PeterMD ED & Sexual Health Review

Complete the ED intake — symptom pattern (episodic vs persistent, onset timing), current medications, blood pressure history, cardiovascular flags, and treatment goals. The free initial consult is async-first for ED (video upgrade available); most PDE5 prescriptions are written within 24 hours of intake completion.

First medication shipment lands in 2–5 business days (faster than the TRT side because no lab work is gating the script). Start with the prescribed dose — typically sildenafil 50mg or tadalafil 10mg for first-time users. Test the response over 2–3 sexual encounters before judging the dose.

Response should be clear by now. If the starting dose is producing reliable function, stay there. If response is partial, message the prescriber for a dose titration — sildenafil up to 100mg or tadalafil up to 20mg covers the majority of cases. If response is absent at maximum dose, the issue is usually not the PDE5 inhibitor — it's an underlying cause (hormonal, vascular, or psychological) that needs a different evaluation.

For men where PDE5 inhibitors are working, this is the maintenance phase — periodic refills, occasional dose check-ins, no required follow-up labs. For men where response is poor, six months is the point to step back and re-evaluate: have a real cardiovascular workup, check hormones, or pivot to shockwave therapy / P-Shot / Trimix at an in-person clinic. PeterMD will refer out for cases that need that next step.