Lifestyle

Getting Erectile Dysfunction Medications Online: What Are Your Options?

by Mike McAvennie11/17/2021

Happy Couple - Ed Meds Hero

Which online medications can treat your ED, how they work, their benefits and their potential side effects.

Erectile dysfunction. It’s an uncomfortable topic for men, but one that needs to be addressed. As you age, your chances of developing some form of sexual disorder increases — most of which are attributable to ED.

Thankfully, help is available. There are several medications out there today that can alleviate erectile dysfunction. Even better, they can be purchased legally online. Best of all, some of them are now available through Hone.

Which online ED medications stand out from the pack? Let’s take a look at your options, their respective health benefits and their potential adverse effects.


What Is Erectile Dysfunction (ED)?


Dr. Jim Staheli, D.O. and Medical Director at Hone, goes into extensive detail as to what ED entails. To summarize, erectile dysfunction is when a man is unable or has difficulty achieving or maintaining an erection during intimacy. One report estimates that as many as 30 million American males [1] suffer from ED, while another study calculates that the worldwide number of men afflicted with ED could rise from 152 million in 1995 to 322 million by 2025. [2]

The severity of one’s ED depends on how frequent—or infrequent—they experience symptoms; anything more than 50 percent of the time indicates that the ED is severe. Furthermore, research points to a strong correlation between erectile dysfunction and age [3] in that your possibility of experiencing ED symptoms increases by about 10 percent per decade. In other words, there’s a 40 percent chance when you enter your forties, a 50 percent chance in your fifties and so on.

What Causes ED?

There's a lengthy list of causes for erectile dysfunction. They include:

  • Clogged blood vessels

  • Diabetes

  • Enlarged prostate

  • Heart disease

  • Hypercholesterolemia (high cholesterol)

  • Hypertension

  • Low testosterone

  • Metabolic syndrome

  • Multiple sclerosis

  • Obesity

  • Parkinson’s disease

  • Peyronie’s disease

  • Prostate cancer treatment

  • Sleep disorders

    Erectile Dysfunction Causes Infographic

    Other factors can play into ED, including drugs (prescription and non-prescription), excessive alcohol consumption, smoking and not exercising enough. ED can also be onset by psychological causes, whether it’s depression, an issue between you and your partner, performance anxiety or other stressors.

Can ED Cause Other Health Issues?

Medical experts often point to an association between erectile dysfunction and cardiovascular disease. Just like heart disease is usually considered an underlying cause of ED, they believe that ED can increase the risk of cardiovascular disease. [4] Studies also show that ED can contribute adversely to a lowered self-esteem [5], which in turn can make your sexual disorder even more significant.


What Medications Can Treat ED?


Fortunately, ED can be treated today in a number of ways. There’s testosterone replacement therapy, which can effectively improve erectile function for men with mild ED caused by Low T. If you believe you suffer from low testosterone and you are unable to achieve an erection, you can measure your biomarkers through Hone’s at-home hormone assessment.

Next, there’s penile injection therapy, of which three types are often prescribed:

  • Papaverine

  • Phentolamine

  • Alprostadil, also known as Prostaglandin E1 (PGE1)

Doctors may also prescribe injectable mixtures of the above medications, including:

  • BiMix, a combination of papaverine and phentolamine

  • Trimix, which combines alprostadil with papaverine and phentolamine

Another option is intraurethral or transurethral medication, in which a tiny suppository is inserted into the opening of your penis. Alprostadil is available as an injectable medication and as an intraurethral treatment.

Last, but certainly not least, is the type of ED meds we’ll focus on here. Oral medications for erectile dysfunction are called phosphodiesterase type 5 (PDE5) inhibitors. A drug that blocks the PDE5 enzyme that’s found in the walls of blood vessels and affects cell signaling throughout areas of the body, PDE5 inhibitors help the blood vessels to relax and boost blood flow to your penis. The drug was originally explored by scientists as a way to treat hypertension and angina. It was something of a happy accident when they discovered that it could also alleviate ED symptoms. Research has since also indicated that PDE5 inhibitors can also help in the treatment of heart disease, cancer and diabetes. [6]

It’s important to understand that PDE5 inhibitors are used primarily for physical causations of erectile dysfunction. If your ED is the result of a psychological issue, PDE5s are not an effective treatment.


Prescription ED Medications and How They Work


All prescription oral ED medications are approved by the US Food and Drug Administration (FDA). Though each one contains slight chemical differences, they’re all designed to work the same way. They boost your body’s production of nitric oxide, a gas that enables the muscles around your penis to relax. As those muscles relax, blood flow to the penis increases, thereby enabling you to achieve an erection.

