Ordering ED Meds Online: What You Should Know First

By: Kristina Buscaino, D.O., M.S.

If you’re experiencing the symptoms of erectile dysfunction (ED) and are thinking about buying ED meds online, consider this as a public service announcement: By some estimates, more than half of ED drugs sold online are fakes, WebMD reports.

This figure represents not just the financial risks of ordering ED meds online, but potential health risks as well. And these hazards can apply still if you order genuine ED drugs from a legitimate online pharmacy, should you do so without first consulting a doctor.

Your doctor can help lower the medical risks of introducing a new drug into your system by performing a thorough exam to identify potential complications. Additionally, and importantly, your doctor can determine whether you have occasional ED or chronic ED that requires further treatment.

Causes of ED That Could Require Treatment

Whether you experience occasional or chronic ED, the source of the issue is the same: a lack of sufficient blood flow to the penis. An estimated 43% of all men experience this at some time in their lives, across all ages, due to medical or emotional issues such as performance anxiety. Full-scale erectile dysfunction, however, occurs persistently.

The uncertainty of chronic ED can have a significant psychological effect on the 30 million to 50 million men estimated to live with ED. That includes 52% of men between the ages of 40 and 70 years.

Persistent ED could also indicate a more serious medical condition, including:

• Diabetes
• Heart, vein, and artery diseases (cardiovascular)
• Kidney disease
• Neurological problems (from spinal cord and nerve injuries, multiple sclerosis, and heavy metal poisoning)
• Peyronie’s disease (curvature of the penis)
• Prostate cancer

What Makes Erectile Dysfunction Drugs Effective

ED drugs carry chemicals that boost your levels of nitric oxide, a natural chemical in your blood that relaxes veins and arteries. As a result, blood flows more effortlessly to the penis, for an easier and longer-lasting erection.

The first ED prescription to accomplish this, sildenafil (Viagra), earned FDA approval in 1998. The pharmaceutical industry soon developed competing drugs, the most recognizable being tadalafil (Cialis), vardenafil (formerly Levitra), and avanafil (Stendra). Three of these drugs – sildenafil, tadalafil, and vardenafil – are now offered as generics.

Each of these drugs has a slightly different chemical composition, but they all achieve the same goal of increasing nitric oxide. However, the differences in their makeups mean that the speeds at which they work, the lengths of effectiveness, and possible side effects can differ.

Buyer Beware: Buying ED Meds Online Exposes You to Risks

The growth of the ED medication market, including “natural remedies,” has contributed to a $1.4 billion ED drug industry in 2024. By 2030, it is projected to be worth close to $2.2 billion.

You can expect a sizeable share of those sales to be made via online pharmacies and medication suppliers, many of which are legitimate, but not all of them. This presents possible medical and financial pitfalls. Among them:

1. Conditions that can worsen with ED meds. Be aware that ED drugs can cause dangerous reactions in people with liver or kidney disease, very high or low blood pressure, recent heart or blood vessel issues, and/or a retina-related eye disease. These conditions might also make ED drugs less effective.
2. ED drugs mix poorly with other meds. When combined with certain prescriptions, ED medications can trigger health-threatening side effects. These mixed-risk drugs include alpha-blockers, nitrates (which dilate the blood vessels), and medicines that suppress an enzyme in the liver and intestines (called CYP3A4).
3. You can take the wrong amounts. Different ED prescriptions require different dosages – Viagra is not meant to be taken daily, for instance. Further, researchers who tested a sample of Viagra purchased online found that only 10% were near the advertised strength, WebMD reports.
4. You may not be prepared for the side effects. Men who take ED drugs might experience headaches, dizziness, body aches, and indigestion. The following also might occur:

• • Vision impairment – When regularly used, ED meds can cause retinal detachment, retinal blood clots, and sudden vision loss, according to a report in JAMA. Other side effects include blurred sight, light sensitivity, and problems telling colors apart.
  • ED med deafness – Ongoing research links hearing loss and/or ear ringing to ED drugs, and the Food and Drug Administration has issued a warning.

5. You might buy fakes, or worse.If more than half of the ED drugs sold online are fakes, as reported by WebMD, then less than half are legitimate. A legally authorized site will be licensed with a state board of pharmacy and require a prescription. It will also clearly post its contact information, including a U.S. address. When uncertain, look up a seller on the National Association of Boards of Pharmacy’s “Safe Pharmacy”

Always Talk to Your Doctor About ED Meds Online

If you are unable to achieve an erection more than 50% of the time, you should consider seeing a urologist. Then you can talk about approaches to treatment, including ED medications that align with your overall health and lifestyle.

You may opt for a different, non-invasive approach. Among those, our urologists provide:

• Low-intensity shockwave therapy (LiSWT) – Using a hand-held wand, the provider directs painless, mild energy pulse to the penis to stimulate tissue and improve blood flow.
• Self-injection therapy – With a very small needle, the patient injects a blood-circulating medication into the base of the penis.
• Penile suppositories – Here, the patient inserts a small medicated pellet into the tip of the penis to improve blood flow.
• A penile pump – A hand-powered vacuum placed over the penis manually draws blood into it for an erection. The patient then places a ring around the base of the penis.

Depending on the cause or severity of your ED, your doctor might discuss a surgical penile implant.

If your first approach involves lifestyle changes and/or ED medications, keep the above warning signs in mind. Ordering ED meds online can be safe, if you take precautions.

Erectile dysfunction is a treatable medical condition and should be discussed. To consult one of our physicians, find an office near you, and request an appointment. Learn more about the causes, symptoms, and treatments we offer.