Sexual Wellness· Medication / Therapy
Sildenafil (Viagra)
- First-line
- As-needed
Sildenafil (Viagra) is a first-line oral medication for erectile dysfunction. Taken 30–60 minutes before sex at 25–100 mg, it blocks PDE5 to allow firmer erections during sexual stimulation. Decades of safety data make it one of the best-characterized medications in men's health.
Typically used for:
Treating erectile dysfunction on demand in men of all ages.
Benefits
What Sildenafil (Viagra) can do for you.
Reliable on-demand effect
Taken about 1 hour before sex; effective for ~4 hours in most men.
Restored confidence
Reliable response to PDE5 inhibitors restores spontaneity and reduces performance anxiety.
Well-studied safety profile
Decades of clinical use, generic availability, and a known side-effect profile make sildenafil the standard first-line option.
Sildenafil was the first FDA-approved phosphodiesterase-5 (PDE5) inhibitor and remains a first-line treatment for erectile dysfunction.12 After decades of post-marketing data, the safety profile is among the best-characterized of any commonly prescribed medication in men's health.3
How it works
During sexual stimulation, nerve signals release nitric oxide in the penis, which raises levels of cGMP and relaxes smooth muscle. The relaxed vasculature allows blood to fill the corpora cavernosa and produces an erection. PDE5 is the enzyme that breaks cGMP back down. Sildenafil inhibits PDE5 — the cGMP signal lasts longer, and the erection is firmer and more reliable.2
Sildenafil does not produce an erection on its own. Sexual stimulation is still required for the underlying nitric-oxide release.
Dosing
Standard dosing is 25, 50, or 100 mg taken approximately one hour before sexual activity.3 The maximum effective onset is roughly 30–60 minutes; the duration of clinically useful effect is around four hours. Fatty meals delay absorption and blunt peak effect — take on an empty stomach when possible.
Who it is for
Sildenafil is appropriate first-line therapy for most men with erectile dysfunction.14 Before escalating to second-line treatments, a competent trial means: titration to the maximum dose, taken on an empty stomach, with adequate sexual stimulation, and a check on testosterone status. Many "treatment failures" are actually under-dosed first attempts.
Cautions and contraindications
- Absolutely contraindicated with nitrates of any form (including amyl nitrite "poppers") — the combination can cause severe, refractory hypotension.
- Caution with alpha-blockers commonly prescribed for BPH. Space dosing or adjust under physician guidance.
- Discuss with your physician if you have unstable cardiovascular disease, recent stroke or MI, severe hepatic or renal impairment, or retinitis pigmentosa.
- Common side effects: headache, flushing, nasal congestion, mild visual changes (blue tint). Usually mild and dose-related.
How it works
From consult to follow-up.
Initial consultation
A board-certified physician reviews your symptoms, history, and goals. At many participating clinics the first visit is complimentary.
Baseline labs
Bloodwork tailored to the protocol. Results come back in days, not weeks. We don't prescribe before we have your numbers.
Personalized protocol
Your physician calibrates your dose based on your labs and your goals — not a template. Adjustments happen as your data evolves.
Ongoing follow-up
Recheck visits at six and twelve weeks, then quarterly. Real follow-up, structured into the plan.
- Duration
- Oral medication taken ~1 hour before activity
- Results timeline
- 30–60 minute onset; ~4-hour effect window
Designed around your schedule
Consults are short
Initial visits are typically 45–60 minutes. Many participating clinics waive the fee for new patients.
Telehealth follow-ups
Where state regulations allow, follow-up visits are conducted via telehealth — no extra drive time.
Medication shipped
Prescriptions ship directly from a 503B-licensed pharmacy to your door. No standing in line.
Quarterly check-ins
Real follow-up at six and twelve weeks, then quarterly. Not constant visits, not zero visits.
Network providers
34 certified physicians offer Sildenafil (Viagra).
Every provider in the network is board-certified and credentialed.