ED Meds Available Through Hone

If their clinical needs medically qualify them, new and current Hone subscribers can get a prescription for one of two oral ED meds online: Tadalafil and sildenafil. To qualify, you must go through an at-home hormone assessment and have an online consultation with a Hone-affiliated physician, who will determine whether or not you meet the clinical requirements for treatment.

Tadalafil

Tadalafil

The generic and more affordable drug that’s widely known by the brand name Cialis (and its lower-dose counterpart, Cialis Daily), tadalafil does more than treat your ED. Research shows that it can also significantly boost your self-esteem and confidence. [7]

Tadalafil can also successfully treat men with benign prostatic hyperplasia (BPH) [8], in which the prostate gland becomes enlarged and can block urine flow from the bladder, as well as lower urinary tract symptoms (LUTS) [9] that result in storage or voiding disturbances. Under the brand names Adcirca and Alyq, tadalafil is used for both men and women who suffer from pulmonary arterial hypertension (PAH) [10], a high blood pressure in the lungs that’s caused by blockage in their small arteries. Studies indicate that in addition to treating PAH, a larger dosage of the oral tablet can improve exercise capacity and duration.

Sildenafil

Sildenafil

Many men regard this PDE5 to be the “Grandaddy of ED Meds.” Under the brand name Viagra (aka “The Little Blue Pill”), sildenafil became the first FDA-approved oral ED treatment in March of 1998. Like tadalafil, studies show [11] that sildenafil can be extremely effective in treating ED as well as in improving confidence and self-esteem. It’s also known for treating those with PAH and providing cardioprotective effects [12] when marketed under the name Revatio, which is also available as an injection or oral suspension (liquid).

For full transparency, both tadalafil and sildenafil are available online through Hone as oral tablets only.

Other Oral ED Medications

There are two additional PDE5 inhibitors that can help you with your sexual impotence: Vardenafil and avanafil. Though they aren’t available through Hone at this time, it’s important to consider all possible options for your ED treatment.

Vardenafil

A generic form of Levitra (oral tablet) and Staxyn (disintegrating oral tablet), vardenafil’s chemical makeup may require smaller dosing to make you erect, though the duration of your erections may not be as long as sildenafil.

Avanafil

Marketed under the brand name Stendra, avanafil’s health benefits are comparable to those of tadalafil and sildenafil. Like vardenafil, however, avanafil can be a more expensive option, and some studies suggest that it may not be as effective at lowering blood pressure.


How To Find The ED Medication That's Right For You


With multiple options from which to choose, it can be a little confusing to determine which oral ED medication will suit you best. Many personal factors should be weighted in your decision and your doctor should review all of the medications with you, as well as inform you of their individual benefits and side effects.


How Quickly Will Your ED Medication Work?


Onset times range between 15 and 60 minutes, depending on when you intend to have intercourse and on which treatment you choose. Also remember that medications for erectile dysfunction don’t just “kick in” on demand.

A 5 mg dose of daily-use tadalafil (Cialis) works fastest to achieve your desired result, while an “as-needed” dose of the same medication (5, 10 or 20 mg, depending on your prescription) should be taken one to two hours before sex. A 5, 50 or 100 mg dose of sildenafil (Viagra), taken an hour before sex, should onset within 30 to 60 minutes, as will a 2.5, 5, 10 or 20 mg tablet of vardenafil. Avanafil, with a dosage of 50, 100 or 200 mg, should be taken 15 to 30 minutes beforehand, which is also how quickly it will take effect.

How long your ED medication lasts will also vary. Daily-use tadalafil doesn’t “wear off” as the effect is continuous, while “as-needed” usage can provide erections for 24 to 36 hours. Sildenafil and vardenafil’s effects can last four to eight hours, while avanafil can deliver results for six to 12 hours.

Regardless of which medication you choose, just be aware that their performance takes a little time to onset and can require some stimulation/foreplay, so plan ahead. Also take into account some other important factors:

  • Taking vardenafil or sildenafil during or just after a heavy or high-fat meal [13] may inhibit your body’s absorption of those drugs, thereby delaying the effects of your treatment and when you can engage in sexual activity.

  • Avoid regularly consuming grapefruit or grapefruit juice [14] while taking PDE5s inhibitors; depending on your treatment, grapefruit can either delay the drug’s desired effects or elevate its blood levels, which can result in or increase adverse side effects.


