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The ways healthcare is delivered have certainly changed in recent years. That includes the ways men can be evaluated for sexual dysfunction, get treatments, and buy medications for their conditions.

The online company Hims has established itself as a provider of products and services not just for sexual health, but also for hair, skin, nutrition, and other aspects of wellness.

If you’re seeking treatment for erectile dysfunction (ED), Hims provides both generic and brand-name medications, as well as licensed physicians to give online diagnoses and guidance.

The company provides similar medical advice and products for premature ejaculation, too.

Let’s take a look.

Hims Inc. was launched in 2017. Hims was joined by their sister company, Hers, a year later.

Hims is a telemedicine company focused on personal wellness. They allow users to provide personal health information to be reviewed by a staff of doctors.

These doctors can, if appropriate, prescribe ED medications. A Hims user can then buy these medications on the Hims website, often for much less money than what other retailer pharmacies charge.

Prescription drugs must be purchased with a Hims subscription that delivers a month’s worth of medications 12 times a year. You can purchase nonprescription products a la carte.

Though many medications and supplements on the market promise to treat ED, Hims focuses on five medications approved by the Food and Drug Administration (FDA). They’re a mix of generic and brand-name products.

Generic versions of well-known medications such as Viagra and Cialis are available at a much lower cost than their brand-name counterparts. Although cheaper, they’ve still gone through a rigorous regulatory approval process to verify their safety and effectiveness.

The following ED treatments are available in pill form. Doses are measured in milligrams (mg):

  • Viagra. Available in 25-mg, 50-mg, or 100-mg doses; lasts 2 to 5 hours.
  • Sildenafil. The active ingredient in Viagra, sold as a generic ED medication with the same doses.
  • Cialis. Available in 2.5-mg, 5-mg, 10-mg, or 20-mg doses; lasts up to 26 hours.
  • Tadalafil. The active ingredient in Cialis, sold as a generic ED drug with the same doses.
  • Avanafil (Stendra). Comes in doses of 50 mg, 100 mg, or 200 mg; lasts up to 6 hours.

For premature ejaculation, Hims sells:

  • Sertraline. The active ingredient in the antidepressant Zoloft, available in pills of 25 mg, 50 mg, or 100 mg.
  • Premature ejaculation spray. Contains lidocaine, which decreases sensitivity of the penis.

Sertraline is also FDA-approved and requires a prescription.

For some, the combination of premature ejaculation treatments and ED medications can be helpful in improving sexual performance.

Through Hims, a licensed physician can assess your medical history and symptoms, and then write appropriate prescriptions for you online.

While the goal of ED medications is to help you get and maintain erections, there are some differences in the three main ingredients in the products offered by Hims. Each is a type of phosphodiesterase type 5 (PDE5) inhibitor.

Active ingredient: sildenafil

Sildenafil helps the muscles in blood vessel walls relax, increasing blood flow to the penis. This makes it easier to get and keep an erection.

The drug won’t cause an erection on its own. Sexual stimulation is still required.

The peak effectiveness of sildenafil is about an hour or so after taking it, so it’s best to take the tablet 30 to 60 minutes before beginning sexual activity. Its effectiveness begins to diminish after about 2 hours.

Active ingredient: tadalafil

Tadalafil is of the same class of drugs (PDE5 inhibitors) as sildenafil, so it works the same way to help you get an erection.

The main difference is that tadalafil stays in the system much longer. The downside is that any side effects from the medication are also more likely to last longer.

Tadalafil is available in a low-dose daily form that takes about 4 to 5 days to become effective. It should stay effective every day as long as you continue to take your daily tablet.

Active ingredient: avanafil

Stendra is a newer PDE5 inhibitor featuring the active ingredient avanafil. It’s not yet available in generic form.

It’s more like sildenafil in that it has a shorter duration than tadalafil. But avanafil differs from sildenafil in some key ways.

It’s faster acting, usually taking about 15 minutes to be effective, and tends to last a little longer.

You can purchase medications directly from Hims on a one-time basis or with a subscription for a monthly supply of the pills mailed 12 times a year.

Subscriptions start at around $20 per month. Medication costs for subscribers include:

  • Viagra: five 50-mg pills for about $425 each month
  • Sildenafil: six 40-mg pills for about $24 each month
  • Cialis: thirty 5-mg pills for about $520 each month
  • Tadalafil: thirty 5-mg pills for about $235 each month
  • Stendra: four 100-mg pills for about $116 each month

The average costs for ED medications through Hims vary considerably, depending on whether you’re buying generic or brand-name products. Also, the nature of the medication and the number of pills provided each month affect the prices.

Buying ED products through Hims isn’t covered by insurance.

Using Hims for ED assessment and treatment could be the right choice for you.

For those with a complex medical history, Hims may not be appropriate. Here are the pros and cons of Hims for ED.

Hims has an A+ rating from the Better Business Bureau, but like many companies, they have their share of positive and negative reviews from customers.

Reviews left on the Better Business Bureau are mixed. Most negative reviews focus on shipping and billing issues rather than the quality of the products. On Trustpilot, customer ratings are also mixed.

