Men’s health, measured
ED has causes. Causes have treatments.
A licensed medical provider reviews your health privately and tells you what’s appropriate — even when the answer is no.
Erectile dysfunction is more common than most men ever say out loud — and it almost never gets said to the one person who can actually do something about it. That’s the entire model here: a private online assessment, an honest read of your health by a licensed medical provider, and medication options only where they’re appropriate for you.
Start Your AssessmentSee the Options
The one thing to know before you spend a dollar.
Actually two, and neither is marketing. First: if you take nitrates in any form — nitroglycerin, isosorbide, tablets, patches, or sprays — sildenafil and tadalafil are off the table. The combination can drop your blood pressure to dangerous levels. It is not negotiable, and it is the first thing screened. Second: ED can be an early warning sign of cardiovascular trouble, because the arteries involved are small and can show strain first. So even if this program isn't the right fit for you, don't ignore it — get a medical provider to look at the health behind it. Start the private assessment; a licensed medical provider screens nitrates first and tells you what's appropriate, even when that's no.
Nobody plans to end up on this page.
You’ve started going to bed later than she does — on purpose. The moment gets close and instead of being in it, you’re managing it. It’s been long enough that "tired" stopped covering it, and the silence around it has gotten louder than the thing itself.
None of that makes you less of anything. It makes you a man with a medical condition — one of the most common in men’s health, and one medicine has real options for. The way through isn’t a pep talk, and it isn’t an unregulated pill from a gas-station counter. It’s a licensed medical provider looking at your actual health and making an actual call.
It’s blood flow and signaling — and sometimes it’s a warning light.
An erection is a vascular event that starts in the brain: arousal signal, nerve response, blood flow. ED means something along that chain isn’t keeping up, and the list of causes is longer than most men assume — blood-pressure and cholesterol changes, diabetes, low testosterone, medication side effects, sleep problems, alcohol, stress.
Here’s the part worth taking seriously: the arteries involved are small, so trouble can show up here years before it shows up anywhere else. Treating ED without looking at the health behind it is treating the dashboard light instead of the engine. That’s why this intake asks real health-history questions — and why "just take a pill" with nobody reviewing your case is the wrong model.
The signal chain
One more thing, said plainly: if what’s weighing on you is more than physical — stress, low mood, a rough stretch — say so in the intake. The 988 Suicide & Crisis Lifeline is there to call or text, any hour, and your medical provider can help sort what’s medical from what isn’t.
Two mechanisms. One decision — and it isn’t made from a menu.
Sildenafil and tadalafil
work on the blood-flow side. They don’t create arousal; they support the vascular response once arousal is there. The practical difference between them is time: sildenafil is shorter-acting and taken as needed, while tadalafil stays active longer — up to about a day and a half — which is why it can also be prescribed as a low daily dose. Sildenafil is the active ingredient in Viagra®; tadalafil is the active ingredient in Cialis®. What’s offered here is not those brand-name products — the plain-English difference is spelled out further down this page.
Apomorphine
works upstream — on dopamine signaling in the brain rather than on blood flow. Two honest sentences about it: no FDA-approved ED medication contains apomorphine, and its published evidence for ED is thinner than sildenafil’s or tadalafil’s. It exists here only inside compounded combination tablets, and whether that trade-off makes sense for you is your medical provider’s call, not a checkout option.
The ODT format. Every option on this page is an orally disintegrating tablet — it dissolves in your mouth, no water, no pill bottle rattling around a gym bag. The format is a convenience, not a potency claim.
The actual menu. Per-pouch prices, no decoder ring.
Everything below is prescription-only and provider-gated: which medication, which strength, and whether any of this is appropriate for you is decided by a licensed medical provider from your health history — not self-selected from a menu. Prices are per pouch of ODT packets, supplied per your plan.
