Trouble getting or keeping an erection — what it usually means:
Persistent erectile dysfunction (ED) is usually vascular (blood-flow) or hormonal, sometimes medication-related, and rarely psychological alone. Generic sildenafil (Viagra) is $1–$5 per dose with GoodRx; tadalafil (Cialis) similar. A $49 TeleDirectMD video visit reviews medical history, medications, and risk factors and prescribes treatment same-day.
Based on the search query: "can't get or keep an erection"
Trouble Getting or Keeping an Erection — What It Usually Means
Talk to a board-certified MD by video — typically a 10-minute visit, with a treatment plan and any prescription routed to your pharmacy of choice.
This page is informational guidance, not a diagnosis. If your symptoms match a clear pattern below, you can start a $49 video visit; if any of the red-flag signs apply, see in-person care or call 911.
- $49 flat — board-certified MD video visit, prescription same-day if appropriate
- 41 states — same-day, evenings & weekends
- HSA / FSA accepted; in-network with Aetna, BCBS, UnitedHealthcare
- Routes you to in-person urgent care or the ER if your symptoms warrant it
Last reviewed on 2026-04-26 by Parth Bhavsar, MD — Board-Certified Family Medicine · NPI 1245687134 · LegitScript Certified · HIPAA-Compliant.
Quick Facts
- What this usually is: Erectile dysfunction
- Treatment: Phosphodiesterase-5 inhibitor (sildenafil, tadalafil, vardenafil)
- Visit cost: $49 flat at TeleDirectMD
- Time to prescription: ~30 minutes after booking
- States: 41 (board-certified MD)
5.0 ★ from 125 verified patient reviews on Google, Zocdoc, WebMD, and Healthgrades.
What This Symptom Usually Means
Erection requires intact blood flow, nerve signaling, and hormonal balance. ED is most commonly a vascular issue — and is one of the earliest signs of cardiovascular disease.
Common contributors: cardiovascular disease, diabetes, low testosterone, antidepressants (SSRIs), blood-pressure medications, alcohol, smoking, and stress.
PDE-5 inhibitors (sildenafil, tadalafil, vardenafil) are first-line and effective for most patients. Generic sildenafil is $1–$5/dose; daily-dose tadalafil $10–$30/month.
When to Seek Care Immediately
If any of the following apply, this page is not the right care path — go to urgent care or the ER, or call 911 if symptoms are severe.
- New ED with chest pain on exertion (cardiovascular workup needed)
- Sudden, complete inability to achieve erection (possibly neurologic or medication side effect)
- ED with low libido and fatigue (low testosterone — may need labs)
- On nitrate medications (cannot use PDE-5 inhibitors safely — needs alternative plan)
- Severe untreated cardiovascular disease
How a TeleDirectMD Visit Handles This
- Visit reviews medical history, medications, cardiovascular risk factors, and frequency/pattern of ED.
- For most healthy patients without contraindications: sildenafil or tadalafil prescribed first visit.
- If symptoms suggest low testosterone: labs ordered through Quest or LabCorp; treatment plan after results.
- Nitrate users or significant cardiovascular disease → in-person cardiology before PDE-5 inhibitors.
What does treatment cost?
A $49 telehealth visit is the cheapest legitimate care setting for this kind of symptom. For a full breakdown comparing telehealth, urgent care, retail clinics, and ER pricing for an online doctor visit, see our master cost guide.
Why TeleDirectMD: A Real Doctor, Not an Algorithm
When you visit TeleDirectMD, you see Dr. Parth Bhavsar, MD — a board-certified Family Medicine physician licensed in 41 states. Not a panel of rotating providers, not a physician assistant, not a chatbot.
- Board-certified Family Medicine — University of Mississippi Medical Center
- NPI 1245687134 — verifiable in the NPPES NPI Registry
- 5.0 ★ across 125 verified reviews (Google, Zocdoc, WebMD, Healthgrades)
- LegitScript-certified telehealth practice
- HIPAA-compliant platform — encrypted video, secure records, no data resale
Patient Reviews — 5.0 / 5 Across 125 Verified Reviews
Verified patient ratings of Dr. Parth Bhavsar, MD aggregated from independent third-party review platforms:
Available in 41 States
The flat $49 rate applies in every state where Dr. Bhavsar is licensed. Select your state for a state-specific page:
Conditions Commonly Treated at the $49 Visit
The same flat $49 visit covers these adult conditions:
Real Patient Scenarios
Mark — generic sildenafil (TX)
New ED at 52. Sildenafil 50 mg prescribed; $4/dose with GoodRx. Effective on first dose.
Total $53 + $20/mo for occasional use.
