Best online ED treatment
Eight telehealth platforms that prescribe sildenafil, tadalafil or vardenafil, scored on how hard they screen, what they stock and what a dose actually costs you.
8 providers reviewed · updated
How we make money. We earn a commission when you start with some of the providers on this page, at no cost to you. It does not affect the order. Scoring happens against the criteria below before any commercial consideration — and this page is the proof: Strut Health pays us more per click than any other provider here and places last, while Sesame Care, which pays us close to nothing, places first.
How we scored them
Every provider is scored out of five against four criteria. The weighting is ours and you are welcome to disagree with it — that is why it is printed here rather than linked. It weighs screening heavily, because the medications on this page are safe drugs with one genuinely dangerous interaction, and the intake form is the only thing standing in front of it.
- Cardiovascular screening35%
- Whether the intake screens for nitrate use, recent cardiac events, uncontrolled hypertension and guanylate cyclase stimulators such as riociguat, and whether a flagged answer escalates to a clinician rather than simply declining. The sildenafil label contraindicates nitric oxide donors in any form; the form is what catches it.
- Cost for how often you actually use it25%
- Per-dose pricing suits a man who needs four tablets a month; a subscription suits daily tadalafil. We score whether the provider offers the model that matches the pattern, and whether the headline figure survives contact with the checkout.
- Medication and format range20%
- Sildenafil and tadalafil at several strengths, vardenafil where offered, and whether chewable, sublingual or dissolving formats exist. Roughly a third of men do not respond adequately to the first PDE5 inhibitor they try, and a one-product platform has nowhere to go next.
- Access and turnaround20%
- State coverage, how long the first shipment takes, and whether a prescriber can be reached to titrate the dose afterwards. A dose that needs adjusting and a support queue that does not answer is a treatment that quietly stops.
Ties. Where two providers score identically, the one with the higher historical earnings-per-click is listed first. That is the only point at which commercial data touches the order, and it applies to ties only. Hims, Maximus and Roman all score 4.1 and are separated by nothing else.
The ranking
- 1
Sesame Care
Best overall
4.3our score
The only provider here that sells you a clinician rather than a subscription. You see the price and pick the specific doctor before booking, get a real video encounter rather than a form, and fill the prescription at your own pharmacy — which for a drug most men take a few times a month is both cheaper and clinically better.
Stands out for
- Video visit listed at $29 to $45, price shown before you book
- Medication from $2 a dose, filled at a pharmacy of your choice
- Same-day appointments, all fifty states, no subscription
Not for you if
A marketplace, so consistency depends on the individual doctor you pick rather than a house protocol, and there is no auto-refill. If you want a box to arrive every month without thinking about it, this is the wrong shape of thing entirely.
- Consult
- $29
- Delivery
- Same Day Consult
- 2
MangoRx
Best fast-onset format
4.2our score
Sildenafil and tadalafil as oral dissolving tablets that absorb partly under the tongue, which is a real pharmacokinetic difference rather than a marketing one, at a flat $59 a month with same-day dispatch and a free consultation.
Stands out for
- Oral dissolving tablets rather than swallowed pills
- Listed at $59 a month with free consultation and shipping
- Same-day shipping
Not for you if
The tablets are compounded with added L-arginine and oxytocin, and the published evidence for that combination specifically — as opposed to the PDE5 inhibitor doing the work — is thin. Only five published reviews exist, so there is little independent signal on the experience.
- From
- $59/mo
- Consult
- Free
- Delivery
- Same-Day Shipping
- 3
Hims
Best chewable option
4.1our score
Hard Mints at $1.63 a use are the cheapest chewable ED medication in telehealth and one of the few offered at scale, backed by all-fifty-state coverage, two-to-five day delivery and the largest fulfilment operation in the category. Ties on score with Maximus and Roman.
