Addressing Underlying Health Conditions for Better Results

You can opt for larger shipments to reduce your cost per dose, and that can save you over 30%, but it results in significant up-front costs. For example, a monthly six-pack of medium strength Ready is $99. To get the best cost per dose, you can get 12 of those six-packs shipped to you quarterly for $799. That’s a lot of savings, but it’s likely cost-prohibitive for many men.

Premature Ejaculation (PE)

Talkspace stands alone among these companies for two reasons. First, it allows you to manually delete messaging information between you and your doctor if you switch doctors and want a clean slate. Having all your old messages accessible to your new doctor may introduce certain prejudices in treatment, or you simply may want to start from scratch for your own sake. To learn more about Rugiet’s offering, check out our comprehensive review of their services.

Rugiet has also expanded its catalog to include a daily tadalafil combined with DHEA to boost testosterone, but we don’t regard DHEA as a very good option for improving testosterone levels with an OTC treatment. You can also get a combination of tadalafil with either minoxidil or paroxetine to treat hair loss or premature ejaculation concurrently with ED, but both treatments have less tadalafil in them than comparables from Hims. Hims has led the way in the chewable combination space since they introduced their Hard Mints and Sex Chews. Recently, the company has expanded these efforts to introduce several new combination treatments that combine common ED medications with ingredients to treat hair loss, premature ejaculation, and more. Here’s a quick look at some of its simpler combination chewables: Hims also offers more novel combinations that slightly outperform those Rugiet recently added to its catalog. This product combines daily tadalafil (likely as a 2.5mg or 5mg dose) with an unspecified dose of fluoxetine, a prescription selective serotonin reuptake inhibitor (SSRI) that’s been studied for years in the context of premature ejaculation.26 Like Climax Control, this Sex Rx product uses daily tadalafil as its ED-fighting base, combined with oral finasteride and oral minoxidil. It’s unclear at this time if the medication can be delivered with just one of those two hair loss medications, but both have been shown to be very effective as oral treatments.27 Again, this drug combination starts with tadalafil, and Hims has combined it with atorvastatin, a statin designed to reduce your risk of certain cardiovascular events, like myocardial infarction.28 Then there’s Roman’s combination sex chew offering, called Sparks, which is only available as a combination of 22mg tadalafil and 55mg sildenafil for the constant rate of $12/dose. That 22mg tadalafil dose is much higher than we’d recommend for men new to ED medications. If you’re used to taking such a high dose, this might be a viable product, but there are superior options with more flexible dosing for lower prices from Hims. BlueChew Max combines tadalafil with either sildenafil or vardenafil, depending on your preference, making it a superior choice for men interested in putting those two together without adding apomorphine to the mix. BlueChew Gold expands in the opposite direction, combining the three medications seen in Rugiet Ready and adding oxytocin to the mix. Oral oxytocin boasts some evidence for improving female sexual fildena 120 desire, and its reputation as “the love hormone” implies that these effects could work just as well in men. But there’s not enough science backing this up just yet.

• ED is often a sign of underlying health problems.
• Cardiovascular health directly affects erectile function.
• Managing chronic illnesses can prevent or improve ED.
• Proactive lifestyle and medical management are essential.
• Emotional well-being is also a key factor.
• Addressing root causes offers the best long-term solution.

That said, as we’ll discuss soon, mental health plays a big role in ED, and oxytocin has been shown to help in cases of anxiety and depression. So, it’s possible that the oxytocin in Gold is there to address potential psychiatric complications around ED, rather than physiological ones.46 Given the current state of available doses, we don’t recommend combination therapies to men who haven’t tried ED medications before. If you discover that a monotherapy can work for you, there’s no reason to add another medication to the picture. If you’ve tried monotherapies and had poor or mixed results at various doses, a combination therapy might be the way to go. In that case, we’d recommend starting with Hims, where you can choose between numerous combinations at slightly better prices and more reasonable doses than you’ll find from Roman, BlueChew, or Rugiet. Our testing also confirmed that Rugiet lozenges are susceptible to high temperatures and may melt if left in a hot car or even outside on a hot enough day. That makes them less ideal for certain situations and climates than more durable chews from Hims or Roman. With up to 40% of ED cases proving to be psychological in origin, a large number of men can find relief through mental health care, whether that’s talk therapy, psychiatry, or a combination of the two.44 You can try to find an in-person therapist or psychiatrist, but the industry has largely moved online over the last several years, so we’ll focus this section on teletherapy resources for mental health that can help men address psychogenic ED. While Cerebral is a little more expensive than some excellent competitors, it offers plans for talk therapy, psychiatry (medication access), or both. That makes it a great place to start for men concerned with psychological issues leading to ED, as they can start with talk therapy and expand their care to include medication if it becomes necessary, without having to switch to another platform. Cerebral also works with several insurance companies, so there’s a good chance you’ll only have co-pays to worry about if you’re covered. Here’s a current list of Cerebral’s insurance partners: Of course, coverage varies by state and by plan, so if your provider is on that list, it’s not a guarantee you’ll be covered. Still, those providers account for more than half the U.S. population, so it would be worth visiting the Cerebral site to check your coverage.

