Discreet, doctor-prescribed treatment for ED, premature ejaculation, and low libido. Shipped in plain packaging. From $2/dose.
Plain box · No name on label · No marketing on the package
Pick the fit
Your clinician reviews your answers and picks the right one — you're never locked into a single option.
Fast-acting PDE5 inhibitor for spontaneity. Take 30–60 minutes before intimacy; effective for roughly 4–6 hours.
Low-dose daily option (or higher as-needed) that keeps you responsive for 24–36 hours without timing pills to sex.
Applied 10–30 minutes before intercourse, topical lidocaine reduces glans sensitivity without affecting your erection.
A daily SSRI used off-label to delay climax. Typically helpful after one to two weeks of consistent dosing.
A compounded cream applied 15–30 minutes before intimacy to boost clitoral blood flow and sensitivity. It supports arousal, not desire.
Compounded intranasal oxytocin used off-label to support a short-lived sense of connection, calm, and arousal before intimacy.
Sexual wellness formulary
Information paraphrased from MedlinePlus (NIH/NLM), FDA labels, and Cleveland Clinic. Always confirm with your clinician.
As-needed PDE5 inhibitor — the classic generic option for ED.
From $36/month
See if Sildenafil fits youSildenafil blocks phosphodiesterase type 5 (PDE5), the enzyme that breaks down cGMP in penile tissue. With sexual stimulation, more cGMP means more blood flow and a firmer erection. It does not increase desire on its own.
Take 30–60 minutes before intimacy (up to 4 hours before).
Effective for roughly 4–6 hours. No more than one dose per 24 hours.
Source: MedlinePlus — Sildenafil
Long-acting PDE5 inhibitor — ideal for daily dosing and spontaneity.
From $42/month
See if Tadalafil fits youTadalafil is a PDE5 inhibitor like sildenafil but with a much longer half-life, enabling either low-dose daily use or higher as-needed dosing. With arousal, it increases blood flow to support a firm erection.
As-needed: at least 30 minutes before activity. Daily: steady state after about a week.
Up to 24–36 hours of responsiveness per dose, hence the 'weekend pill' nickname.
Source: MedlinePlus — Tadalafil
Topical anesthetic that reduces penile sensitivity to help delay climax.
From $29/month
See if Lidocaine fits youLidocaine temporarily blocks sodium channels in surface nerves, dulling stimulation of the glans and shaft. Applied before intercourse, it can extend time-to-ejaculation without affecting erection quality.
Apply 10–30 minutes before intimacy.
Effect lasts roughly 30–60 minutes. Wash the area before intercourse to avoid transferring numbness to your partner.
Daily SSRI used off-label to delay ejaculation in lifelong or distressing PE.
From $39/month
See if Sertraline fits youSSRIs raise synaptic serotonin, which — as a side effect — delays the ejaculatory reflex. Sertraline is one of several SSRIs (paroxetine, fluoxetine, escitalopram, citalopram) used off-label for PE, usually daily, sometimes 'on-demand' a few hours before sex.
Meaningful improvement usually after 1–2 weeks of daily dosing.
Taken once daily. Do not stop abruptly — taper under medical guidance.
FDA boxed warning
FDA boxed warning for all antidepressants: increased risk of suicidal thinking in children, adolescents, and young adults. Monitor closely for mood changes.
Source: Cleveland Clinic — Premature Ejaculation (SSRI off-label)
The original name-brand sildenafil — same molecule, branded manufacturing and blister packaging.
From $89/month
See if Viagra® fits youViagra® is the brand name for sildenafil, a PDE5 inhibitor that increases cGMP in penile tissue so blood flow improves with arousal. Clinically equivalent to the generic; the difference is manufacturing, packaging, and price.
Take 30–60 minutes before intimacy (effective up to about 4 hours before).
Roughly 4–6 hours of responsiveness. One dose per 24 hours maximum.
Source: MedlinePlus — Sildenafil
Compounded topical applied before intimacy to boost clitoral blood flow and sensitivity.
From $79/month
See if Arousal fits youA compounding pharmacy prepares the cream using vasodilators (commonly L-arginine and low-dose sildenafil) that relax local blood vessels. Applied to the clitoral area, it may increase blood flow, warmth, and responsiveness in about 15–30 minutes. It does not raise desire on its own.
Apply 15–30 minutes before intimacy.
Localized effect lasts roughly 30–60 minutes. Wash before intercourse to avoid partner transfer.
FDA boxed warning
This is a compounded preparation — not an FDA-approved combination product. Quality depends on the compounding pharmacy, and individual ingredients have their own warnings.
Source: FDA — Compounding and the FDA
Compounded intranasal oxytocin used off-label to support connection and arousal.
From $99/month
See if Oxytocin fits youOxytocin is the bonding hormone released during intimacy and breastfeeding. As a compounded nasal spray it is absorbed through the nasal mucosa; some patients report a short-lived sense of connection, relaxation, and arousal when used before intimacy. Evidence is limited and use is off-label.
Typically 10–30 minutes after a spray in each nostril.
Short-acting — effects usually fade within 30–60 minutes.
FDA boxed warning
Compounded intranasal oxytocin is not FDA-approved for sexual wellness and is prescribed off-label. Evidence is early and individual response varies.
Source: NIH — Oxytocin overview
The Process
Backed by science
Weight loss · GLP-1
Sexual wellness
Tell us about your medical history, BMI, and goals. A US-licensed clinician reviews everything — most intakes are reviewed within 24 hours.
⚡ Takes ~3 minutesIf appropriate, your clinician prescribes a GLP-1 (semaglutide or tirzepatide) and the pharmacy ships in plain packaging.
⚡ Ships in 5–7 daysFree clinician messaging, dose adjustments, and coaching — so you're not just shipped a vial. Trial data: avg 15–21% body weight reduction at 68–72 weeks.
⚡ Ongoing careOur Medical Team
Medical Director
Internal Medicine · Obesity Medicine
Lead Pharmacist
Compounding & dispensing oversight
Lead Care Coach
Behavioral support · GLP-1 protocol
HIPAA Compliant
Your data is protected
Why Vital Pole
FAQ
You complete a short health intake (about 3 minutes), a US-licensed clinician reviews everything you submit, and — if therapy is appropriate — a prescription is sent to a partner pharmacy that ships in plain packaging. You then message your care team anytime for dose adjustments, side-effect questions, or coaching. Cancel from your dashboard in one click.
Still have questions? Message our care team →
Physician-led care for metabolic weight loss and sexual wellness — same care team, one platform.
~3 minutes · No card needed · HSA/FSA eligible · Cancel anytime
FDA-approved
Medications only
US-licensed
Clinicians + pharmacies
1-click
Cancel anytime