Jamal — daily tadalafil (FL)
Wanted spontaneity. Daily tadalafil 5 mg $25/mo with GoodRx.
Total $74/mo for full-time treatment.
Rob — nitrate user redirected (PA)
On nitrates for angina. PDE-5 inhibitors contraindicated; referred to in-person cardiology for alternative plan.
Right care path; safety first.
Frequently Asked Questions
Is ED a sign of heart disease?
It can be. ED is one of the earliest signs of cardiovascular disease — the small penile arteries are affected before the larger coronary arteries. New ED warrants a discussion of heart-disease risk factors.
Can I get sildenafil online?
Yes. After a $49 video visit reviewing medical history, medications, and contraindications, sildenafil or tadalafil can be prescribed same-day. Generic sildenafil is $1–$5/dose with GoodRx.
How much does ED medication cost?
Generic sildenafil: $1–$5/dose with GoodRx. Generic tadalafil: $1–$3/dose, or $10–$30/month for daily 5 mg. Brand-name Viagra/Cialis is much more expensive — most patients prefer generic.
Sildenafil vs. tadalafil — which is better?
Sildenafil works in 30–60 minutes and lasts 4 hours — best for planned occasions. Tadalafil works in 30 minutes, lasts 36 hours, and is also available as a low-dose daily pill — best for spontaneity.
Are there ED medications I shouldn't take?
PDE-5 inhibitors are contraindicated with nitrates (heart medications) and cause severe hypotension. They're used cautiously with severe cardiovascular disease, very low or high blood pressure, and certain liver/kidney conditions.
Will my insurance cover ED treatment?
Generic sildenafil/tadalafil with GoodRx is often cheaper than insurance copays. The $49 telehealth visit is in-network with Aetna, BCBS, UHC in select states; cash-pay otherwise.
Can low testosterone cause ED?
Yes — but it's less common than vascular causes. If you have low libido and fatigue alongside ED, labs (testosterone, LH, FSH) are warranted. The visit can order them through Quest or LabCorp.
Should I exercise more if I have ED?
Yes. Aerobic exercise, weight loss, smoking cessation, and reducing alcohol all improve erectile function. PDE-5 inhibitors plus lifestyle changes work better than either alone.
$49 Cash-Pay or In-Network with Aetna, BCBS, UHC
The $49 flat rate applies to all 41 states. If you have insurance, TeleDirectMD is in-network with Aetna, BCBS, and UnitedHealthcare in select states — your standard telehealth copay applies in place of the $49.
Cost & Platform Comparisons
From Symptom to Treatment Plan
Most patients searching "can't get or keep an erection" are looking for two things: what this is and how to get treated quickly. The visit covers both — a focused history with a board-certified MD, a clear diagnosis or working diagnosis, and a prescription routed to your pharmacy of choice when one is appropriate.
The Erectile dysfunction treatment page covers the full clinical picture for the routed condition — what we treat, what we don\'t, eligibility, medications, and references. Use the symptom page to decide whether a $49 visit is the right next step.
Why a $49 Visit Matters Here
In 2024, 26.7 million Americans under 65 were uninsured per KFF, and 38.6% of uninsured adults reported delaying or skipping needed care due to cost. For symptoms like the one this page covers — non-emergency, treatable with a focused visit and a generic prescription — a $49 telehealth visit is often the lowest-friction path to actually getting treated.
A 2024 Penn Medicine / JAMA Network Open study of 160,000+ visits found telemedicine episodes averaged $96 vs. $509 for in-person care — about 5× cheaper. For appropriate conditions, the savings come without any clinical compromise.
What To Do Next
- Check the red-flag list above. If any apply, this page is not the right care path — go to in-person urgent care or the ER.
- If symptoms match the patterns described, book a $49 video visit. Most appointments take 10–15 minutes.
- If a prescription is appropriate, it\'s sent to your pharmacy of choice — usually within 30 minutes of the visit ending.
- If the visit determines a different care path is needed (lab work, in-person exam, specialist referral), you\'ll receive clear next steps. No charge for the misroute.
Ready to talk to a doctor? $49 flat. No insurance required.
Same-day, evenings & weekends. Board-certified MD. 41 states. Last reviewed 2026-04-26.
Medical Disclaimer
This page is informational and is not a diagnosis or substitute for medical care. Last reviewed 2026-04-26 by Parth Bhavsar, MD (NPI 1245687134), board-certified Family Medicine. Telehealth services are for non-emergency conditions in adults 18+ physically located in one of TeleDirectMD\'s 41 licensed states at the time of the visit. We do not prescribe controlled substances. If you are experiencing a medical emergency — including any of the red-flag scenarios above — call 911 or go to the nearest emergency room.