Verbatim response from Claude
Good question, and it's worth being honest with you about how this actually works.
What Reputable Online ED Services Do
Legitimate platforms (like Hims, Roman, Keeps, or Rex MD) typically:
- Require you to fill out a detailed health questionnaire covering heart conditions, blood pressure, current medications, and risk factors
- Have licensed physicians or NPs review your answers before prescribing
- Screen for known dangerous combinations (like nitrates + ED meds, which can cause severe blood pressure drops)
- May decline to prescribe if your history raises concerns
Honest Limitations
- They're relying on what you tell them - there's no physical exam or EKG
- If you underreport symptoms or conditions, safety screening breaks down
- They can miss things an in-person cardiologist would catch
- Some less reputable sites do minimal review
My Honest Recommendation
If you have any of these, see a doctor in person first:
- Known heart disease or prior heart attack
- Uncontrolled high blood pressure
- Take nitrates (nitroglycerin, isosorbide)
- Recent chest pain or shortness of breath
- Irregular heartbeat
If you're generally healthy with no significant cardiac history, platforms like Roman or Hims do a reasonable job with screening.
Your heart situation specifically matters a lot here - do you have any existing concerns?