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Since these are prescription meds, we need to ask a few health questions.
Why we ask: Your answers help the licensed clinician determine if treatment is right for you.
Here's how it works:
- Answer a few quick questions
- Choose your treatment
- Complete your order and checkout
Erectile Dysfunction Questionnaire
What symptoms have you experienced in the last 12 months?
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Erectile Dysfunction Questionnaire
Do you get erections at night and/or when you wake up in the morning?
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Erectile Dysfunction Questionnaire
Have you ever experienced, or do any of the following apply to you?
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Erectile Dysfunction Questionnaire
What heart or cardiovascular conditions have you had?
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Erectile Dysfunction Questionnaire
Have you had a heart attack in the last 3 months?
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Erectile Dysfunction Questionnaire
What diseases of the genitals or urinary symptoms have you had?
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Erectile Dysfunction Questionnaire
Have you ever taken medication or supplements for ED before?
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Erectile Dysfunction Questionnaire
What’s the name of the medication you were taking?
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Erectile Dysfunction Questionnaire
Have you had a physical exam with a healthcare provider in the past 5 years?
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Erectile Dysfunction Questionnaire
Have you had blood work done in the last 2 years for ED?
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Erectile Dysfunction Questionnaire
What was your most recent blood pressure reading?
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Erectile Dysfunction Questionnaire
Do you experience any of the following cardiovascular symptoms?
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Erectile Dysfunction Questionnaire
Please tell us more about your prolonged leg cramps.
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Erectile Dysfunction Questionnaire
Tell us about your lifestyle.
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Erectile Dysfunction Questionnaire
Please list any surgeries or hospitalizations. If none, please continue.
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Erectile Dysfunction Questionnaire
Do you have any other information or questions for the doctor?
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Erectile Dysfunction Questionnaire
PDE5i Consent
You have been diagnosed with or have reported that you have a known diagnosis of organic or psychogenic (situation) erectile dysfunction, a condition characterized by the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Phosphodiesterase Type 5 Inhibitors (PDE5i) are medications prescribed to treat this condition by enhancing erectile function.
Common PDE5 inhibitors include Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Stendra). These medications work by increasing blood flow to the penis during sexual stimulation.
The use of PDE5 inhibitors may improve your ability to achieve and maintain an erection, enhance sexual performance and satisfaction, and improve your quality of life and personal relationships.
While PDE5 inhibitors are generally well-tolerated, possible side effects may include headache, flushing, indigestion or upset stomach, nasal congestion, dizziness or lightheadedness, visual disturbances such as blurred vision or changes in color perception, back pain or muscle aches (more common with Tadalafil), hearing loss or ringing in the ears (rare), priapism (a prolonged erection lasting more than four hours), and allergic reactions like rash, itching, or swelling. Do not use PDE5 inhibitors if you take nitrates for chest pain (angina), use recreational drugs called "poppers" (amyl nitrate or nitrite), have severe heart or liver problems, have recently had a stroke or heart attack, or have low blood pressure.
Alternative treatments include lifestyle changes such as exercise, weight loss, quitting smoking, and reducing alcohol intake; psychotherapy or counseling for psychological causes of erectile dysfunction; vacuum erection devices, which are mechanical pumps to induce erections; penile injections or suppositories where medications are administered directly to the penis; hormone therapy if low testosterone levels are contributing to erectile dysfunction; and surgical options like penile implants or vascular surgery.
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Acknowledgement
Pharmacy Consent