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CONDITION

Erectile Dysfunction (ED)

Why ED happens, what it can signal about the rest of your health, and how we treat it at Vital Society.

The short answer

Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for sexual activity. It's usually multifactorial — vascular, hormonal, neurological, and lifestyle inputs all matter — and it's often the earliest visible sign of underlying cardiovascular or metabolic disease. Effective treatment combines a proper workup (testosterone, thyroid, metabolic labs, cardiovascular risk) with the right PDE5 inhibitor — Tadalafil, Sildenafil, or Vardenafil — and, when indicated, testosterone optimization.

Common causes of ED

  • Vascular: poor blood flow, endothelial dysfunction, hypertension
  • Hormonal: low testosterone, thyroid dysfunction, elevated prolactin
  • Metabolic: insulin resistance, diabetes, obesity
  • Neurological: nerve damage, spinal issues
  • Medications: SSRIs, beta blockers, finasteride, opioids
  • Lifestyle: poor sleep, alcohol, smoking, chronic stress
  • Psychological: performance anxiety, depression, relationship stress

Why ED deserves a real workup

The penile arteries are small — roughly 1–2 mm in diameter — and among the first vessels to show endothelial dysfunction. That's why new-onset ED can precede a cardiovascular event by 3–5 years. Prescribing a pill without checking testosterone, thyroid, HbA1c, lipids, blood pressure, and cardiovascular risk is a missed opportunity. At Vital Society, an ED consultation includes a comprehensive lab panel — not just a prescription.

Treatment options and pricing

Pricing is transparent and shipped-to-home. Contact us for current tiered pricing on all three PDE5 inhibitors.

Tadalafil (generic Cialis)

Our most-prescribed PDE5 inhibitor. Lasts up to 36 hours; can be taken as-needed or as a low daily dose for spontaneity. Well-tolerated with additional benefits for endothelial function and prostate-related symptoms.

Sildenafil (generic Viagra)

The original PDE5 inhibitor. Works in 30–60 minutes, lasts ~4 hours. Best taken on an empty stomach.

Vardenafil (generic Levitra)

Similar to sildenafil with a slightly faster onset and different tolerability profile. A good option when sildenafil produces side effects.

Combination therapy

When Low T is present, we typically pair TRT with PDE5 support. Testosterone alone rarely fixes ED, but the combination outperforms either treatment alone.

The TRT + ED connection

Testosterone doesn't produce erections directly — vascular and neurological function does. But testosterone drives libido and modulates the nitric oxide pathway that PDE5 inhibitors work on. In men with combined Low T and ED:

  • • PDE5 inhibitors work better when testosterone is optimized
  • • Some men no longer need PDE5 support once hormones are restored
  • • Libido, morning erections, and confidence typically return first

What to expect from a Vital Society ED consult

  • Comprehensive lab panel (hormones, thyroid, metabolic, PSA)
  • Cardiovascular risk review
  • Discussion of medications, dosing, and preferences
  • Prescription shipped in discreet packaging
  • Ongoing follow-up as needed

Frequently asked questions

What causes erectile dysfunction?+

ED is almost always multifactorial: vascular (poor blood flow), hormonal (low testosterone, thyroid, prolactin), neurological, psychological, medication side effects, or lifestyle-related (sleep, alcohol, stress). Because early ED is often the first visible sign of vascular disease, it deserves a real workup — not just a prescription.

Is ED a sign of a bigger health problem?+

Often, yes. The penile arteries are small and among the first to show endothelial dysfunction. New-onset ED can precede a cardiovascular event by 3–5 years. That's why we screen metabolic, hormonal, and cardiovascular markers when patients present with ED.

What's the difference between Tadalafil, Sildenafil, and Vardenafil?+

All three are PDE5 inhibitors that improve blood flow. Sildenafil (Viagra) works in ~30–60 min and lasts ~4 hours. Vardenafil (Levitra) is similar but slightly faster. Tadalafil (Cialis) lasts up to 36 hours and can be taken as a low daily dose, giving on-demand spontaneity. Your provider matches the medication to your lifestyle and cardiovascular profile.

Can low testosterone cause ED?+

Low T reduces libido and can worsen ED, though most ED is primarily vascular. When both are present, addressing testosterone often significantly improves response to PDE5 inhibitors — and some men no longer need them.

Do PDE5 inhibitors work if I have low testosterone?+

They can, but the response is often blunted when testosterone is low. In men with combined Low T and ED, we typically optimize hormones and prescribe PDE5 support in parallel for the strongest, fastest results.

Are these medications safe long-term?+

For most men, yes. Daily low-dose tadalafil is well tolerated and has additional benefits (improved endothelial function, prostate-related symptom relief). We screen for cardiovascular contraindications and interactions (especially nitrates) before prescribing.

Is treatment discreet?+

Yes. Consultation, labs, and medications are handled through our clinic. Prescriptions ship directly to your home in plain packaging.

Related treatments at Vital Society

Not sure if this is you?

A 15-minute consultation with our team is complimentary. We'll listen, review your history, and tell you honestly whether treatment makes sense.