How Do I Legally Buy ED Medications Online Through Hone?


Buy Ed Meds Online

It’s perfectly legal to buy ED meds online and through Hone, provided:

  • You have an active Hone membership subscription to receive medication

  • New Hone members must complete their at-home hormone assessment, have their lab results reviewed during a scheduled, telemedical consultation with a Hone-affiliated physician, complete confirmatory testing and enroll in a membership subscription to receive medication

  • You meet the clinical requirements for the doctor to diagnose you with erectile dysfunction and recommend treatment

  • You agree to follow additional treatment options recommended by your doctor, including changes to diet, lifestyle and rest

  • You have a valid, legal prescription signed by your doctor

One other important note: Existing Hone subscribers can not retroactively add ED medications to their current plan. They must wait for their next scheduled consultation to speak with the physician about adding ED meds.

In short, the process to get ED medications online through Hone is very much the same as going through an evaluation of your hormone levels. if you’re new to Hone, the process is very much the same as going through an evaluation of your hormone levels. For more details, go to Hone's How It Works page. If you’re still not sure how to proceed, please feel free to reach out to us at support@honehealth.com.


Why Legal Procurement of ED Meds Matters


Should you decide to buy your oral ED meds elsewhere, bear in mind that, like purchasing testosterone online, it's risky and potentially very hazardous to your health. Sildenafil and tadalafil’s brand names are among the most counterfeited drugs in the world. [15] Meanwhile, sites that offer nonprescription or herbal/natural ED meds are straight-up scamming you.

Please, be very careful about where you buy your online ED medications. Make sure any doctors and pharmacies you’re dealing with on the internet also have addresses based within the United States, and that you fulfill all clinical requirements for a legal, viable prescription of medication.


Will Insurance Cover My Online ED Medication?


At this time, Hone’s online medications and services are not covered by insurance. Many insurances won’t cover these costs. Most that do cover them will do so with copays that are similar to, if not higher than, the price you’ll pay at Hone.

If you’re new to Hone and have just ordered an at-home assessment panel, keep in mind that the cost also includes an online consultation with a Hone-affiliated physician, which you’ll need to have before you can get a prescription for ED medication. Furthermore, your assessment, consultation and ED medications are all handled from the privacy and comfort of your home, which can save you considerable cost and time.

Another option to consider is that Hone also accepts Health Savings Account (HSA) and Flexible Spending Account (FSA) card payments. Such tax-advantaged accounts are in place to help you save for medical purposes, including online ED medications. If HSA and/or FSA elections are available to you, take advantage of them and save some money.


What ED Medications Can And Can’t Do


Obviously, drugs that treat erectile dysfunction do precisely what they’re engineered to do: They can help you get and maintain an erection whenever you’re sexually stimulated. They can also give you the boost you need when engaging in sexual intercourse.

There are several significant misconceptions about ED meds’ capabilities, including:

ED meds can boost your libido: FALSE. A lot of the misunderstanding comes from the fact that many of us think that having erectile dysfunction is the same as having a lifeless libido. That simply isn’t the case.

ED is primarily a vascular disorder. Whereas trouble with your libido, or sex drive, is often the result of a hormonal imbalance, such as low testosterone. Yes, the two conditions often do go hand-in-hand, so to speak; if everything works properly, your body will generally respond to an urge for sexual intimacy with an erection. At the same token, when your libido loses the desire to have intercourse, your ability to become erect also suffers.

Medications intended for erectile dysfunction treat only the ED, however. They can’t increase your libido or your desire to have intercourse. Testosterone replacement therapy (TRT) can help boost your sex drive, and studies show it can improve erectile function in males with mild ED. [16]

ED drugs can keep you erect even after you’ve climaxed: FALSE. Sorry, gents. There’s no truth that being on ED medication can keep you going once you’ve “gone.” Once you ejaculate, your erection disappears and needs time to recharge.

PDE5 inhibitors can treat all men with ED: FALSE. Some men’s conditions may be too severe for oral ED medication to help them. These drugs also can’t help males whose ED is the result of:

  • Psychological causes

  • Underlying health conditions

  • Diabetes

  • Post-prostate surgery or surgeries that may have caused nerve damage

ED medications can “cure” erectile dysfunction: FALSE. Oral PDE5s that are prescribed can only treat and alleviate the symptoms of a man’s ED. They can’t completely eliminate ED. It’s an important distinction you should understand before deciding on treatment.