Customer comments about getting timely responses are also common, but Hims appears to be willing and ready to address customer complaints with refunds and other solutions.

When used as prescribed, Hims ED medications are generally safe and well tolerated.

But because ED medications affect circulation, it’s important to share with the Hims physicians any information about your cardiovascular health and any other medications you take.

Avoid PDE5 inhibitors if you take alpha-blockers or nitrate medications. The ED medications could cause a dangerous drop in blood pressure.

Less serious side effects of ED medications include:

  • flushing of the face
  • headaches
  • nasal congestion

While moderate alcohol consumption isn’t likely to interfere with any ED medications, excessive drinking can not only limit the effectiveness of the medication, but also lead to complications such as orthostatic hypotension. This is the medical term for a sudden drop in blood pressure that can cause fainting or falls.

When to get medical attention

Seek medical attention if you experience any of these rare but serious side effects of ED medications:

  • priapism, or an erection that doesn’t go away
  • changes to hearing, like sudden hearing loss
  • changes to vision in one or both eyes

Yes, Viagra, Cialis, and Stendra are FDA-approved. However, it’s important to note that the generic versions of those drugs may differ slightly from the original patented drug, although the active ingredients are the same.

That being said, not all Hims products are FDA-approved, since their offerings also include many herbal remedies, medications, and other products. Verify what drug you’re buying and check the FDA status.

In addition to the medications available through Hims, you have many other options to treat ED. They include:

  • other prescription medications
  • supplements
  • lifestyle changes
  • alternative treatments

Start with a healthcare professional

As with any medical concern, your first stop is often a consultation with a primary care physician. You could also see a urologist for treatment.

If you don’t have a primary care doctor, the Healthline FindCare tool may help you find primary care doctors and urologists in your area.

Find a local health clinic

If you don’t have insurance, local health centers, sexual health clinics like Planned Parenthood, and other medical clinics may be able to provide low-cost or free care.

Lifestyle changes

ED can sometimes be a sign of an underlying health condition, or it can reflect a need for some lifestyle changes. Consider the following:

  • Healthy nutrition that focuses on fruits, vegetables, whole grains, and proteins may help your overall health and help you maintain a moderate weight. Overweight and obesity are risk factors for ED.
  • Limiting alcohol consumption may also help improve sexual performance. The same is true for quitting smoking. Smoking harms the health of your blood vessels.
  • Reducing stress may help, too. There are many ways to relieve stress in the present and long term.
  • Treating depression and anxiety can also help. Your psychological health is key to better sexual performance.

Other online services

Telemedicine and subscription services

The online market for reliable ED medications has expanded in recent years, with companies similar to Hims offering prescription medications through the mail.

Like Hims, BlueChew is a subscription service offering monthly supplies of tadalafil and sildenafil pills.

Roman is another online provider of ED medications as well as treatments for other medical issues, such as heart disease and eczema.

If trying an online prescription program for ED medications interests you, do some more research, compare prices and other features, and find a provider with whom you are comfortable.

Online comparison tools for pharmacies near you

Filling prescriptions outside of subscription services like Hims is significantly less expensive. You can price out the cost of these medications at local pharmacies using online tools.

Read more about Hims vs. Roman.

Injections

Though more invasive than taking a pill, self-administered injection therapy is a proven means of treating ED safely and effectively. The medications and syringes used in the injections are available with a prescription only.

Surgery

For a more permanent but even more invasive solution, you may want to talk with your doctor about penile implant surgery.

Prescription pills like those offered through Hims are just one form of treatment for ED.

Choosing the right ED medication for you depends on several key factors, including your lifestyle, overall health, and sexual habits.

Tadalafil (Cialis) is a longer-acting medication, allowing you the spontaneity of sexual activity at any time.

Sildenafil and avanafil, on the other hand, are generally effective for about 4 to 6 hours. They should be taken at least 30 minutes before sexual activity.

Is Hims rights for me?

Hims can be a great service if you know what kind of ED medication is a good solution for you. By using Hims, you get to bypass a regular in-person visit to the doctor or another visit to a pharmacy.

That being said, Hims may not be a great fit for people who would rather explore more natural, non-prescription solutions first.

How often can you take Hims?

According to Hims, doctors will typically prescribe three dose strengths of Viagra — 25 mg, 50 mg, or 100 mg. For most patients, the recommended dose is 50 mg taken as needed, approximately 1 hour before sexual activity.

Based on the effectiveness of the drug and your ability to tolerate it, your provider may adjust the dosage. The maximum dose per day is 100 mg of sildenafil, so don’t take any more if that much is working for you.

Is it safe to use with other ED medications?

Doctors don’t advise you to combine any ED medications for a better erection on your own. None of these drugs are approved by the FDA for use with one another.

Hims is a telemedicine company that specializes in medications for sexual dysfunction and other wellness products.

It offers privacy and “one-stop shopping” that allows you to consult with a licensed doctor and receive a prescription for an ED medication before subscribing to get the medication delivered monthly to your home.

Hims can provide convenience, ease of access, and privacy for getting ED medications, but other options may be more affordable.