Erectile dysfunction
You can get hard. You just can’t trust that you’ll stay hard.
Sex should not start with the question: is it going to work tonight?
Maybe you need an on-demand pill. Maybe you want less planning. Maybe pills are no longer enough. Embrace gives you a clinician-guided path to ED treatment based on what is actually happening to you — starting with the problem, not the prescription.
Start My Private ED EvaluationPrescription treatment only when medically appropriate. Availability and prescribing requirements vary by state.
In short
EmbraceHealth.ai offers three prescription treatment paths for erectile dysfunction, chosen by a licensed clinician after a private online evaluation. Sildenafil is an FDA-approved oral PDE5 inhibitor generally taken as needed about an hour before sexual activity, from $49. Tadalafil is an FDA-approved oral PDE5 inhibitor with a longer treatment window — as-needed dosing has shown improvement in erectile function versus placebo up to 36 hours after dosing, and labeling also includes once-daily dosing at appropriate doses — from $79. Tri-Mix is a compounded intracavernosal injection typically containing alprostadil, papaverine and phentolamine, at $149; it acts locally rather than through the PDE5 pathway and may be considered for appropriately selected men whose response to oral therapy has been inadequate. Tri-Mix is not FDA-approved. All three require sexual stimulation or clinical instruction as applicable, none guarantees an outcome, and none is prescribed automatically.
Why “just take an ED pill” is not much of a plan
Most ED websites make this look simple.
Pick a pill.
Choose a dose.
Check out.
Hope it works.
But men do not all have the same problem. One guy can get an erection but loses it during sex. Another wants an on-demand option. Another hates trying to predict when sex will happen. Another has already used pills and says: “They used to work. Now I never know.”
Those are different situations. They should not all be treated like the same checkout decision.
And erectile dysfunction itself can have different contributing factors. Medications, cardiovascular health, metabolic health, psychological factors and other medical conditions can matter.
Not: “Which pill looks good?”
But: “What is actually going wrong?”
That is why Embrace starts with an evaluation rather than a product carousel. A clinician reviews whether treatment is appropriate and which available option makes sense for you.
How an erection actually works
An erection depends partly on increased blood flow into the penis. During sexual stimulation, your body releases nitric oxide. That increases a chemical messenger called cGMP.
cGMP helps smooth muscle relax so blood can flow into erectile tissue. An enzyme called PDE5 breaks cGMP down.
Sildenafil and tadalafil inhibit PDE5. That helps preserve cGMP and supports the body’s natural erectile response during sexual stimulation. It is why both require sexual stimulation to work, and why neither creates desire or produces an erection on its own.
Tri-Mix does something different. Injected directly into erectile tissue, its three components act locally through complementary pathways to relax smooth muscle and increase blood flow — without depending on the PDE5 pathway at all. That is why it belongs on a separate treatment path rather than in a dropdown beside the tablets.
What men actually want
Not marketing promises. This.
“I want to stop wondering if I’m going to lose it.”
Treatment cannot guarantee what happens during every sexual encounter. But getting properly evaluated gives you a rational treatment plan instead of guessing.
“I don’t want the whole night to revolve around medication.”
Different ED medications have different dosing approaches and treatment windows. Your clinician can help determine which approach may better fit your circumstances.
“I want to be present instead of checking whether I’m still hard.”
ED can become mentally consuming. Addressing the medical problem may remove one source of uncertainty, although medication does not itself treat every psychological or relationship factor involved in sexual performance.
“I want another option if the pills aren’t enough.”
There are treatment options beyond oral PDE5 inhibitors. Intracavernosal injection therapy may be considered in appropriately selected patients.
“I just want a real plan.”
That is the point. Not another bottle appearing in the mail with no idea what happens next.
What makes the Embrace approach different?
It is not a “better sildenafil molecule.” We are not going to pretend it is. And we are not going to call Tri-Mix magic.