Do ED Medications Have Side Effects?


Most prescription medications come with potential side effects. Oral ED meds are no exception. And because they all work so similarly, it’s not surprising that they all have similar adverse effects.

Mild side effects commonly associated with ED medications can include:

  • Headache

  • Digestive issues, including dyspepsia (indigestion), bloating and/or diarrhea

  • Reflux

  • Dizziness

  • Hypotension/lower blood pressure

  • Flushing, ranging from skin blotches/redness to rashes

  • Rhinitis — cold-like symptoms including congestion, runny or stuffy nose

  • Fatigue

  • Muscle pain, usually in the lower back

  • Vision changes (Blurriness, blue- or green-tinted vision, sensitivity to light)

  • Shortness of breath

  • Ringing in ears

  • Allergic reactions

More serious side effects, though extremely rare, can also occur. Seek immediate medical attention if you experience either of the following: 

  • Priapism, or a prolonged, often painful erection that lasts longer than four hours

  • Sudden vision or hearing loss


Who Shouldn't Take ED Medications?


Before taking any oral medications to treat erectile dysfunction, make your doctor aware of any prescription medications you’re already on, and alert them to any pre-existing conditions you have beforehand. The reason is simple: ED drugs may interact poorly with your other medications. They can also exacerbate symptoms of pre-existing conditions, or nullify the effects of medications used to treat those conditions.

Let your doctor know immediately if you take any of these medications:

  • Nitrates — primarily prescribed for angina or chest pain, including nitroglycerin, isosorbide, “poppers” (amyl nitrite or amyl nitrate) and niroprusside

  • Alpha blockers — often used in tandem with other medications to treat hypertension or prostate problems in males

  • Riociguat — a drug used to treat pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH)

Pre-existing conditions that should also be considered before your physician approves an ED medication include:

  • Congestive heart failure

  • Angina

  • Heart attack over the past three months

  • A stroke or heart rhythm problem over the past six months

  • Aortic stenosis

  • Low blood pressure

  • Uncontrolled high blood pressure

  • Penile deformities, such as Peyronie’s disease (curvature of the penis)

  • Rare genetic eye disorders (e.g. retinitis pigmentosa)

  • Sickle cell disease

  • Leukemia

  • Multiple myeloma

  • Severe liver problems

  • A kidney disease that necessitates dialysis

Be sure to also inform your doctor if you’re scheduled to undergo any surgeries in the near future, including dental procedures.


Is It Safe To Switch ED Medications?


Though their chemical mixtures may differ and can slightly vary in terms of their benefits and side effects, all PDE5 inhibitors contain the same key ingredients and work essentially the same way. Therefore, you can expect very similar results among them.

If you find that one of the milder side effects in your ED treatment doesn’t agree with you, you will want to ask your doctor whether another medication may offer less of those side effects. They will most likely approve a change in ED medication with little to no problem, so don’t make any changes to your treatment without their knowledge or medical consent.

Will I Have To Stay On ED Medication For The Rest Of My Life?

Is erectile dysfunction permanent, and if so, will you always need treatment? Honestly, it depends.

As we’ve previously stated, ED meds don’t “cure” your ED. They treat it, alleviating or relieving the symptoms associated with your disorder.

However, it’s all contingent on the cause of your ED. If it’s brought on by an unhealthy diet or lifestyle, alcohol, sleep or medications that can onset erectile dysfunction, then your ED can be reversible, or in this case “curable.” The impetus is on you to change your daily lifestyle habits.

If the cause of your ED is psychological or emotional, or the result of underlying health conditions, then your ED is more likely to be treatable rather than curable. Things like depression, low testosterone and anxiety are the source of your ED. Treat those maladies, and you can subside your ED. Stop taking your medication, and chances are your ailments return. The same goes for your ED.


Why Customers Should Trust Hone Over Competitors


Hone’s vision extends well beyond hormone optimization. We’ve dedicated ourselves to provide you with the latest and most reliable, science-backed treatments, as well as offer guidance on helping you improve multiple facets of your life, from diet and exercise to your mental and emotional wellbeing.

Every day, Hone’s hormone optimization plans help thousands of men rediscover the best versions of themselves. We want to help millions more with something that’s personally intimate to both you and your partner. Now we can do so with our offerings of clinical counsel and medication that can improve your erectile function, as well as your overall outlook on life.