Stands out for
- Hard Mints chewable listed at $1.63 a use
- Sildenafil listed at $4 a dose in 25 mg, 50 mg and 100 mg
- All fifty states, two to five day delivery
Not for you if
The highest-volume asynchronous intake on this page, which is the least suitable place to work through a cardiac history or a long medication list. Subscription cancellation is the most-cited complaint against the brand and applies to ED plans the same as any other.
- From
- $4/dose
- Consult
- Free
- Delivery
- 2-5 Days
- 4
Maximus
Best for partial responders
4.1our score
The only provider here offering a tadalafil-and-vardenafil sublingual protocol — two PDE5 inhibitors with different onset and duration profiles under one prescription, written by board-certified physicians. It exists for the man whose first monotherapy half-worked, which is the case most platforms have no answer to.
Stands out for
- Tadalafil sublingual listed at $49.99 a month
- Tadalafil plus vardenafil dual-compound protocol available
- Board-certified prescribers, all fifty states, free priority shipping
Not for you if
The dual-compound protocol is a clinical-judgement upgrade, not a default, and published evidence comparing it to single-drug therapy is limited. If plain tadalafil works, you are paying for an option you do not need at $49.99 a month.
- From
- $49.99/mo
- Consult
- Free
- Delivery
- 3-5 Days
- 5
Roman
Best experience
4.1our score
The most polished platform in men's telehealth, 8,400 published reviews, the largest prescriber network and a free-consult flow that turns around fast. Included and ranked purely on merit — our affiliate programme with Roman is unapproved, so this listing earns us nothing.
Stands out for
- Generic sildenafil or tadalafil listed at $15 a dose
- 8,400 published reviews, all fifty states
- Free consultation with fast prescriber turnaround
Not for you if
Breadth over depth, and at $15 a dose it is several times the per-dose price of Strut Health or Hims for the same generic molecules. You are paying for the interface and the support operation, not the medication.
- Consult
- Free
- Delivery
- 2-5 business days
- 6
PeterMD
Best medication catalogue
4.0our score
Sildenafil and tadalafil across the full strength range plus the Mt. Everest compounded combination, all under one prescriber, with 13,882 published reviews behind the operation. If your first dose needs changing, the next option is on the same account.
Stands out for
- Sildenafil listed at $62.50 for ten tablets, about $6.25 each
- Mt. Everest combination available alongside the plain generics
- 13,882 published reviews; free physician consultation
Not for you if
The ED intake does not order a testosterone panel by default, so a case that is actually hormonal will be treated as if it were vascular. Turnaround is five to seven days, the slowest here, and the 44-state footprint is the narrowest.
- From
- $62.50
- Consult
- Free
- Delivery
- 5-7 Days
- 7
DudeMeds
Best flat monthly subscription
3.9our score
Sildenafil or tadalafil at $19 a month with the consultation, the shipping and the medication in one figure and nothing charged on top. For a man who wants a predictable line on the card statement rather than a per-dose calculation, that is the clearest offer here.
Stands out for
- ED treatment listed at $19 a month, all inclusive
- Free consultation and free shipping, all fifty states
Not for you if
Four published reviews. There is almost nothing independent to go on, and the catalogue stops at the two standard generics — no chewable, no sublingual, no combination if the first one underperforms.
- From
- $19/mo
- Consult
- Free
- Delivery
- 2-5 Days
- 8
Strut Health
Best per-dose price
3.8our score
Sildenafil at $1.60 a dose and tadalafil at $2.50 is the lowest credible per-dose pricing in US telehealth, with the consultation and shipping free and no subscription required. Placed last on our scoring despite paying us more per click than anyone else on this page.
Stands out for
- Sildenafil listed at $1.60 a dose, tadalafil at $2.50
- Free consultation and free shipping, no subscription
Not for you if
A 3.2-star Trustpilot average over 750 reviews, with shipping delays and unanswered support the recurring themes, and a three-to-seven day pipeline. The saving is real; so is what it costs you when something needs sorting out.
