The ways healthcare is delivered have certainly changed in recent years. That includes the way 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 not just of products and services related to sexual health, but for hair, skin, nutrition, and other aspects of wellness.

For men seeking treatment for erectile dysfunction (ED), Hims provides both generic and brand-name medications as well as licensed physicians to provide 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. It was joined by its sister company, Hers, a year later.

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

These doctors can, if appropriate, prescribe ED medications that a Hims user can then buy 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. Nonprescription products can be purchased a la carte.

Though there are many medications and supplements on the market promising 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: 25 mg, 50 mg, or 100 mg; lasts 2 to 5 hours
  • Sildenafil: the active ingredient in Viagra, sold as a generic ED medication with same doses
  • Cialis: 2.5 mg, 5 mg, 10 mg, 20 mg; lasts up to 26 hours
  • Tadalafil: the active ingredient in Cialis, sold as a generic ED drug with same doses
  • Stendra (avanafil): 50 mg, 100 mg, 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 men, the combination of premature ejaculation treatments and ED medications can be helpful in improving sexual performance.

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

While the goal of ED medications is to help men achieve and maintain erections, there are some differences in the three main ingredients in Hims’ products. 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 achieve 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 men achieve erections.

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 linger 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.

Medications are purchased 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:

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

The average costs for ED medications through Hims varies 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 may be the right choice for many men.

For those with a complex medical history, it 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, it has its 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 were 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.

You should 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 it can 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 (an erection that doesn’t go away)
  • changes to hearing, like sudden hearing loss
  • changes to vision in one or both eyes

In addition to the medications available through Hims, you have many options to treat ED. They include other prescription medications, supplements, lifestyle changes, and alternative treatments.

Start with a healthcare provider

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

If you don’t have a primary care provider, the Healthline FindCare tool may help you find primary care providers 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 lose weight if necessary. 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.


Though more invasive than popping 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.


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 men 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.

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.