Verbatim response from Claude
That's a really important safety question. Here's an honest answer:
Legitimate services do screen for cardiac safety, but the thoroughness varies:
Better platforms that do more robust screening:
- Hims, Roman, and Rex MD ask detailed health history questions about heart conditions, blood pressure, and medications (especially nitrates, which dangerously interact with ED drugs)
- Keeps and HealthyMale also conduct structured intake questionnaires
- The best ones require you to disclose current medications and conditions before a provider reviews your case
What they specifically check for:
- Nitrate medications (absolute contraindication)
- Uncontrolled blood pressure
- Recent heart attack or stroke history
- Certain blood pressure medications
Honest limitations:
- They rely heavily on what you tell them - they can't run an EKG
- Some lower-quality or foreign telehealth sites do minimal screening
- If you have active cardiac disease, an in-person cardiologist visit before starting ED medication is genuinely recommended
My suggestion: If you have any heart history, consider starting with your primary care doctor or cardiologist rather than a telehealth platform, or at minimum be completely transparent about your full health history on these platforms.
The medication risks are real - this isn't an area to cut corners on disclosure.