Combination ODTs (compounded)
| Option | In each ODT | 6-pack pouch | 12-pack pouch |
|---|---|---|---|
| Triple Powered — High | Sildenafil 110 mg + tadalafil 22 mg + apomorphine 2 mg | $132 | $216 |
| Triple Powered — Low | Sildenafil 55 mg + tadalafil 11 mg + apomorphine 2 mg | $126 | $204 |
| Double Powered — High | Sildenafil 110 mg + tadalafil 22 mg | $120 | $192 |
| Double Powered — Low | Sildenafil 55 mg + tadalafil 11 mg | $114 | $180 |
| Powered Up — Tadalafil | Tadalafil 10 mg + apomorphine 2 mg | $108 | $168 |
| Powered Up — Sildenafil | Sildenafil 50 mg + apomorphine 2 mg | $108 | $168 |
Classic single-molecule ODTs (compounded)
| Option | Dosing | Pouch price |
|---|---|---|
| Classic Tadalafil | 10/20 mg as needed · or 2.5 mg daily | $72 per 12-packet pouch · $112 per 28-packet daily pouch |
| Classic Sildenafil | 50/100 mg as needed | $72 per 12-packet pouch |
More molecules isn’t automatically better — it’s more pharmacology, which is exactly why a medical provider decides. These cards are informational: you don’t pick a strength here. Your options are confirmed at the end of the medical intake, after a licensed medical provider has reviewed your history and determined what’s appropriate to offer you. Cancel any time; future pouches stop billing.
How the trade-offs line up — not a checkout. Which molecule, which strength, or whether any of this is appropriate is decided by a licensed medical provider from your health history, not from this strip.
You want something only when the moment calls for it
A shorter-acting molecule taken as needed — sildenafil is shorter-acting and used as needed.
You'd rather not plan around timing
The longer-acting molecule stays active up to about a day and a half — which is why it can also be prescribed as a low daily dose. That's tadalafil.
Swallowing pills is the annoying part
Every option here is an orally disintegrating tablet — dissolves in your mouth, no water. The format is a convenience, not a potency claim.
You take nitrates, or your cardiovascular picture needs attention first
The honest answer may be no medication until that's addressed — and that's your provider's first screen, not an afterthought.
Private by design. Reviewed by a person.
1
Assessment — an online intake, about five minutes: health history, every medication you take (blood-pressure medicines and nitrates especially), and what’s changed. Completing it costs nothing.
2
Provider review — a medical provider licensed in your state reviews your case asynchronously, typically within 24–48 hours. Not an algorithm. Not a sales page.
3
A visit only when it’s needed — if your case calls for a live conversation, you get a prescheduled video visit with a medical provider. If it doesn’t, you skip it. Async-first is the default, not a shortcut past medicine.
4
Ships, then stays reviewed — if prescribed, your medication ships from a state-licensed compounding pharmacy in discreet packaging, and a refill review with your medical provider every 12 weeks keeps the prescription honest.
Because these medications aren’t controlled substances, availability is broader than testosterone therapy — the assessment confirms your state in about a minute.
Read this part even if you skip the rest.
Nitrates are a hard stop.If you take nitrates in any form — nitroglycerin tablets, patches, sprays, isosorbide — sildenafil and tadalafil are off the table. The combination can drop blood pressure to dangerous levels. This is the first thing your medical provider screens for, and it is not negotiable.
Your heart goes first.Sex is exertion. If your cardiovascular picture can’t safely carry exertion — a recent cardiac event, unstable chest pain, uncontrolled blood pressure — the answer to ED medication may be no until that’s addressed. A provider who won’t say no isn’t protecting you.
Prostate and blood-pressure medicines interact.Some prostate-relaxing medications and some antihypertensives stack with these medications’ blood-pressure effects. List everything in the intake; dosing decisions depend on it.
The everyday list.Headache, flushing, congestion, upset stomach; sildenafil can cause temporary visual changes, tadalafil can cause back or muscle aches. Apomorphine adds its own: nausea, dizziness, drowsiness, yawning, and drops in blood pressure. Most effects pass; your medical provider tells you which ones shouldn’t be waited out.
The emergency line.An erection lasting more than four hours is a medical emergency that can cause permanent damage — emergency room, not wait-and-see. Same for chest pain during sex, or any sudden change in vision or hearing.
Never stack.Don’t combine these with any other ED medication — including "herbal" or gas-station products, which regulators have repeatedly found to contain undisclosed prescription-strength ingredients at unknown doses.
All of this is why the model is provider-gated. Your medical provider decides — and the answer might be no. That’s the feature, not the fine print.
What these are — and what they aren’t.
Sildenafil is the active ingredient in Viagra®. Tadalafil is the active ingredient in Cialis®. Those brand-name products are FDA-approved; the compounded ODTs offered through this program are not FDA-approved — they’re a different regulatory category. Each one is prepared to your medical provider’s prescription by a state-licensed compounding pharmacy. Same molecules, in the case of sildenafil and tadalafil; not the same drug products, and not the products studied in the brand-name clinical trials. Apomorphine goes a step further: it isn’t an ingredient in any FDA-approved ED medication at all, in any form.
