Injection
PT-141
Bremelanotide, a melanocortin agonist for low sexual desire (FDA-approved in women; used off-label in men). On-demand dosing before sexual activity.
Starting at $159/mo
Explore sexual health treatments
built around your physiology.
Confidence, on your terms. Performance has a physiology behind it. We look at the whole picture, hormones included, and treat the cause, not just the moment. Discreetly, start to finish.
A change in performance is a signal,
worth reading, not hiding.
Erection problems become more common with age, and in large cohort studies they go together with a higher risk of heart attack and other cardiovascular events.¹ Weight, blood pressure, blood sugar and activity affect both the heart and the erections.²
Our in-house care team of U.S.-licensed physicians and nurse practitioners checks your heart risk, your hormones and the medicines you take, then chooses a treatment and adjusts it as your body responds, so you are never guessing about the next step.
- 1.Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies, Vlachopoulos CV et al., Circulation: Cardiovascular Quality and Outcomes, 2013.
- 2.Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial, Esposito K et al., JAMA, 2004.
What the research shows
for performance and the years ahead.
- Better function69%
of sexual attempts succeeded with sildenafil, dose raised as needed up to 100 mg, in men with erectile dysfunction in the last four weeks of a 12-week study, versus 22% with placebo (329 men in the dose-escalation study).
Sildenafil Study Group, NEJM 1998 - Lower risk, observed25%
lower risk of death from any cause among 23,816 men with erectile dysfunction and heart risk factors who had a PDE5 inhibitor prescription, compared with 48,682 similar men who did not, followed for about three years. Observational: an association, not a trial.
Kloner RA et al., Journal of Sexual Medicine, 2023 - Better with weight loss31%
of obese men with erectile dysfunction (17 of 55) reached an IIEF score of 22 or more after a program to lose 10% or more of body weight, versus 3 of 55 men given general advice.
Esposito K et al., JAMA, 2004
Across 92,757 men followed for about six years in pooled cohort studies, erectile dysfunction went with a 25% higher risk of death from any cause. Vlachopoulos CV et al., Circulation: Cardiovascular Quality and Outcomes, 2013
Trial results are with sildenafil at the doses studied, in men with erectile dysfunction, using brand-name products. Our products are compounded or generic versions, which these trials did not study. Cohort figures show an association, not that a medicine or a treatment makes life longer. All figures are averages, not predictions for you.
The right treatment
fits your health, not a formula.
Most men do not need a routine built from scratch. A physician reviews your heart, your medicines and your hormones, chooses the dose and schedule that suit you, and stays with you when something changes, including how you feel about it.
Our physicians look at the whole picture first, check the heart when it matters, and treat the cause, discreetly from start to finish, with plans starting at $59 a month.
Start hereWe study the parts of sexual health
most programs overlook.
Performance is only the visible part. An erection is a signal from the blood vessels, and treatment choices depend on the heart, the hormones and the medicines you already take. Our research pages set out what the trials show, with their limits.
Erections as a vital sign:
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
Every sexual health treatment,
in one place.
Real products and real prices from our pharmacy. Your physician helps you choose the medicine, the form and the dose.
Injections
5Measured doses you give yourself at home, usually once a week or once a day.
Injection
Phenylephrine Injection
Emergency intracavernosal alpha-agonist (vasoconstrictor) to reverse priapism (erection lasting >4 hours). Use as directed by provider only.
Starting at $169/mo
Injection
Bi-Mix Injection
Combination of papaverine and phentolamine for intracavernosal injection. Vasodilator mix for erectile dysfunction. Priapism risk and rescue requirements.
Starting at $171/mo
Injection
Quad-Mix Injection
Four-drug intracavernosal injection (papaverine, phentolamine, PGE1, and atropine) for maximum vasodilation. Advanced formulation requiring careful dosing.
Starting at $171/mo
Injection
Tri-Mix Injection
Three-drug intracavernosal injection (papaverine, phentolamine, and PGE1/alprostadil) for potent penile vasodilation. Requires proper injection technique and priapism awareness.
Starting at $179/mo
Dissolving tablets
4Dissolves under the tongue. No needles.
Dissolving tablet
Sildenafil / Tadalafil ODT
Sildenafil and tadalafil in one orally disintegrating tablet: a quick start with a long window, taken as needed before sex. Prescribed by a licensed physician.
4, 8 or 12 tablets per month
Starting at $59/mo
Dissolving tablet
Sildenafil ODT
Sildenafil citrate dissolving tablets for rapid sublingual absorption and convenient dosing.
4, 8 or 12 tablets per month
Starting at $59/mo
Dissolving tablet
Tadalafil ODT
Tadalafil dissolving tablets for convenient daily dosing and as-needed use, supporting consistent sexual function and spontaneity.
4, 8 or 12 tablets per month
Starting at $79/mo
Dissolving tablet
Oxytocin ODT
Oxytocin in orally disintegrating tablet form. Supports sexual desire, bonding, and mood. Taken daily by mouth or before intimacy.
30 tablets per month
Starting at $129/mo
Troches
11A small lozenge that dissolves in the mouth.
