erectile dysfunction. An endocrinologist helps treat hormonal conditions, such as low testosterone, and may be able to prescribe testosterone replacement therapy (TRT) to help.

After your exam and any further testing, your doctor or specialist will discuss treatment options with you. Examples of common ED treatment options are listed above. Your doctor may also discuss certain lifestyle changes - like quitting smoking, increasing physical activity, or making diet changes - that may help improve your ability to get and keep erections.

Video ED consults on Sesame are 100% private and confidential. Erectile dysfunction may be a sign of underlying health concerns, such as high blood pressure, diabetes, high cholesterol, and more. If you are experiencing persistent and disruptive erectile dysfunction, it is recommended that you speak to a health care provider as soon as possible to discuss treatment options.

Is erectile dysfunction curable?

There are several treatment options doctors may recommend to reverse or treat erectile dysfunction and prevent it from occurring persistently. Some methods to help ED on your own may include:

Exercise: Moderate to vigorous physical activity done several times a week can increase blood flow by lowering blood pressure. This can help blood move through blood vessels in the body easily during sexual stimulation. Obesity, high blood pressure, and poor vascular health are all underlying causes of erectile dysfunction. Adopting a regular exercise routine can help reverse these effects.

Counseling/ Therapy: Erectile dysfunction can be caused by stress, anxiety, or depression. These mental health risk factors affect sexual stimulation and can make sexual performance/ arousal difficult. Speaking to a licensed counselor or therapist can help you with stress management, relationship issues, depression, and anxiety. Sesame offers Video Mental Health Visits with licensed therapists in Sunnyvale, CA.

Routine Physical Exams: Some cases of ED can be caused by underlying medical conditions. Routine physical examinations are recommended for all adults, as they can help catch serious health problems and conditions early. ED might signify problems such as high blood pressure, diabetes, low testosterone, and more. If you are experiencing persistent ED, talk to your physician about any symptoms or concerns you may have. A primary care physician can screen for diseases, and discuss treatment options with you.

Quitting Smoking: Smoking causes blood vessels to narrow, limiting blood flow to different parts of your body. This can seriously affect your ability to get and maintain an erection. Additionally, chemical addiction can lead to psychological side effects, further complicating your ability to respond to sexual stimulation. Quitting smoking is a major lifestyle change that can positively impact your sexual health, your vascular/ cardiovascular health, and your mental health.

If lifestyle changes and mental health counseling doesn't improve your ability to get and keep an erection, you may want to speak to your primary care physician about your persistent erectile dysfunction. A primary care physician can discuss ED treatment options for you, including:

Prescription medication: Your doctor may prescribe oral medication (known as PDE5 inhibitors) to treat persistent ED. The Food and Drug Administration (FDA) requires a prescription to obtain these drugs, but they have been proven effective by clinical trials. Oral erectile dysfunction medication relaxes muscles in the penis by increasing the effects of nitric oxide in the body. Nitric oxide widens blood vessels, resulting in improved blood flow throughout the body. This can help you get an erection in response to sexual stimulation. These drugs do not cause erections but allow the blood flow needed for function during sexual intercourse. These prescription drugs include:
- Viagra (Sildenafil)
- Cialis (Tadalafil)
- Levitra (Vardenafil)
- Stendra (Avanafil)


These oral medications have been known to cause mild, short-term side effects such as headaches, congestion, muscle aches, and indigestion. Because of this, it is recommended that you talk to your doctor before taking any PDE5 inhibitors to be sure that oral medication is the right treatment plan for you.

Alprostadil injection/ urethral suppository: Alprostadil is a drug used to treat ED that opens blood vessels and increases blood flow, improving erectile function. Alprostadil is most commonly administered in 1 of 2 ways: through injecting a tiny needle into the base or side of the penis, or through an intraurethral suppository (placing a small suppository of the drug in the penis through the urethra). Alprostadil will usually begin to work in about 5-20 minutes. Alprostadil therapy is generally considered effective and safe. Side effects are minor but may include some discomfort, mild bleeding, and a prolonged erection after ejaculation.

Penis pump (vacuum device): A vacuum erection device is a hollow tube with a pump attached that is operated either by hand or with a battery. The pump pulls air out of the tube, creating a vacuum around the penis. This pulls blood into the penis, causing an erection. After the penis is erect, you slip a tension ring around the base of the penis to keep blood in that area. This should help you keep an erection long enough for sex.

Testosterone therapy: If erectile dysfunction is being caused by low testosterone levels, your doctor may prescribe testosterone replacement therapy (TRT) to help improve libido and erectile function. TRT can be done through patches, gels, and injections. Side effects of TRT are minor, but you should speak with your doctor before starting TRT, to discuss any health risks.

Is ED a symptom of other medical conditions?

Erectile dysfunction can certainly be a physical side effect of several medical conditions and psychological issues.