What the compounded route offers: combinations and a dissolving-tablet format that don’t exist as brand-name products, at the per-pouch prices printed above. What it doesn’t offer: FDA approval, or a claim to be the same thing. You’ll see other sites blur that line. We’re required not to — and we wouldn’t anyway, because the men reading this page can handle the actual facts.
Brand-name products
Approval statusFDA-approved drug products — Viagra® (sildenafil), Cialis® (tadalafil).
Evidence baseThe products studied in the brand-name clinical trials.
FormatConventional tablets.
Compounded ODTs
Approval statusNot FDA-approved — a different regulatory category.
Who prepares itA state-licensed compounding pharmacy, to your medical provider’s prescription.
FormatOrally disintegrating tablets, including combinations that don’t exist as brand-name products.
Straight answers, short version.
Is this available in my state?
Broadly, yes — these aren’t controlled substances, so availability is wider than TRT. The assessment confirms your state in about a minute.
Do I need labs first?
Generally no for ED. The intake asks real health-history questions instead, and if something in your answers needs a closer look, your medical provider handles it — including a video visit when your case requires one.
Can I just order the strongest one?
No. Which option and strength — or whether medication is appropriate at all — is your medical provider’s decision, made from your health history.
I take heart or blood-pressure medication. Is this off the table?
Nitrates, yes — that combination is dangerous and is screened out first. Other medications require provider judgment; list everything in the intake.
Are these the same as Viagra® or Cialis®?
No. Sildenafil and tadalafil are the same active molecules, but compounded ODTs are not the brand-name drugs and are not FDA-approved. The full plain-English breakdown is above.
Will anyone know?
Packaging is discreet, and the assessment happens privately online — no waiting room, no pharmacy counter conversation.
From the Learn library
Two plain-language guides that go deeper than this page — how the online path actually works, and how the two most common molecules really differ.
Learn · Sexual Health
How Online ED Treatment Actually Works
The async provider review, when a live visit is required, and the one screening question that can stop everything.
Read the guide →
Learn · Sexual Health
Sildenafil vs. Tadalafil: The Honest Differences
Two molecules, one real difference — time. Plus what an ODT is versus a branded tablet.
Read the guide →This isn’t for everyone.
Some men who complete this assessment don’t get an ED prescription — a medication conflict, a blood-pressure picture that needs attention first, or an underlying cause that deserves treatment instead of masking. If that’s you, a medical provider tells you directly, before you pay for medication. That’s not the system failing. That’s the system.
If medication is appropriate, it ships discreetly, at the per-pouch prices printed above, with a real review every 12 weeks.
Either way, you stop pretending it isn’t happening.
Start Your Assessment
Gentlemen’s Health Collective is a men’s telehealth platform and does not provide medical services; all medical care is provided by our medical provider partner, an independent network of US-licensed medical providers. All medical decisions — including whether treatment is appropriate, which medication, and at what strength — are made by a medical provider licensed in your state; prescriptions are issued only where clinically appropriate. Compounded preparations of sildenafil, tadalafil, and apomorphine (including all combination ODTs shown on this page) are not FDA-approved for these specific formulations; they are dispensed by state-licensed compounding pharmacies operating under USP <795> standards and are distinct from brand-name, FDA-approved products such as Viagra® (sildenafil) and Cialis® (tadalafil). Apomorphine is not an ingredient in any FDA-approved medication for erectile dysfunction. Individual results vary; clinical trial data, where referenced, applies to the brand-name, FDA-approved products and not to compounded preparations. ED medications must never be combined with nitrates. Seek emergency care for an erection lasting more than four hours, for chest pain, or for sudden vision or hearing changes. Prices shown are per pouch as stated; pouches are supplied and billed per the plan you confirm at the end of the medical intake; refill reviews with a medical provider occur every 12 weeks. No surprise price hikes — any pricing change is communicated in advance, before it affects your plan. 100% self-pay; insurance is not required or billed. Cancel any time; future pouches stop billing; past payments are not refundable. This program is not a substitute for primary medical care, and this page is general information, not medical advice; it describes no guaranteed outcomes. If you are experiencing a medical emergency, call 911. If you are struggling with low mood or thoughts of self-harm, call or text 988 (Suicide & Crisis Lifeline), any hour.