The difference is the treatment pathway. Instead of forcing you to decide what drug you need, we start with the question that actually matters: what is going wrong?
- “I can get hard, but I lose it.”
- “I want something for occasional use.”
- “I hate planning sex around medication.”
- “My medication used to work better.”
- “I tried pills and I’m still struggling.”
- “I don’t know why this is happening.”
Those answers give the clinician better context. From there, your clinician can determine whether sildenafil, tadalafil, another treatment approach, further evaluation, or potentially injectable therapy is medically appropriate.
Right problem. Appropriate option. Clinical oversight. A path forward if the first option is not the right one.
Three different problems. Three different treatment paths.
Your clinician decides which is appropriate. These summaries are here so you understand what the options actually are before you fill in the intake.
Path one — on demand
“I want an option for when I know sex may happen.”
Sildenafil is a PDE5 inhibitor and the active ingredient in Viagra. It supports the natural erection pathway during sexual stimulation. It does not create sexual desire, does not automatically cause an erection, and sexual stimulation is still required.
For most patients, prescribing information lists 50 mg approximately one hour before sexual activity, though it may be taken from roughly 30 minutes to four hours beforehand. It should not be taken more than once daily. That makes it straightforward for men who prefer an on-demand approach rather than daily medication.
Sildenafil
Oral PDE5 inhibitor — as needed
From $49
50 mg: $49/month, $129 for 3 months. 100 mg: $69/month, $179 for 3 months.
FDA-approved for erectile dysfunction. Your clinician determines the appropriate dose — do not assume a higher dose works better, as higher doses can also increase adverse effects.
- Onset roughly 30 minutes to 4 hours
- Maximum dosing frequency once daily
- Requires sexual stimulation
- Must not be used with nitrates
Path two — less planning
“I don’t want my sex life built around taking a pill at exactly the right moment.”
Tadalafil is also a PDE5 inhibitor and the active ingredient in Cialis. It supports the same nitric oxide and cGMP pathway. The practical difference is its longer duration of action.
For as-needed treatment, tadalafil has demonstrated improvement in erectile function compared with placebo up to 36 hours after dosing. That does not mean a 36-hour erection — it means a wider window during which the medication may support erectile response when sexual stimulation occurs. FDA-approved labeling also includes once-daily dosing for ED at appropriate doses.
That can suit men who want a wider window rather than having intimacy feel tied to a narrow medication schedule. It still requires sexual stimulation.
Tadalafil
Oral PDE5 inhibitor — daily or as needed
From $79
5 mg daily: $79/month, $199 for 3 months. 20 mg as needed: $99/month, $179 for 3 months.
FDA-approved for erectile dysfunction. Whether treatment is daily or as-needed, and at what dose, must be determined by the prescribing clinician.
- Longer treatment window than sildenafil
- May be taken without regard to food
- Requires sexual stimulation
- Must not be used with nitrates or riociguat
Path three — beyond the pills
“I’ve tried the pills. I need to know what comes next.”
This is where ED care should not end with “sorry, try another tablet.”
Tri-Mix is an injectable compounded medication generally containing alprostadil, papaverine and phentolamine. These medications act locally in the penis through complementary pathways that relax smooth muscle and increase blood flow. Unlike sildenafil and tadalafil, intracavernosal injection therapy acts directly at the penis and does not depend on the same PDE5 pathway.
That makes injection therapy an option clinicians may consider in some men who have not had an adequate response to oral treatment. The American Urological Association specifically identifies intracavernosal injections as an option and notes that men who find PDE5 inhibitors inadequate or ineffective may choose this approach.
It also requires more respect than swallowing a tablet. Dose matters. Technique matters. Training matters. Knowing what to do if an erection lasts too long matters.
Tri-Mix Injection
Compounded intracavernosal injection
$149
Prescription and availability depend on clinician evaluation, state rules and pharmacy availability.
