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Erectile dysfunction (ED) is the medical term for trouble getting or maintaining an erection that is satisfying for sexual activities.

ED is common, even among people who are young and otherwise healthy. Its prevalence increases with age.

Occasional ED is not always a cause for concern, but if trouble with erections is frequent or getting worse, the cause may be an underlying health condition that needs treatment.

Below, we describe which medical specialists and telehealth options can help people with ED. We also explain what tends to happen at the appointment and list some questions to ask the doctor.

People usually first raise concerns about ED with their primary care provider, or family doctor.

The doctor asks about the symptoms and the person’s medical history. They may also ask if there is a family history of diabetes or heart disease, which can sometimes cause ED.

The doctor may then order simple blood work to help determine if the ED likely stems from an underlying health condition.

Depending on the outcomes of the consultation and blood test, the doctor may then refer the person to a specialist. The type of specialist depends on the most likely cause of ED at this point.

Below, we describe some of these medical specialists in more detail.

Urologist

A urologist is a doctor who specializes in diagnosing and treating conditions of the urinary tract, as well as sexual concerns in males.

They may help diagnose and treat, for example:

A person with ED may receive a referral to a urologist if:

  • Their current treatment is not working.
  • Their primary care provider suspects that a health issue is affecting the urinary or reproductive system.
  • They have a long-term urinary or reproductive condition that increases their risk of ED.

Cardiologist

Heart disease and ED share many risk factors. Because of this, ED can sometimes signal an underlying issue with the heart, and cardiovascular problems can increase the risk of developing ED.

A cardiologist is a doctor who specializes in diagnosing and treating conditions of the heart and blood vessels. A person may receive a referral to a cardiologist if:

  • They have preexisting heart or cardiovascular disease.
  • They have a risk of this kind of health issue.
  • They have a family history of heart or cardiovascular disease.
  • Their primary care doctor or urologist is unable to diagnose another cause of ED.

Endocrinologist

An endocrinologist is a doctor who specializes in diagnosing and treating hormonal conditions. They may treat imbalances in testosterone or estrogen, as well as conditions such as diabetes.

An appointment with an endocrinologist usually involves blood work and answering questions about lifestyle and sexual history.

Depending on the cause of ED, the doctor may prescribe or recommend:

Mental health professional

Mental health conditions can cause ED, and they can also develop in response to it.

For example, the following are sometimes the primary cause of ED:

A psychotherapist or psychiatrist may recommend talking therapy, medication, or a combination.

How we choose telehealth providers

Medical News Today chooses telehealth providers that meet the following criteria:

  • Licensed in the United States: The companies must have U.S.-licensed healthcare professionals that review all assessments and prescribe medication.
  • Legitimate medication: The companies must provide ED medication that the Food and Drug Administration (FDA) has approved.
  • Privacy: The companies must offer discreet packaging.

It is possible to receive help for ED via an online or telehealth platform. Many of these companies advertise ED services because they know that speaking about it with a doctor in person makes some people uncomfortable.

But many health conditions that can cause ED require in-person testing. For example, a doctor cannot diagnose diabetes or cardiovascular disease online.

So doctors with online services may prescribe medication as a short-term ED treatment. But they usually recommend a follow-up appointment with a specialist in person. This is especially likely if a person has other symptoms or a risk of conditions such as diabetes or heart disease.

Below are some telehealth companies that offer prescription ED medication.

Roman

Roman sells generic and branded sildenafil (Viagra) and tadalafil (Cialis) in various dosages:

  • Viagra, in dosages of 25, 50, and 100 milligrams (mg), starting at $70 per dose
  • generic Viagra, in dosages of 25, 50, and 100 mg, starting at $34 per dose
  • sildenafil, the active ingredient in Viagra, in dosages of 20, 40, 60, 80, and 100 mg, starting at $2 per dose
  • Cialis, in daily and per-dose forms, starting at $13
  • generic Cialis, in daily and per-dose forms, starting at $8

Learn more about Roman.

After a person signs up for Roman, a doctor or nurse practitioner gets in touch to discuss the symptoms and treatment options. The company ships the medication to a person’s house in discreet packaging within 2 days.

Hims

Hims offers the following prescription ED treatments:

  • generic Viagra, starting at $4 per dose
  • Viagra, starting at $70 per dose
  • Stendra, starting at $59 per use
  • daily tadalafil, at $99 per month
  • daily Cialis, cat $525 per month

Learn more about Hims.

