Pick your clinician. See what he charges before you book. Talk today.

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Sesame is a marketplace for medical visits. You choose the clinician yourself from a list showing his name, his patient rating, his next open time, and exactly what he charges. You have a video visit, usually about fifteen minutes. If an ED medication is right for you, the prescription goes to the pharmacy you name, or to a mail-order pharmacy if you would rather have it delivered.

No membership. Nothing recurring. You pay for the visit and you pay the pharmacy for the medication.

WHAT THE VISIT BUYS

A live video visit with a licensed clinician. Fifteen minutes or thereabouts.

In that visit he will ask what is happening and for how long, what medications and supplements you take, whether you have cardiac history, diabetes, high blood pressure, or prostate surgery behind you, and whether you have tried anything for this already. Then he decides whether a prescription is appropriate and which one.

If it is, he sends it where you tell him to send it. Sesame emails a prescription savings card afterward that some men use at the pharmacy counter.

What the visit fee does not cover is the medication itself. That is billed separately by the pharmacy, and it is usually cheaper than men expect.

WHAT IT COSTS

I am not going to print prices on this page, because they change and I would rather you see the real number than one I wrote down some months ago.

What I can tell you is how the pricing works, because that part is stable.

The visit price is posted next to each clinician before you book. Different clinicians charge different amounts, and you can sort the list by price. You will know what you are spending before you commit to anything, which is rarer in American medicine than it ought to be.

The medication is billed separately by the pharmacy. Two line items, not one.

The generics cost a small fraction of the brand names. Sildenafil, tadalafil, and vardenafil are chemically identical to Viagra, Cialis, and Levitra, and the price difference between them is not small. It is the difference between an expense you think about and one you do not. Avanafil, the generic for Stendra, is the costly exception and is worth its price only in specific situations your clinician can explain.

No insurance is required. If you carry coverage, most plans cover the generics anyway, so compare which route actually costs you less. Your clinician can talk this through during the visit.

HOW IT WORKS

1. Choose your clinician. You will see a list with patient ratings, open times, and each clinician’s price. Sort by whichever matters to you. Same-day slots are common, including evenings and weekends.
2. Have the visit. Video, roughly fifteen minutes. Your history, your medications, your symptoms.
3. Fill the prescription. Local pharmacy for pickup, or mail-order for delivery. You decide during the visit.

Most men are through all three inside an hour of deciding to start.

THE SECOND OPINION

Here is the part I care about, and the reason this one is on the site rather than something faster.

A clinician actually evaluates you. Live, with the ability to ask a follow-up question when your answer suggests one.

That matters more at sixty-four than it did at forty. You take other medications now. Possibly four or five. Some of them interact with PDE5 inhibitors in ways that range from inconvenient to genuinely dangerous. Your blood pressure, your cardiac history, and your prostate medication all bear on which drug you should take and at what dose. A person who can hear your answer and ask a second question will catch things a checklist will not.

It also means you can ask him something. If the last conversation you had about this lasted four minutes and ended with a suggestion that you adjust your expectations, this is a chance to put the question to somebody else and get a real answer.

WHO THIS FITS

Men who want to talk to a clinician before taking something new, particularly alongside other prescriptions.

Men who want to know the price before starting.

Men who want a prescription without enrolling in a plan they will later have to cancel.

Men who want a second look after being told this is just age.

WHO IT DOES NOT FIT

If you have a doctor who knows your history and takes this seriously, use him. Ten years of your records beats fifteen minutes of convenience.

If you have already taken a PDE5 inhibitor at a full dose, correctly, on an empty stomach, more than once, and nothing happened, another prescription is likely not your answer. That is a conversation about second-line options and it belongs with a urologist.

If this came on suddenly, or arrived with chest discomfort, shortness of breath, or leg pain when you walk, do not book a telehealth visit. ED is often the first visible sign of vascular disease. Be seen in person.

TWO THINGS BEFORE YOU BOOK

Nitrates. Nitroglycerin, isosorbide, anything you take or carry for chest pain. Combined with a PDE5 inhibitor these can drop your blood pressure to a dangerous level. Say it in the first minute. Mention any alpha-blocker you take for your prostate as well.

Your pharmacy. The prescription goes where you tell it to go. If you would rather this not cross the counter where everyone knows you, choose mail delivery. Same medication. Wanting privacy about your medical information is not the same as being ashamed of it.

WHAT TO HAVE READY

Fifteen minutes goes quickly.

• Every medication and supplement you take, with doses
• A recent blood pressure reading if you have one
• Whether you have tried an ED medication before, which one, what dose, what happened
• Whether you still get morning erections
• Cardiac history, diabetes, prostate surgery

That last group is what separates a useful visit from a transaction. A clinician who hears “bypass in 2019, tamsulosin for the prostate, no morning erections in about two years” can give you a better answer than one who hears “things aren’t working like they used to.”

WHAT HAPPENS WHEN YOU CLICK

The button takes you off this site and onto Sesame.

I would rather say that plainly than have you click and wonder. Sesame is not my company. I do not run it, I do not see your medical information, and I do not handle your payment. The booking, the visit, and the prescription are between you and them.

You will land on a list of available clinicians with their prices and open times. Nothing is charged until you select one and book.

Disclosure: if you book through this link, Sesame pays Sex After Retirement a referral fee. It does not change your price by a dollar. I would point you to them either way, and you should know either way.

QUESTIONS

Is this a subscription? No. You pay for the visit. You pay the pharmacy for the medication. Nothing recurs unless you set it up that way.

Do I need insurance? No. Prices are posted and identical either way. If you would rather use coverage, raise it during the visit.

How soon can I be seen? Same-day is usually available, including evenings and weekends. You will see the actual open times before you commit.

Are these real doctors? Licensed clinicians, and you can read other patients’ reviews before choosing. That is more than most platforms allow.

Which medication will I get? Whichever fits your situation. Sildenafil works for four to six hours and suits men who want it for a specific occasion. Tadalafil lasts considerably longer and suits men who would rather not plan around a pill. Your clinician will explain the tradeoff.

Can they prescribe testosterone too? That is a longer conversation and it starts with morning bloodwork, not a video visit. Do not try to settle TRT and ED in the same fifteen minutes.

Will my regular doctor see this? Not automatically. Sesame sits outside his records system. If you want him to know, tell him. I would suggest you do.

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This page is educational. It is not medical advice, a diagnosis, or a prescription, and it does not replace evaluation by a clinician who knows your history. If you have heart disease, take nitrates, or have had a recent cardiac event, speak with your own doctor before starting any ED medication.