Tri-Mix is not FDA-approved as a finished drug product. It is compounded, and compounded medications are not reviewed by the FDA for safety, effectiveness or quality before marketing in the same manner as FDA-approved drugs.
- Acts locally, not through the PDE5 pathway
- Requires injection training and clinical supervision
- Priapism is the most serious risk
- AUA recommends an in-office injection test
The Embrace ED pathway
Four steps, and the fourth is the one most pill sites do not have.
Tell us what is actually happening
Complete a private medical intake. Can you get an erection? Do you lose it? Has this happened once or repeatedly? Have you used ED medication before, and what happened?
A clinician reviews your information
Medical history, current medications, contraindications and previous ED treatment all matter. You do not have to diagnose yourself.
Treatment is prescribed only when appropriate
Your clinician determines which option is medically appropriate and at what dose. No medication is prescribed automatically.
If option one is not enough, the conversation continues
Depending on your circumstances, other ED treatment options may be considered. The relationship should not be pill shipped, good luck.
Completing an evaluation does not guarantee a prescription.
“I’ve tried ED medication before.”
Good. Tell the clinician exactly what happened. What medication? What dose? How many times did you try it? Did you get an erection but lose it? Did it work sometimes but not others? Did you experience side effects? Did it stop working as well as you expected?
Those details matter. “I tried Viagra once and it didn’t work” does not automatically tell a clinician that every ED treatment has failed.
And if oral therapy really has not produced an adequate response, that information matters too. The answer should not automatically be: buy more pills.
“What if this doesn’t work for me?”
No legitimate ED treatment can promise that every man will respond. We won’t make that promise.
The advantage of having a treatment pathway is that your care does not have to begin and end with a single product. A clinician can review your history, medications, contraindications, prior treatment and response.
If one option is inappropriate or inadequate, the next step can be discussed. That is a much better plan than repeatedly buying whatever medication happens to appear in an ad.
“Why should I pay Embrace instead of buying the cheapest generic online?”
If price is the only thing that matters to you, generic sildenafil is available from many providers. We are not going to pretend otherwise.
Embrace is for the man who wants more than click → pill → good luck. You are paying for access to an actual treatment pathway: an evaluation, appropriate prescribing, multiple ED treatment options, a place to return if the first treatment does not solve the problem, and a broader view of your health when your history suggests it deserves one.
Final treatment, dose, pharmacy availability and prescribing requirements depend on clinical eligibility and applicable state rules.
“Isn’t this embarrassing?”
You know what is more uncomfortable? Spending another six months worrying every time sex might happen. Avoiding initiation. Making excuses. Wondering whether your partner thinks you are no longer attracted to them. And Googling the same question at 1 a.m.: why can’t I stay hard?
ED is a medical problem. Treat the conversation that way. Privately. Directly. Without the macho nonsense.
“Is this safe?”
That is exactly why there is a medical evaluation. Sildenafil and tadalafil are prescription medications and are not appropriate for everyone. They should not be used with nitrates, because the combination can cause a dangerous drop in blood pressure. Your clinician also needs to know about your medical history and other medications.
Tri-Mix requires additional precautions because it is injected directly into the penis and can cause complications including pain, bruising, fibrosis and prolonged erection or priapism. Injection technique and dose matter.
Do not combine ED medications or change your dose unless specifically instructed by your clinician. Seek emergency medical attention for an erection lasting four hours or longer.
Common questions
What medications does Embrace prescribe for erectile dysfunction?
The American Urological Association recommends oral PDE5 inhibitors as first-line therapy for erectile dysfunction. Embrace clinicians prescribe sildenafil and tadalafil. For men whose response to oral therapy is inadequate or who cannot use PDE5 inhibitors, a clinician may discuss Tri-Mix, a compounded intracavernosal injection.
What is the difference between sildenafil and tadalafil?