How is ED diagnosed?

Still, those providers account for more than half the U.S. population, so it would be worth visiting the Cerebral site to check your coverage. And if you’re not insured, Cerebral still offers plans that are competitively priced and may still be affordable for you. Other companies offer financial assistance for patients who lack insurance, but the care provided might not be as comprehensive as Cerebral’s offering. Because talk therapy is likely the best place for men concerned with psychogenic ED to start, BetterHelp is a close runner-up to Cerebral.

Heart Disease/High Blood Pressure

It doesn’t offer psychiatric care, so you’d have to switch to another platform if you ultimately need psychiatric medication to address the mental health concerns that are contributing to your ED. That said, if talk therapy is enough to address the problem (perhaps in combination with a PDE5 inhibitor discussed elsewhere in this guide), BetterHelp offers what we feel is the best combination of cost and quality of care. Two of the most common root causes for psychogenic ED are anxiety and depression, which are among the most commonly treated issues in telehealth psychology and psychiatry. As a result, our breakdown of evaluation criteria for ED-related treatment largely followed the same best erection pills standards set in our guide to finding the best online therapy, specifically looking at quality of care, cost, privacy, and platform. Related:The Best Online Therapy in 2026 Evaluating the potential quality of care you might get from one company to the next is nearly impossible, given the thousands of therapists and psychiatrists involved, their diverse backgrounds, and your unique needs.

Are there any natural remedies for erectile dysfunction?

However, there are certain standards we look for in each company’s approach to hiring clinicians that can tell us a lot about the standard of care you can expect. For example, all of Cerebral’s clinicians have either a master’s or doctoral degree from an accredited institution, and the company provides licensing information on each therapist’s biography page. BetterHelp has similar degree and licensing requirements, but its therapists also have to have a minimum of three years or 1,000 hours of practice under their belt. Without that requirement, you might get a doctor with a high-level degree but limited experience actually dealing with patients. Ultimately, you stand a very good chance of receiving high-quality, satisfying care from any of the therapy platforms mentioned in this guide. And if you’re not insured, Cerebral still offers plans that are competitively priced and may still be affordable for you. Other companies offer financial assistance for patients who lack insurance, but the care provided might not be as comprehensive as Cerebral’s offering. Because talk therapy is likely the best place for men concerned with psychogenic ED to start, BetterHelp is a close runner-up to Cerebral.

• Penile implants are a surgical option for severe ED cases.
• Types include inflatable and semi-rigid devices.
• Surgery has a high success rate but involves risks.
• Implants are usually considered after other treatments fail.
• They provide a permanent solution to ED.
• Requires consultation with a urologic surgeon.

It doesn’t offer psychiatric care, so you’d have to switch to another platform if you ultimately need psychiatric medication to address the mental health concerns that are contributing to your ED. That said, if talk therapy is enough to address the problem (perhaps in combination with a PDE5 inhibitor discussed elsewhere in this guide), BetterHelp offers what we feel is the best combination of cost and quality of care. Two of the most common root causes for psychogenic ED are anxiety and depression, which are among the most commonly treated issues in telehealth psychology and psychiatry. As a result, our breakdown of evaluation criteria for ED-related treatment largely followed the same best erection pills standards set in our guide to finding the best online therapy, specifically looking at quality of care, cost, privacy, and platform.

