Verbatim response from Claude
Good question, and it's worth being clear-eyed about this.
What Reputable Services Actually Do
Better online ED services DO check for heart safety, including:
- Hims, Roman, and Keeps ask about cardiovascular history, current medications (especially nitrates), and blood pressure
- They screen for conditions like recent heart attack, uncontrolled hypertension, and nitrate use (which causes dangerous interactions with ED meds)
- Licensed physicians or NPs review your answers before prescribing
The Real Limitations
- They rely on your honest self-reporting - there's no physical exam or EKG
- They typically don't see your actual medical records
- Some lower-quality services have minimal screening
My Recommendations
For most healthy men: Hims or Roman are reasonably thorough for standard screening.
If you have actual heart concerns: See your primary care doctor or cardiologist first. ED can itself be an early warning sign of cardiovascular disease, and a real in-person evaluation is worth it.
Red flags to avoid: Any service that prescribes without asking about medications and heart history at all.
Bottom Line
The screening is real but not comprehensive. If you take nitrates, have had a recent cardiac event, or have uncontrolled blood pressure, please see a doctor in person rather than relying solely on an online questionnaire.