- From
- $1.60
- Consult
- Free
- Delivery
- 3-7 Days
Side by side
| # | Provider | Best for | Score | From | Delivery |
|---|---|---|---|---|---|
| 1 | Sesame Care | Best overall | 4.3 | Not published | Same Day Consult |
| 2 | MangoRx | Best fast-onset format | 4.2 | $59/mo | Same-Day Shipping |
| 3 | Hims | Best chewable option | 4.1 | $4/dose | 2-5 Days |
| 4 | Maximus | Best for partial responders | 4.1 | $49.99/mo | 3-5 Days |
| 5 | Roman | Best experience | 4.1 | Not published | 2-5 business days |
| 6 | PeterMD | Best medication catalogue | 4.0 | $62.50 | 5-7 Days |
| 7 | DudeMeds | Best flat monthly subscription | 3.9 | $19/mo | 2-5 Days |
| 8 | Strut Health | Best per-dose price | 3.8 | $1.60 | 3-7 Days |
Frequently asked questions
- Do you earn money from these recommendations?
- Yes, from some of them, at no additional cost to you. It does not affect the order, and this page is the clearest evidence of that we have. Strut Health carries the highest earnings-per-click of any provider here and places eighth of eight. Sesame Care, whose programme returns under two cents a click, places first. PeterMD, MangoRx and Roman pay us nothing at all. Earnings only ever separate two providers our own scoring rates identically, which is stated in the methodology rather than buried.
- What should an online ED provider check before prescribing?
- One thing above all others. The sildenafil label contraindicates administration to patients using nitric oxide donors such as organic nitrates or organic nitrites in any form, because the combination potentiates their hypotensive effect, and it separately contraindicates guanylate cyclase stimulators such as riociguat. A legitimate intake asks about nitrate medication, recent cardiac events, blood pressure control and your full medication list, and escalates rather than prescribes when an answer flags. A form that asks none of that and prescribes anyway is not screening you.
- Is the cheapest per-dose price actually the cheapest?
- Only if you use it at the frequency the pricing model assumes. At $1.60 a dose, Strut Health is cheaper than everyone for a man taking four tablets a month — about $6.40 — and DudeMeds' $19 a month is cheaper for anyone taking twelve or more. Maximus at $49.99 a month and MangoRx at $59 only make sense at daily or near-daily use, or for the specific formats they carry. Work out your own frequency before comparing two headline numbers that are measuring different things.
- Why is BraveRX not on this list?
- Because there is nothing to rank it on. BraveRX appears in our ED directory and scores 3.0, but it publishes no price and no state list before you complete its intake quiz — our catalogue records its starting price as the sentence "Pricing shown after the intake quiz" and holds no pricing tiers at all. Its compounded combinations, which include apomorphine and icariin alongside the standard PDE5 inhibitors, are also formulations no standard generic pharmacy will make, and we could not source what they cost. It still appears on the ED provider hub, where nothing is being ranked.
- Is generic sildenafil as good as Viagra?
- Same active ingredient, same strengths, same mechanism — sildenafil citrate at 25 mg, 50 mg and 100 mg is sildenafil citrate whoever dispenses it. The difference is the distribution model and the price, which is why per-dose figures on this page run from $1.60 to $15 for what is pharmacologically the same tablet. A small minority of patients report tolerability differences between brand and generic that come from inactive ingredients rather than the drug, but that is uncommon and not a reason to start with the brand.
- What if the medication does not work?
- Test the prescribed dose properly first — PDE5 inhibitors need sexual stimulation to work at all, and sildenafil in particular is blunted by a heavy meal and by alcohol — across two or three attempts rather than one. Then ask the prescriber to titrate: sildenafil to 100 mg or tadalafil to 20 mg covers most cases. If the maximum dose does nothing, the drug is not the problem, and no telehealth platform on this page is the right place to find out what is. Sudden-onset ED under fifty in particular is often the first sign of vascular disease and warrants an in-person cardiovascular workup.
Related
Educational reference, not medical advice. Which provider suits you depends on your labs and your history — that is a conversation with a clinician, not a ranking.