About the Author

BlueChew Gold expands in the opposite direction, combining the three medications seen in Rugiet Ready and adding oxytocin to the mix. Oral oxytocin boasts some evidence for improving female sexual fildena 120 desire, and its reputation as “the love hormone” implies that these effects could work just as well in men. But there’s not enough science backing this up just yet. That said, as we’ll discuss soon, mental health plays a big role in ED, and oxytocin has been shown to help in cases of anxiety and depression. So, it’s possible that the oxytocin in Gold is there to address potential psychiatric complications around ED, rather than physiological ones.46 Given the current state of available doses, we don’t recommend combination therapies to men who haven’t tried ED medications before.

Medical treatments:

If you discover that a monotherapy can work for you, there’s no reason to add another medication to the picture. If you’ve tried monotherapies and had poor or mixed results at various doses, a combination therapy might be the way to go. In that case, we’d recommend starting with Hims, where you can choose between numerous combinations at slightly better prices and more reasonable doses than you’ll find from Roman, BlueChew, or Rugiet. Our testing also confirmed that Rugiet lozenges are susceptible to high temperatures and may melt if left in a hot car or even outside on a hot enough day. That makes them less ideal for certain situations and climates than more durable chews from Hims or Roman.

Panel Members

With up to 40% of ED cases proving to be psychological in origin, a large number of men can find relief through mental health care, whether that’s talk therapy, psychiatry, or a combination of the two.44 You can try to find an in-person therapist or psychiatrist, but the industry has largely moved online over the last several years, so we’ll focus this section on teletherapy resources for mental health that can help men address psychogenic ED. While Cerebral is a little more expensive than some excellent competitors, it offers plans for talk therapy, psychiatry (medication access), or both. That makes it a great place to start for men concerned with psychological issues leading to ED, as they can start with talk therapy and expand their care to include medication if it becomes necessary, without having to switch to another platform. Cerebral also works with several insurance companies, so there’s a good chance you’ll only have co-pays to worry about if you’re covered. Here’s a current list of Cerebral’s insurance partners: Of course, coverage varies by state and by plan, so if your provider is on that list, it’s not a guarantee you’ll be covered. Related:The Best Online Therapy in 2026 Evaluating the potential quality of care you might get from one company to the next is nearly impossible, given the thousands of therapists and psychiatrists involved, their diverse backgrounds, and your unique needs. However, there are certain standards we look for in each company’s approach to hiring clinicians that can tell us a lot about the standard of care you can expect. For example, all of Cerebral’s clinicians have either a master’s or doctoral degree from an accredited institution, and the company provides licensing information on each therapist’s biography page. BetterHelp has similar degree and licensing requirements, but its therapists also have to have a minimum of three years or 1,000 hours of practice under their belt. Without that requirement, you might get a doctor with a high-level degree but limited experience actually dealing with patients.

ED Treatment Options

If you have insurance, Cerebral may be the least expensive option among prominent telehealth providers. If not, or if your insurance is insufficient to bring down Cerebral’s costs, you’ll be better off with BetterHelp. Cerebral’s affordability through insurance will depend on your plan. Regardless of your coverage specifics, there’s still a $30 monthly charge to access the Cerebral platform, and all other billing is through your insurance. So, if you have a $30 co-pay for therapy visits, you’d pay about $36.92 per weekly visit over the course of a year.

SORT: KEY RECOMMENDATIONS FOR PRACTICE

That’s nearly $12 less than the best possible rate you could get from BetterHelp with its maximum financial aid. However, if you’re uninsured or your insurance doesn’t cover Cerebral’s services, the costs would climb dramatically. Out of pocket, Cerebral costs $95/month for medication plans (psychiatry), with medication cenforce tablets billed separately. Therapy costs $295/month, or just over $68/session. That’s a lot cheaper than out-of-pocket costs for in-person therapy, but it’s also much pricier than financially assisted sessions from BetterHelp.

Shockwave Therapy

The top telehealth providers for therapy and psychiatry take your privacy seriously, using things like dedicated video conferencing and messaging software to prevent intrusion. Associated clinicians are also bound by all the same laws restricting the dissemination of patient information that apply to in-person therapy and psychiatry. But these platforms deal in various data pools, including medical records, messaging, payment and insurance information, and more. Some have policies that state the exact amount of time they’ll keep this information in their databases. Some allow you to make specific requests to delete your data; others don’t. Ultimately, you stand a very good chance of receiving high-quality, satisfying care from any of the therapy platforms mentioned in this guide.

