> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Erectile dysfunction

> How an online consultation for erectile dysfunction works, what the doctor rules out first, and the treatments a doctor may consider.

Erectile dysfunction is a common issue, and the cause can be cardiovascular, hormonal, or psychological. The online consultation starts by ruling out anything serious before proposing a treatment.

## What the consultation evaluates

The doctor reviews your symptoms, cardiovascular history, current medication and allergies to distinguish between physical and psychological causes. Worry about sexual performance is sometimes the primary driver rather than a physical cause — see [performance anxiety](/library/conditions/performance-anxiety) for how a doctor tells the two apart. Certain answers, such as nitrate medication, rule out some treatments entirely because of a dangerous interaction.

## Your path to treatment

A licensed doctor reviews your answers about your health, medical history and current medication as part of a sexual-health consultation, to work out the likely cause before considering treatment.

<Steps>
  <Step title="Start your online visit">
    Answer a questionnaire about your health and goal. No in-person appointment, no travel — you'll know within 24 hours if you're a candidate.
  </Step>

  <Step title="A doctor reviews your case">
    A licensed doctor reviews your answers personally. If they need clarifications, they message you in the private chat on your account. If treatment is appropriate, they sign an electronic prescription.
  </Step>

  <Step title="Review and payment">
    If the doctor does not approve treatment, the consultation fee is refunded in full within 48 hours.
  </Step>

  <Step title="Ongoing support">
    Private chat with your doctor for questions, a 4-week check-in, and renewal before your prescription expires.
  </Step>
</Steps>

<CardGroup cols={3}>
  <Card title="Licensed EU doctors" icon="user-doctor" />

  <Card title="Prescription in under 24 hours" icon="clock" />

  <Card title="Full refund if not approved" icon="rotate-left" />
</CardGroup>

## Treatments a doctor considers

PDE5-inhibitor tablets are one option a doctor may consider once the cause has been assessed — see [avanafil](/library/medicines/avanafil) for one such medicine, its EU authorisation, and its trial evidence, and the [Spedra (avanafil) usage guide](/library/guides/spedra-avanafil) for day-to-day dosing.

<Note>
  Worry about sexual performance is sometimes the primary driver rather than a physical cause. See [performance anxiety](/library/conditions/performance-anxiety) for how a doctor tells the two apart.
</Note>

## Common questions

<AccordionGroup>
  <Accordion title="How is erectile dysfunction evaluated in an online consultation?">
    The doctor reviews a questionnaire about your symptoms, medical history and current medication. They assess cardiovascular health, hormonal factors and psychological causes. If they need clarifications, they message you in the private chat on your account.
  </Accordion>

  <Accordion title="What treatments does the doctor consider for erectile dysfunction?">
    PDE5-inhibitor tablets such as [avanafil](/library/medicines/avanafil) are one option. The doctor may also consider [Vitaros (alprostadil cream)](/library/medicines/vitaros) when tablets are unsuitable. The decision depends on the cause identified during the consultation.
  </Accordion>

  <Accordion title="How long until you see results?">
    Response varies by treatment and individual. With on-demand tablets such as avanafil, the effect can begin within 15 to 30 minutes. The doctor reviews your response and adjusts the plan if needed.
  </Accordion>

  <Accordion title="Can I consult for erectile dysfunction from Spain?">
    Yes. A licensed EU doctor reviews your case remotely and, if appropriate, issues an electronic prescription valid at any EU pharmacy under Directive 2011/24/EU.
  </Accordion>

  <Accordion title="Is my sexual health consultation fully confidential?">
    Yes. Your answers and the doctor's decision stay in your private account. The doctor messages you through the secure chat on your account.
  </Accordion>

  <Accordion title="What happens if the doctor does not approve treatment?">
    If the doctor does not approve treatment, the consultation fee is refunded in full within 48 hours. Declining is a normal outcome and does not mean the issue cannot be addressed through another route.
  </Accordion>
</AccordionGroup>

## How Hi-Doctor handles it

One consultation, one doctor, one decision. See [pricing](/essentials/pricing) for the consultation fee, [how it works](/essentials/how-it-works) for the full process, and [safety](/essentials/safety) for how eligibility checks and doctor review work. Medication, if prescribed, is paid separately, at a pharmacy of your choice.

## Start a consultation

<Card title="Sexual health consultation" icon="stethoscope" href="https://hi-doctor.ai/consultation/sexual-health/1">
  Answer the sexual health questionnaire and a registered doctor reviews it.
  They decide whether treatment is appropriate, which one, and at what dose —
  and declining is a normal outcome. See [what it costs](/essentials/pricing)
  and [how the review works](/essentials/how-it-works).
</Card>

<Warning>
  This page is reference information, not medical advice and not a prescription.
  Whether a medicine is appropriate for you is decided by a registered doctor
  after reviewing your consultation.
</Warning>