When signing up for Hims, a person fills in an online form, detailing their symptoms and medical history. The company pairs each person with a licensed healthcare professional in their state who reviews the form and prescribes treatment, if necessary. The company then ships it in discreet packaging to the person’s home.

Lemonaid

Lemonaid provides generic Viagra and Cialis, starting at $2 per dose. The company also offers generic Cialis daily, which it recommends for people who have sex five or more times a week.

To use this service, a person completes an online assessment. A healthcare professional based in the U.S. reviews it and asks follow-up questions, if necessary. If they write a prescription, the company ships the medication in discreet packaging to the person’s home.

A person should be prepared to answer a lot of questions during their first appointment for ED. The more information a person can provide, the greater the likelihood that the doctor can diagnose the cause of the ED.

The doctor may ask:

  • When did the ED begin?
  • Do certain things seem to trigger it?
  • Does the ED occur all the time or only some of the time?
  • Does it occur before or during sex?
  • How long does it typically take to get an erection?
  • Is it possible to ejaculate or orgasm during sexual activity or masturbation?
  • Do you feel anxious or notice other feelings when trying to have an erection?
  • Do you have any other symptoms?

The doctor may also ask about lifestyle factors, such as diet and exercise habits.

Diagnostic procedure

To diagnose ED, a doctor may perform the following tests:

When seeing a doctor about ED, it may help to ask:

  • What are the most likely causes of ED in someone my age, with my overall health?
  • Will treating an underlying medical issue fix the ED? How long will it take to see results?
  • Are there any other symptoms I should watch for?
  • What are the risks and benefits of ED medication?
  • Are there any other treatment options?
  • Could lifestyle changes help?

The treatment options for ED depend on its cause. The sections below describe some potential treatments in more detail.

Viagra

One popular ED treatment is Viagra, and its active ingredient is sildenafil. This works by increasing blood flow to the penis.

Sildenafil may be a suitable treatment option when ED:

  • is occasional
  • is age-related
  • has no underlying cause that a doctor can find

Lifestyle changes

A doctor may recommend the following lifestyle changes to help treat ED:

  • quitting smoking
  • avoiding or limiting alcohol consumption
  • getting regular exercise
  • having a healthy diet
  • receiving treatment, including counseling, for any mental health conditions that may be contributing to ED, such as:
    • stress
    • anxiety
    • depression
    • trauma
  • going to couples counseling to explore ways of managing ED with a partner

Treatments for underlying health conditions

ED can sometimes result from a medical condition, such as diabetes or heart disease. In some cases, treating the underlying health issue resolves the ED or keeps it from getting worse.

Other treatments

Some other options for ED treatment include:

  • testosterone injections, for those with low testosterone
  • injections of a vasodilator into the penis, which helps promote blood flow
  • a penis pump, which pulls blood into the penis to sustain an erection
  • penile implant surgery

Below are answers to some frequently asked questions about approaching a doctor about ED.

Do I need a prescription for ED medication?

A person needs a prescription for medications such as Viagra or Cialis. A primary care physician or a doctor at a telehealth company can provide it.

The healthcare professional will review the person’s symptoms and medical history and prescribe a medication that best suits their needs.

Some companies sell herbal remedies for ED, but speak with a healthcare professional before taking any of these.

The FDA warns that many over-the-counter ED products have undisclosed amounts of prescription medications, which can cause severe side effects.

How do I ask my doctor for Viagra?

It can help to go to an appointment prepared with a list of questions, especially if ED is causing any anxiety. A person might ask:

  • Which medication or treatment is most suitable for me?
  • Does my insurance cover the cost of any treatment?
  • Will the medication interact with anything else I am taking?
  • What are the possible side effects?
  • How long does it take for the treatment to start working?
  • What are the next steps if this does not work?
  • Will I need to see a specialist?
  • Could any lifestyle changes help?

A healthcare professional should not be uncomfortable discussing ED. If anyone feels that their doctor is not taking their concerns seriously or is otherwise not providing the expected level of care, they can ask for a different doctor.

ED is common and can occur at any age. It may cause frustration, worry, and embarrassment.

An occasional inability to get or maintain an erection is not necessarily a cause for concern. But frequent ED could signal an underlying mental or physical health condition that requires treatment.

Anyone with ED symptoms should visit a doctor for a diagnosis and treatment. An online doctor may prescribe a short-term treatment, but diagnosing the cause usually requires in-person testing. This diagnosis is necessary for treating ED in the long term.