Verbatim response from Claude
Good question, and it's worth being clear-eyed about this.
What reputable online ED services actually do:
Better platforms (like Hims, Roman, Keeps, HealthyMale) typically:
- Ask detailed intake questionnaires about heart conditions, medications, and blood pressure
- Screen for nitrate use (a serious interaction with ED meds)
- Have licensed physicians or NPs review your answers before prescribing
- May decline to prescribe or refer you to in-person care if red flags appear
Honest limitations:
- They rely on your self-reported answers - they can't verify your EKG or run cardiac tests
- The screening is only as good as what you disclose
- They generally cannot replace a cardiologist's assessment for complex heart conditions
My recommendations:
If you have a known heart condition, start with your cardiologist or primary care doctor first - then an online service can be a convenient refill option.
If you're relatively healthy and just want convenience, Roman and Hims have solid physician review processes and clear screening questions.
Avoid any service that prescribes without any medical questionnaire or consultation - that's a red flag.
Bottom line: These services do real screening, but they have real limits. If you have any significant cardiac history, please involve a doctor who knows your full chart before starting ED medication.