Troche
Sildenafil / Tadalafil Troches
Combination troche of two PDE5 inhibitors for potent effect and extended duration. Rapid sublingual absorption.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Sildenafil SL Troches
Sildenafil citrate sublingual troches, 125 mg formulation for enhanced effect. Rapid onset under the tongue.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Sildenafil Troches
Sildenafil sublingual troches for rapid onset, absorbed under the tongue for faster effect than tablets. As needed before sexual activity.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Tadalafil / Apomorphine
Combination of tadalafil and apomorphine for dual-mechanism erectile support with potential dopamine agonism. Note nausea and hypotension risk.
4, 8 or 12 doses per month
Starting at $59/mo
Troche
Tadalafil / Sildenafil / Apomorphine Troches
Triple combination troche with dual PDE5 inhibitors plus apomorphine for maximum potency and central dopamine stimulation.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Tadalafil Troches
Sublingual tadalafil troche for rapid absorption with extended duration. Quick onset, hours-long effect.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Apomorphine / Sildenafil / Tadalafil / Vardenafil Troches
Quad-mix troche combining three PDE5 inhibitors with apomorphine dopamine agonist for maximum potency and comprehensive mechanism.
4, 8 or 12 troches per month
Starting at $69/mo
Troche
Tadalafil / Vardenafil / Apomorphine Troches
Combination of tadalafil (extended duration) and vardenafil (rapid onset) with apomorphine for comprehensive dual-PDE5 and dopamine support.
4, 8 or 12 troches per month
Starting at $69/mo
Troche
Vardenafil / Apomorphine
Combination of vardenafil and apomorphine in both capsule and troche forms for dual-mechanism erectile support.
4, 8 or 12 doses per month
Starting at $69/mo
Troche
Female Desire Troches
Sublingual troche for female sexual desire and arousal. Combines apomorphine, bremelanotide, oxytocin, and L-theanine for comprehensive support.
4, 8 or 12 troches per month
Starting at $59/mo
Troche
Oxytocin Troches
Oxytocin in troche (lozenge) form with creme de menthe flavoring. Supports sexual desire and bonding with pleasant taste.
30 troches per month
Starting at $129/mo
Tablets
2Taken by mouth with water.
Tablet
Sildenafil Tablets
Commercial sildenafil tablets for erectile dysfunction, prescribed at multiple strengths for flexible dosing. As needed before sexual activity.
4, 8 or 12 tablets per month
Starting at $59/mo
Tablet
Tadalafil Tablets (Commercial)
Commercial tadalafil tablets for daily and as-needed dosing, supporting consistent sexual function and spontaneity.
4, 8, 12 or 30 tablets per month
Starting at $59/mo
Capsules
4Taken by mouth with water.
Capsule
Sildenafil Capsules
Sildenafil citrate capsules for rapid absorption, offering as-needed erectile support with moderate duration.
4, 8 or 12 capsules per month
Starting at $59/mo
Capsule
Tadalafil Capsules 25 mg
Tadalafil capsule for as-needed or daily use, providing 24-36 hour duration. Flexible dosing for erectile dysfunction.
4, 8 or 12 capsules per month
Starting at $59/mo
Capsule
Vardenafil Capsules
Vardenafil capsules for as-needed erectile support with moderate duration. Reliable PDE5 inhibition.
4, 8 or 12 capsules per month
Starting at $59/mo
Capsule
Tadalafil - Men
A low daily dose of tadalafil that improves blood flow, so you can get and keep an erection when aroused at any time of day, without planning around a pill. Prescribed and dosed by a licensed physician.
30 capsules per month
Starting at $149/mo
Creams
3Applied to the skin at the same time each day.
Cream
Climax Cream
Topical cream for female sexual enhancement and orgasm support. Combination of arginine, ergoloid, pentoxifylline, sildenafil, and theophylline.
Starting at $116/mo
Cream
Ecstasy Cream for Her
Topical cream for female sexual arousal and pleasure. Contains oxytocin, theophylline, arginine, and sildenafil for enhanced sensation and response.
Starting at $138/mo
Cream
Intimate Moisturizer (Hyaluronic Acid / Vitamin A / Vitamin E)
Long-acting vulvar moisturizer for vaginal dryness, atrophy, and discomfort. Non-hormonal support for intimate health.
Starting at $179/mo
Solutions
1Applied with a dropper.
Solution
Sildenafil / Tadalafil / Vardenafil Drops
Triple-PDE5 inhibitor solution in ampules, one per day for sustained sexual function and confidence over 30 days.
Starting at $139/mo
30 treatments in this area, all from our live catalog.
Questions,
answered.
Contact supportWhich one is right for me?
Sildenafil works for about 4 to 6 hours; vardenafil is similar; tadalafil can last up to 36 hours and also comes as a low daily dose. Your physician recommends one based on your health, your other medicines and how you want to take it.
Daily or as needed?
As-needed doses are taken before sex. Daily low-dose tadalafil keeps a steady level so you don't have to plan. Your physician helps you choose.
How fast does it work?
Most as-needed doses are taken 30 to 60 minutes before sex; troches and dissolving tablets are taken 20 to 30 minutes before. Sexual stimulation is still needed.
What are the common side effects?
Headache, flushing, stuffy nose, indigestion and back or muscle aches are the most common, and usually mild. Seek help right away for an erection lasting more than 4 hours or a sudden change in vision or hearing.
Can I take it with my other medicines?
Never with nitrates or riociguat. Alpha-blockers and some other medicines need care. List everything you take in your evaluation so your physician can check.
How is it billed?
Monthly, every 3 months or every 6 months; longer plans cost less per month. Shipping is free and you can pause or cancel anytime.