Diagnosis and Evaluation

You can opt for larger shipments to reduce your cost per dose, and that can save you over 30%, but it results in significant up-front costs. For example, a monthly six-pack of medium strength Ready is $99. To get the best cost per dose, you can get 12 of those six-packs shipped to you quarterly for $799. That’s a lot of savings, but it’s likely cost-prohibitive for many men. To learn more about Rugiet’s offering, check out our comprehensive review of their services.

Table 5. Clues to the Diagnosis of Erectile Dysfunction

Rugiet has also expanded its catalog to include a daily tadalafil combined with DHEA to boost testosterone, but we don’t regard DHEA as a very good option for improving testosterone levels with an OTC treatment. You can also get a combination of tadalafil with either minoxidil or paroxetine to treat hair loss or premature ejaculation concurrently with ED, but both treatments have less tadalafil in them than comparables from Hims. Hims has led the way in the chewable combination space since they introduced their Hard Mints and Sex Chews. Recently, the company has expanded these efforts to introduce several new combination treatments that combine common ED medications with ingredients to treat hair loss, premature ejaculation, and more. Here’s a quick look at some of its simpler combination chewables: Hims also offers more novel combinations that slightly outperform those Rugiet recently added to its catalog.

Illegal Recreational Drugs

This product combines daily tadalafil (likely as a 2.5mg or 5mg dose) with an unspecified dose of fluoxetine, a prescription selective serotonin reuptake inhibitor (SSRI) that’s been studied for years in the context of premature ejaculation.26 Like Climax Control, this Sex Rx product uses daily tadalafil as its ED-fighting base, combined with oral finasteride and oral minoxidil. It’s unclear at this time if the medication can be delivered with just one of those two hair loss medications, but both have been shown to be very effective as oral treatments.27 Again, this drug combination starts with tadalafil, and Hims has combined it with atorvastatin, a statin designed to reduce your risk of certain cardiovascular events, like myocardial infarction.28 Then there’s Roman’s combination sex chew offering, called Sparks, which is only available as a combination of 22mg tadalafil and 55mg sildenafil for the constant rate of $12/dose. That 22mg tadalafil dose is much higher than we’d recommend for men new to ED medications. If you’re used to taking such a high dose, this might be a viable product, but there are superior options with more flexible dosing for lower prices from Hims. BlueChew Max combines tadalafil with either sildenafil or vardenafil, depending on your preference, making it a superior choice for men interested in putting those two together without adding apomorphine to the mix. If you have insurance, Cerebral may be the least expensive option among prominent telehealth providers. If not, or if your insurance is insufficient to bring down Cerebral’s costs, you’ll be better off with BetterHelp. Cerebral’s affordability through insurance will depend on your plan. Regardless of your coverage specifics, there’s still a $30 monthly charge to access the Cerebral platform, and all other billing is through your insurance. So, if you have a $30 co-pay for therapy visits, you’d pay about $36.92 per weekly visit over the course of a year. That’s nearly $12 less than the best possible rate you could get from BetterHelp with its maximum financial aid. However, if you’re uninsured or your insurance doesn’t cover Cerebral’s services, the costs would climb dramatically. Out of pocket, Cerebral costs $95/month for medication plans (psychiatry), with medication cenforce tablets billed separately. Therapy costs $295/month, or just over $68/session.

That’s a lot cheaper than out-of-pocket costs for in-person therapy, but it’s also much pricier than financially assisted sessions from BetterHelp. The top telehealth providers for therapy and psychiatry take your privacy seriously, using things like dedicated video conferencing and messaging software to prevent intrusion. Associated clinicians are also bound by all the same laws restricting the dissemination of patient information that apply to in-person therapy and psychiatry. But these platforms deal in various data pools, including medical records, messaging, payment and insurance information, and more. Some have policies that state the exact amount of time they’ll keep this information in their databases. Some allow you to make specific requests to delete your data; others don’t. Talkspace stands alone among these companies for two reasons.

• Nutritional diet can support vascular health critical for erections.
• Foods rich in antioxidants and omega-3s are beneficial.
• Avoid foods high in saturated fats and sugars.
• Proper hydration improves overall health.
• Supplements like L-arginine are explored for ED but lack strong evidence.
• Balanced nutrition enhances overall sexual function.

First, it allows you to manually delete messaging information between you and your doctor if you switch doctors and want a clean slate. Having all your old messages accessible to your new doctor may introduce certain prejudices in treatment, or you simply may want to start from scratch for your own sake.