Both are PDE5 inhibitors supporting the same nitric oxide and cGMP pathway. The practical difference is the treatment window. Sildenafil is generally taken as needed roughly one hour before sexual activity. Tadalafil has a longer window — as-needed dosing has demonstrated improvement in erectile function compared with placebo up to 36 hours after dosing — and FDA-approved labeling also includes once-daily dosing for ED at appropriate doses. Neither is universally better.
Do ED medications create an erection automatically?
No. PDE5 inhibitors support the body’s natural erectile response, but sexual stimulation is still required. They do not create sexual desire and they do not keep you erect continuously.
What is Tri-Mix?
Tri-Mix is a compounded injectable medication generally containing alprostadil, papaverine and phentolamine. It is injected directly into penile erectile tissue, where the three medications act through complementary pathways to relax smooth muscle and increase blood flow. Because it acts locally, it does not depend on the PDE5 pathway used by sildenafil and tadalafil.
Is Tri-Mix FDA approved?
No. Tri-Mix is a compounded combination and the compounded product itself is not FDA-approved. Only alprostadil is FDA-approved in the United States as a single-agent intracavernosal ED medication. FDA does not review compounded medications for safety, effectiveness or quality before marketing in the same manner as FDA-approved drugs.
What if the first medication does not work for me?
Tell your clinician exactly what happened — which medication, what dose, how many attempts, whether you got an erection and lost it, and whether you had side effects. One disappointing experience does not tell a clinician that every ED treatment has failed. If oral therapy really has been inadequate, that information matters too, and other treatment approaches can be discussed.
Can I combine ED medications?
Do not combine ED medications or change your dose unless specifically instructed by the clinician managing your care. More medication does not automatically mean a better result — it can mean more risk.
Are ED medications safe?
That is what the medical evaluation is for. Sildenafil and tadalafil are prescription medications and are not appropriate for everyone. They must not be used with nitrates, because the combination can cause a dangerous drop in blood pressure. Tri-Mix requires additional precautions because it is injected directly into the penis and can cause pain, bruising, fibrosis and prolonged erection or priapism. Seek emergency medical attention for an erection lasting four hours or longer.
Can erectile dysfunction be a sign of something else?
It can. Medications, cardiovascular health, metabolic health, psychological factors and other medical conditions can all contribute to erectile dysfunction. That is part of why a clinician reviews your broader history rather than only filling an order.
Stop treating every failed night like an isolated incident.
One bad night happens. But if you keep asking whether you’ll get hard, whether you’ll stay hard, whether the pill will work, whether she’ll notice, whether you’ll lose it again — the risk of doing nothing is not simply another failed sexual encounter. It is allowing uncertainty to become the normal state of your sex life.
You do not need a promise. You need information. You need options. And you need a plan for what happens if option one is not enough.
Start My Private ED EvaluationNo pretending. No guessing which medication you need. A licensed clinician will determine whether prescription ED treatment is appropriate and which options may be considered.
Important medical information
Prescription medication requires evaluation by a licensed healthcare professional and is prescribed only when medically appropriate.
Sildenafil and tadalafil are PDE5 inhibitors used for erectile dysfunction. They require sexual stimulation to support an erectile response and are not appropriate for everyone. Do not take PDE5 inhibitors with nitrate medications. Tell your clinician about all prescription medications, over-the-counter medications, supplements and medical conditions.
Tri-Mix is a compounded injectable medication generally containing alprostadil, papaverine and phentolamine. Tri-Mix as a compounded combination is not FDA-approved. FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed in the same manner as FDA-approved medications. Intracavernosal injection therapy requires appropriate instruction, dosing and clinical supervision. Potential risks include injection-site discomfort, bruising, fibrosis, hypotension and prolonged erection or priapism.
Seek immediate medical attention for an erection lasting four hours or longer, sudden vision or hearing changes, chest pain, or other serious symptoms.
Treatment results vary. No outcome is guaranteed. Availability, consultation requirements, prescribing procedures and pharmacy fulfillment vary by state. This information is educational and is not a substitute for individualized medical advice.