References:

[1] Nunes KP, Labazi H, Webb RC. New insights into hypertension-associated erectile dysfunction. Curr Opin Nephrol Hypertens. 2012 Mar;21(2):163-70. doi: 10.1097/MNH.0b013e32835021bd. PMID: 22240443; PMCID: PMC4004343.

[2] Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999 Jul;84(1):50-6. doi: 10.1046/j.1464-410x.1999.00142.x. PMID: 10444124.

[3] Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994 Jan;151(1):54-61. doi: 10.1016/s0022-5347(17)34871-1. PMID: 8254833.

[4] Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011 Sep 20;58(13):1378-85. doi: 10.1016/j.jacc.2011.06.024. PMID: 21920268.

[5] Özkent MS, Hamarat MB, Taşkapu HH, Kılınç MT, Göger YE, Sönmez MG. Is erectile dysfunction related to self-esteem and depression? A prospective case-control study. Andrologia. 2021 Feb;53(1):e13910. doi: 10.1111/and.13910. Epub 2020 Nov 20. PMID: 33215726.

[6] Das A, Durrant D, Salloum FN, Xi L, Kukreja RC. PDE5 inhibitors as therapeutics for heart disease, diabetes and cancer. Pharmacol Ther. 2015 Mar;147:12-21. doi: 10.1016/j.pharmthera.2014.10.003. Epub 2014 Oct 31. PMID: 25444755; PMCID: PMC4494657.

[7] ​​Li JP, Li F, Guo WB, Zhou QZ, Liu CD, Mao XM, Tan WL, Zheng SB. [Efficacy of low-dose tadalafil on ED assessed by Self-Esteem and Relationship Questionnaire]. Zhonghua Nan Ke Xue. 2010 Dec;16(12):1147-9. Chinese. PMID: 21348208.

[8] Mónica FZ, De Nucci G. Tadalafil for the treatment of benign prostatic hyperplasia. Expert Opin Pharmacother. 2019 Jun;20(8):929-937. doi: 10.1080/14656566.2019.1589452. Epub 2019 Mar 22. PMID: 30901259.

[9] Wang Y, Bao Y, Liu J, Duan L, Cui Y. Tadalafil 5 mg Once Daily Improves Lower Urinary Tract Symptoms and Erectile Dysfunction: A Systematic Review and Meta-analysis. Low Urin Tract Symptoms. 2018 Jan;10(1):84-92. doi: 10.1111/luts.12144. Epub 2016 Nov 5. PMID: 29341503.

[10] Henrie AM, Nawarskas JJ, Anderson JR. Clinical utility of tadalafil in the treatment of pulmonary arterial hypertension: an evidence-based review. Core Evid. 2015 Nov 2;10:99-109. doi: 10.2147/CE.S58457. PMID: 26587013; PMCID: PMC4636095.

[11] Althof SE, O'leary MP, Cappelleri JC, Hvidsten K, Stecher VJ, Glina S, King R, Siegel RL; International SEAR Study Group. Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: Results from an international, multi-center, double-blind, placebo-controlled trial. J Sex Med. 2006 May;3(3):521-9. doi: 10.1111/j.1743-6109.2006.00234.x. PMID: 16681478.

[12] Kontaras K, Varnavas V, Kyriakides ZS. Does sildenafil cause myocardial infarction or sudden cardiac death? Am J Cardiovasc Drugs. 2008;8(1):1-7. doi: 10.2165/00129784-200808010-00001. PMID: 18303932.

[13] He ZJ. [Effects of food and alcohol on the pharmacokinetics of vardenafil]. Zhonghua Nan Ke Xue. 2005 Jun;11(6):477-9. Chinese. PMID: 15999499.

[14] Bailey DG, Dresser GK. Interactions between grapefruit juice and cardiovascular drugs. Am J Cardiovasc Drugs. 2004;4(5):281-97. doi: 10.2165/00129784-200404050-00002. PMID: 15449971.

[15] Coelho Neto J, Lisboa FLC. ATR-FTIR characterization of generic brand-named and counterfeit sildenafil- and tadalafil-based tablets found on the Brazilian market. Sci Justice. 2017 Jul;57(4):283-295. doi: 10.1016/j.scijus.2017.04.009. Epub 2017 Apr 22. PMID: 28606335.

[16] Rizk PJ, Kohn TP, Pastuszak AW, Khera M. Testosterone therapy improves erectile function and libido in hypogonadal men. Curr Opin Urol. 2017 Nov;27(6):511-515. doi: 10.1097/MOU.0000000000000442. PMID: 28816715; PMCID: PMC5649360.

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