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
Independent · Medically reviewed
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:
Medically reviewed
Every clinical claim is checked by a licensed clinician before it publishes, and re-checked on a schedule.
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
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
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.
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.
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.
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