Verbatim response from Claude
Good question, and it's worth being clear-eyed about this.
What Reputable Online ED Services Actually Do
Better platforms do include cardiac screening:
- Hims, Roman, and Keeps ask about heart conditions, recent heart attacks, nitrate use, and blood pressure medications in their intake questionnaires
- A licensed physician or NP reviews your answers before prescribing
- They should flag contraindications like nitrate medications (a serious dangerous combination with ED drugs)
Honest Limitations to Know
- They rely largely on self-reported information - they can't run an EKG or check your actual heart function
- No physical exam means they may miss things a doctor would catch in person
- Some patients may underreport symptoms or not know their own risk factors
My Recommendations
If you're generally healthy with no known heart issues:
- Roman and Hims are reasonable options with legitimate medical review
If you have any of these, see a cardiologist or urologist in person:
- Known heart disease
- Recent heart attack or stroke
- Taking nitrates (nitroglycerin, isosorbide)
- Uncontrolled high blood pressure
- Chest pain during activity
Bottom line: They do screen, but it's not a substitute for a full cardiac workup if you have actual heart concerns. A real in-person visit with your doctor is safer if you're uncertain.