Erectile dysfunction is one of the most common forms of male sexual dysfunction. In fact, ED affects nearly 30 million men worldwide. The prevalence of ED cases can be attributed to aging. However, men of all ages experience sexual dysfunction caused by a wide range of health conditions.

Aside from age, common causes of ED include:
- Poor vascular health (heart disease, high blood pressure, lack of blood flow)
- Substance abuse
- Diabetes
- Obesity
- Multiple sclerosis (MS)
- Psychological problems (such as depression or anxiety)
- Peyronie's disease (scar tissue inside the penis)
- Spinal cord injuries
- Medications


Erectile dysfunction can be a touchy subject for a lot of guys. If you have difficulty getting or keeping an erection once in a while, you are not alone. Millions of men worldwide experience some form of ED at some point in time. If your ED is persistent, or if you're worried that it's a side effect of other health conditions, speak to a men's health care provider or Doctor of Urology as soon as you can. ED is extremely common but can signify underlying health risks such as heart disease, diabetes, or obesity. The good news? Most cases of ED are easily treatable with a prescription.

What are some physical causes of sexual dysfunction in men and women?

There are a number of physical factors and health concerns that may cause sexual dysfunction in both men and women. Sexual function can often be a sign of health and well-being, while dysfunction may be caused by physical conditions such as:

  • Obesity
  • Vascular problems (heart disease, high blood pressure)
  • Diabetes
  • Thyroid disease (hyper/hypothyroidism)
  • Hormone imbalances
  • Substance abuse

There are many causes of sexual dysfunction, but there are also many ways to treat it. If you are struggling with sexual performance or experiencing anxiety about sex, book a video visit with health care providers on Sesame to discuss your symptoms and talk about treatment options.

What types of doctor appointments are recommended for men in their 20s & 30s?

If you have any of the conditions we just mentioned - acne, anxiety, hypertension, or ED - you should see a doctor to get care. If you're sexually active, you should get tested for STIs regularly.

But the most important type of visit in your 20s and 30s is with a primary care doctor. Now is the perfect time to establish a relationship with a primary care doctor who can get to know you and your health over time - starting with a routine check-up.

What types of doctor appointments are recommended for men in their 40s & 50s?

If you have any of the conditions listed above - anxiety, hypertension, hair loss, high cholesterol, or ED - you should see a doctor to get care. In addition, doctors recommend a shingles vaccination at 50.

Doctors also recommend 3 important cancer screenings:
1. Colonoscopy at 45 - or earlier if you have a family history of colon cancer.
2. Prostate cancer screening at 50 - or earlier if you have a family history of prostate cancer.
3. Lung cancer screening at 55 if you're a smoker.

What types of doctor appointments are recommended for men in their 60s & up?

If you have any of the conditions listed above - anxiety, hypertension, hair loss, high cholesterol, or ED - you should see a doctor to get care. In addition, doctors recommend a shingles vaccination at 50 and a pneumococcal vaccination at 65.

Doctors also recommend 4 important screenings:
1. Colonoscopy at 45 - or earlier if you have a family history of colon cancer.
2. Prostate cancer screening at 50 - or earlier if you have a family history of prostate cancer.
3. Lung cancer screening at 55 if you have a history of smoking.
4. Abdominal aortic aneurysm screening at 65 if you have a history of smoking.

What is tadalafil?

Tadalafil - commonly sold under the brand name Cialis - is a prescription medication that is used to treat erectile dysfunction (ED) and the symptoms of benign prostatic hyperplasia (BPH). Tadalafil may also be prescribed as a treatment for pulmonary arterial hypertension (PAH; high blood pressure in the blood vessels that carry blood to the lungs). Tadalafil is classified as a phosphodiesterase (PDE) inhibitor, a group of medications that relaxes muscles and increases blood flow to certain areas of the body.

Because tadalafil encourages circulation throughout the body, it can help increase blood flow to the penis during sexual stimulation. It should be noted that tadalafil does not protect against sexually transmitted diseases.

What is tadalafil used to treat?

Tadalafil is primarily prescribed to treat erectile dysfunction and prostate enlargement (benign prostatic hyperplasia). Erectile dysfunction affects an estimated 30 million Americans. By promoting greater blood flow, tadalafil works alongside sexual stimulation to help men get and keep an erection.

It is important to note that while tadalafil treats erectile dysfunction, it does not prevent the transmission of sexually transmitted diseases (STDs).

In some cases, tadalafil may be prescribed as a treatment for pulmonary arterial hypertension (PAH). Because it relaxes blood vessels in the lungs and allows for improved blood flow, tadalafil can help reduce dizziness and chest pressure caused by PAH, while increasing a patient’s ability to breathe.

How does tadalafil work?

