Program · ED
Erectile dysfunction care
A private, clinical visit to find the cause and the treatment that fits. We check blood pressure, blood sugar and medications first, because erection changes can be an early sign of something else.
A medical visit, not a mail order.
Erectile dysfunction is common and it is medical. Erections depend on blood flow, nerves, hormones and mood all working together, so a change can come from any of them, including medications you take for something else.
It can also be one of the first signs of narrowed blood vessels, diabetes or high blood pressure. That is why our first visit is a real medical visit, with a clinician, a blood pressure check and labs when they are needed. Then we go over treatment.
Reasons men book this visit
- Erections that are harder to get or keep than before
- Changes that started after a new medication
- Treatment from an online service that stopped working, or caused side effects
- A partner has raised it and you want a straight medical answer
What it might also be
We check for these before treating anything.
- High blood pressure or high cholesterol
- Diabetes or prediabetes
- Blood pressure, prostate or antidepressant medications
- Low testosterone
- Smoking, heavy drinking or poor sleep
- Stress, anxiety or relationship strain
Candidacy
Decided by your labs and a licensed clinician.
Not by a quiz, and not by what you ask for. These are the questions the clinician works through with you.
It may fit if
- You want the cause checked, not just a prescription mailed to you
- You take other medications and want them reviewed for interactions
- Oral medication has not worked well and you want to know the next options
Not the right call if
- You take nitrate medication for chest pain (such as nitroglycerin). Oral ED medications with nitrates can drop blood pressure dangerously. We will talk about other routes
- You have chest pain with activity that has not been checked. That needs a heart work-up first
- You need a penile implant or vascular surgery. We refer to urology for those
How it works here
What happens, and when.
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Visit 1
History and exam
About 30 minutes. Medications, health history, blood pressure and a brief exam.
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Same week
Labs if needed
Usually blood sugar, cholesterol and a morning testosterone level.
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Plan
Options explained
What each option involves, how it is taken and its side effects. You choose.
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4 to 6 weeks
Check-in
A short video visit to adjust the dose or try a different option.
Treatment options we discuss.
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Oral medication
PDE5 inhibitors such as sildenafil or tadalafil. Taken before sex, or as a low daily dose for some men.
Generic versions are often low cost at the pharmacy.
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Treating the cause
Adjusting a blood pressure or mood medication with your prescriber, treating sleep apnea, managing blood sugar, cutting down on smoking and alcohol.
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Referral to our consulting urologist
For injections, vacuum devices or surgical options when oral medication is not enough or is not safe for you.
Dr. Marchetti sees patients here on Thursdays.
What we do not offer Acoustic wave therapy
It is widely advertised, but the research is still early and the cost is high. We will tell you if that changes.
Safety
Side effects and safety, stated plainly.
- Nitrates
- Never combine oral ED medication with nitrates or recreational poppers. The combination can cause a sudden, dangerous drop in blood pressure.
- Common side effects
- Headache, flushing, a stuffy nose, indigestion and back or muscle aches. These are usually mild and fade within hours.
- Rare but serious
- Sudden vision or hearing loss, or an erection lasting more than 4 hours, needs emergency care right away.
- Heart health
- Sex is physical activity. If you get chest pain or shortness of breath with exertion, we check your heart before prescribing.
Monitoring
How we keep an eye on it.
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01
Check-in at 4 to 6 weeks to review how the plan is working and any side effects
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02
Blood pressure at each in-person visit
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03
Yearly review of medications, blood sugar and cholesterol
What it costs · ED care
$95 to $145 first visit
Included
- A 30-minute visit with a clinician, in person or on video
- Blood pressure check and medication review
- A written plan with side effects explained
- Follow-up messages and one check-in visit within 90 days
Not included
- Medication, filled at your pharmacy. Generic options are often low cost with a discount card
- Labs, if needed ($59 to $129 depending on the panel)
- After 90 days, ongoing care is $25 to $45 a month, or pay per visit
Common questions.
All questionsWill anyone know why I am there?
The front desk sees an appointment type, not a reason. Text reminders say only "Baseline: appointment reminder". The billing line on your card statement reads BLH CLINIC TULSA.
Can I do the first visit by video?
Yes, if you have had a blood pressure reading in the last 6 months and have no chest pain with activity. Otherwise we ask you to come in once.
Is ED a sign of low testosterone?
Sometimes, but more often it is about blood flow. We check a morning testosterone level when your symptoms point that way, not by default.
Other programs
Labs + consult · $189 to $249
Start with a number, not a guess.
Book two morning draws and a 40-minute results visit with a clinician. If treatment does not fit, we say so, and you leave with your results and a plan.
Rather talk first? (918) 555-0143, weekdays 7 a.m. to 5:30 p.m.
Important safety information
Every treatment here is prescribed only after a licensed clinician reviews your history and labs. This is a summary, not medical advice. Questions
- ED medication
- Never take with nitrates or poppers: blood pressure can drop dangerously. Get emergency care for sudden vision or hearing loss, or an erection lasting more than 4 hours. Common side effects are headache, flushing and a stuffy nose.
- Testosterone therapy
- Not for men with normal testosterone, prostate or breast cancer, or a high hematocrit. Can cause infertility that does not always reverse, raise red blood cell counts and PSA, and worsen sleep apnea. Requires blood work at 6 to 8 weeks, 3 to 6 months, 12 months and every 6 to 12 months after. Gel can transfer to others by skin contact. Testosterone is a Schedule III controlled substance.
- GLP-1 medicines
- Not used with a personal or family history of medullary thyroid cancer or MEN2. Nausea and constipation are common early. Severe belly pain can signal pancreatitis or gallbladder problems and needs urgent care.
- Finasteride and minoxidil
- Finasteride can cause sexual side effects and mood changes, and it halves PSA readings. Minoxidil can cause shedding at first, scalp irritation and, as a tablet, dizziness or fluid retention. Benefits fade after stopping.