Brandon Crandall, NP
Men's Health / Erectile Dysfunction · Syracuse, NY
Candace Remington, NP
Men's Health / Erectile Dysfunction · Tampa, FL
Deb Gross, NP
Men's Health / Erectile Dysfunction · Centralia, WA
Dr. Adriana Rosales, MD
Men's Health / Erectile Dysfunction · Seattle, WA
Dr. Aleix Bazzi, MD
Men's Health / Erectile Dysfunction · Beverly Hills, CA
Dr. Amit Grover, MD
Men's Health / Erectile Dysfunction · Seattle, WA
Dr. Ashish Bhavsar, MD
Men's Health / Erectile Dysfunction · Orange County, CA
Dr. Bona Lee, MD
Men's Health / Erectile Dysfunction · Dallas, TX
Dr. Brad Sellers, DO
Men's Health / Erectile Dysfunction · Dallas, TX
Patient reviews — Sildenafil (Viagra)
★★★★★5.0from 1 review
Tom K.
★★★★★Seattle, WA · Jun 2025
First-line therapy worked. Cost less than I expected and the urologist took the time to dose-titrate correctly. Should have done this years ago.
Source: Internal Sample
Where to get it
Available in 23 cities.
Pick your metro to see the local clinics, providers, and booking options.
- Beverly Hills, CA2 clinics2 providers
- Dallas, TX2 clinics4 providers
- New York, NY2 clinics2 providers
- Orange County, CA2 clinics2 providers
- Syracuse, NY2 clinics2 providers
- Tampa, FL2 clinics3 providers
- Albany, NY1 clinic1 provider
- Albuquerque, NM1 clinic1 provider
- Boca Raton, FL1 clinic2 providers
- Burlington, ON1 clinic1 provider
- Centralia, WA1 clinic1 provider
- Cleveland, OH1 clinic1 provider
How they compare
Sildenafil vs Tadalafil
| Mechanism | PDE5 inhibitor — enhances blood flow to the penis via the nitric-oxide pathway | PDE5 inhibitor — same mechanism as sildenafil |
|---|---|---|
| Half-life | ~4 hours | ~17.5 hours |
| Onset | 30–60 minutes | 30 minutes to 2 hours |
| Dosing | 25–100 mg, ~1 hr before sex | 10–20 mg as-needed, or 2.5–5 mg daily |
| Food interaction | Fatty meals delay onset | Minimal |
| Daily-dose option | No | Yes — often best for situational ED or BPH overlap |
| Common side effects | Headache, flushing, nasal congestion, blue-tinted vision | Headache, back pain, muscle aches |
| Best for | Planned, single-event use | Spontaneity, BPH overlap, daily use |
| Typical price (generic) | ~$2–6 per dose | ~$2–8 per dose; daily ~$30–60/month |
What sets us apart
Real physicians. Real labs. Real follow-up.
GentsMed is a network of board-certified physicians held to a single clinical standard — built to replace the cash-pay men's-health mills with actual medicine.
- Board-certified physicians.
- Every provider is licensed, NPI-verified, and credentialed by the GentsMed or Urosculpt certification board — no nurse-only prescribers, no offshore consults.
- A single clinical standard.
- Whether you see a urologist in Tampa or a dermatologist in New York, the protocol meets the same criteria.
- Labs-driven, not guess-driven.
- No prescriptions without baseline labs. No cookie-cutter dosing. Quarterly bloodwork is built into the plan.
- Real follow-up.
- Not a 'set it and forget it' Rx mill. Every protocol includes structured follow-up at 6 and 12 weeks, then quarterly.
- Transparent pricing.
- Starting-from prices where we have them, honest "consult for pricing" where we don't. No surprise bills.
- Your records stay with your physician.
- GentsMed is the network. We do not store your PHI. Your clinical data lives with your treating physician, where it belongs.
Frequently asked questions
References
- Burnett AL, et al. Erectile Dysfunction: AUA Guideline. J Urol. 2018;200(3):633–641.(AUA)
- Goldstein I, et al. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998;338(20):1397–1404.(NEJM)
- FDA label: Viagra (sildenafil citrate) tablets, for oral use.(FDA)
- Hatzimouratidis K, et al. EAU guidelines on erectile dysfunction: an update. Eur Urol. 2010;57(5):804–814.(EAU)
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