Tadalafil is part of a family of drugs known as PDE5 (phosphodiesterase) inhibitors. These medications block certain enzymes in the body that can lead to narrowed blood vessels and poor circulation. Tadalafil relaxes muscles and opens up these blood vessels, allowing for blood to circulate more freely through the body.

As a treatment for ED, tadalafil can help promote blood flow to the penis during sexual stimulation. It will not cause an erection on its own, but it will help encourage circulation that can lead to stronger, longer-lasting erections. When tadalafil is being used to treat BPH, it allows muscles in the bladder and prostate to relax, relieving persistent symptoms of benign prostatic hyperplasia. These symptoms may include an urgent need to frequently urinate, or difficulty with urination. Finally, as a treatment for PAH, tadalafil improves blood flow to the lungs, which can reduce symptoms such as shortness of breath, chest pressure, and difficulty breathing.

Can I get tadalafil online?

Yep! With Sesame Rx, you can get medication delivered right to your door with free and fast delivery - no insurance necessary. Our fully-integrated prescription service lets your doctor write you a prescription (or refill an existing one) during your visit. That way, you can focus on getting better and not worry about how and when you’ll get your prescription.

How long does it take for tadalafil to work?

Tadalafil is a fast-acting prescription medication that will start to work within 30-60 minutes after ingestion. As a treatment for erectile dysfunction, tadalafil should be taken at least 30 minutes before sexual activity. It is important to note that tadalafil is not enough to cause an erection by itself. Tadalafil helps increase blood flow, which can improve erections that result from sexual stimulation.

Tadalafil is meant to be taken only once a day. Do not increase the dosage or stop taking tadalafil unless directed by your doctor.

What is sildenafil?

Sildenafil is a phosphodiesterase inhibitor (PDE-5) used to treat erectile dysfunction (ED). It works by increasing blood flow and oxygen to the penis, helping you more easily attain an erection. It may also be used for purposes not listed in this medication guide. Though sildenafil helps treat ED, it neither cures the condition nor increases sexual desire. Sildenafil does not protect against the spread of sexually transmitted infections (STIs) or prevent pregnancy.

Talk to your doctor about whether sildenafil may be right for you.

What is sildenafil used to treat?

Sildenafil is used to treat erectile dysfunction. It stimulates blood flow to the penis, which can help cause an erection.

It should not be taken by people who take certain medications for separate health conditions, including the following: Nitrate medication: often used to treat chest pain (angina). This combination of drugs can cause a sudden, unsafe drop in blood pressure. Guanylate cyclase stimulators (riociguat), a medication that treats pulmonary arterial hypertension. Other erectile dysfunction treatments: Combining some ED medications with sildenafil can result in temporary or permanent vision loss. Poppers

Before taking sildenafil, tell your doctor if you have: Had a heart attack, stroke, low blood pressure, high blood pressure, stomach ulcers, severe vision loss, or heart problems Pulmonary hypertension Had heart surgery (within the last 6 months) Had an erection that lasted longer than 4 hours A deformed penis Liver, kidney, or blood cell, or bleeding problems Retinitis pigmentosa

Are there benefits to taking Viagra daily?

Sildenafil (Viagra) is often prescribed by Doctors of Urology to treat erectile dysfunction. As a PDE5 inhibitor, Viagra relaxes blood vessels, encouraging blood to flow freely through them. This can lead to longer, and stronger erections. This blood flow to the penis can also help combat premature ejaculation, as the erection is more firm.

Outside of sexual health, Viagra may help prevent heart attacks and improve the ability to urinate (by easing muscles in the prostate). These side effects are "off-label", meaning that Viagra has not been approved by the FDA to address these conditions, but they are potential benefits to taking Viagra every day.

Note: Do not take more than one dose of Viagra within 24 hours. This can lead to severe side effects such as nausea, dizziness, and blurred vision. Before taking Viagra every day, consult with your doctor about your dosage.

How long does it take for sildenafil to work?

In most cases, it takes about 30 minutes for sildenafil to take effect. For maximum effectiveness, it is recommended that you take the medication at least 1 hour prior to sexual intercourse for maximum effectiveness.

How does sildenafil work?

Sildenafil belongs to a class of drugs known as phosphodiesterase (PDE) inhibitors. PDE inhibitors help dilate your blood vessels and improve blood flow. Sildenafil increases blood flow to the penis, making it easier for you to achieve an erection.

Can I get sildenafil online?

Yep! SesameRx is our medication delivery program that delivers your prescription medication right to your front door. After your virtual or in-person visit with a doctor through Sesame, you can fill your new or existing prescription with Sesame Rx starting at just $5 a month. Now you can spend more time doing the things you want to do, without having to carve out time to drive to the pharmacy. Enjoy a fully integrated prescription service that fits your schedule. Yep, it’s really that simple. Please note that all prescriptions are at the discretion of your doctor.

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