
- Longevity
- Weight management
- Metabolic health
Dr. Benjamin H. Krasne, M.D.
A board-certified physician who brings a rigorous, pharmacology-driven lens to longevity medicine and weight management.
ED is extraordinarily common — and extraordinarily treatable. Tadalafil, sildenafil, and the Triple Action Performance Blend (tadalafil + PT-141 + oxytocin) cover most cases. HealifyNow evaluates, prescribes when appropriate, and ships discreetly. Free initial consultation.
Erectile dysfunction affects roughly half of men over 40 to some degree. The good news: modern treatment is highly effective and increasingly accessible.
Erectile dysfunction is the consistent inability to achieve or maintain an erection sufficient for satisfying sexual activity. It's not just an aging issue — younger men experience it too, often driven by stress, anxiety, vascular factors, or medication side effects. The Massachusetts Male Aging Study found that 52% of men aged 40-70 reported some degree of ED, with prevalence rising substantially with age.
The mechanism of erection involves coordinated signaling between the brain (arousal), the autonomic nervous system (parasympathetic dilation), the vascular system (blood flow into the corpus cavernosum), and smooth muscle relaxation in the penile tissue. ED can come from disruption at any of these levels. Vascular ED (most common over 40) responds well to PDE-5 inhibitors. Neural ED (after prostate surgery, diabetic neuropathy) often requires different approaches. Psychogenic ED responds to a combination of medication and addressing the underlying anxiety.
HealifyNow's ED program starts with a real clinical evaluation — your symptoms, medical history, medications, and what you've tried before. Based on that, your clinician prescribes the most appropriate treatment: tadalafil (the long-acting PDE-5 inhibitor that works up to 36 hours), sildenafil (the shorter-acting first-line option), or the Triple Action Performance Blend (a compounded dissolvable tablet combining tadalafil 10mg, PT-141 2000mcg, and oxytocin 100iu in one dose). For members where PDE-5 inhibitors aren't enough or aren't appropriate, alternatives exist.
The free initial consultation matters. ED can be a marker of cardiovascular disease, diabetes, low testosterone, or other treatable conditions — your clinician should look at the whole picture, not just write a prescription for a pill.
The core indication. PDE-5 inhibitors restore reliable function in most cases.
Combining medication with addressing the anxiety produces the best outcomes.
SSRIs, certain blood pressure medications, and others affect erections. Your clinician can identify and address.
ED can be the first symptom of cardiovascular disease, diabetes, or low testosterone. Worth checking.
From your first message to your medication arriving at your door — clinician-guided, every step.
A care team member meets with you to understand your goals, medical history, and treatment preferences. The first visit is no-cost and no-commitment — we want you to be confident before moving forward.
Connect by secure video or phone with a U.S.-licensed physician or nurse practitioner who reviews your full picture — labs, prior treatments, current medications, and lifestyle — and decides what is clinically appropriate.
If your clinician determines treatment is right for you, they issue a prescription that goes to a licensed U.S. pharmacy. We coordinate discreet shipping, or you can fill it locally. Follow-up visits are built in.
PDE-5 inhibitors (tadalafil, sildenafil, vardenafil). Erections begin when sexual arousal triggers nitric oxide release in the corpus cavernosum. NO activates guanylate cyclase, which produces cGMP, which relaxes smooth muscle and allows blood flow in. PDE-5 (phosphodiesterase type 5) breaks down cGMP. PDE-5 inhibitors block that breakdown, so cGMP stays elevated longer, smooth muscle stays relaxed, and erectile response is amplified.
Tadalafil vs. sildenafil. Tadalafil has a 17.5-hour half-life — effective for up to 36 hours from a single dose, or via daily low-dose (2.5-5 mg) for continuous effect. Sildenafil has a 4-hour half-life — best taken 30-60 minutes before sexual activity on an empty stomach.
PT-141 (bremelanotide). Works centrally, not peripherally. Activates melanocortin receptors in the brain, increasing desire and arousal. Useful when the issue is desire rather than mechanics, or when PDE-5 inhibitors alone aren't enough.
Oxytocin. Used in low doses sublingually to enhance the connection and pleasure components of intimacy. Often paired with tadalafil and PT-141 in the Triple Action Performance Blend.
Testosterone. If low testosterone is part of the picture (often the case in men 40+ with ED), TRT can significantly improve erectile function alongside other benefits. Your clinician will check labs.
Your clinician will review every relevant detail with you. Here are the most important points to know up front.
Combining PDE-5 inhibitors with nitrate medications (for chest pain) can cause dangerous blood pressure drops. Your clinician will screen for this.
ED can be the first symptom of cardiovascular disease. A real evaluation includes considering whether further cardiac workup makes sense.
Some blood pressure medications and alpha-blockers can interact with PDE-5 inhibitors. Your clinician reviews your full medication list.
Headache, flushing, nasal congestion, mild back pain — most resolve with continued use or dose adjustment.
All medications must be prescribed by a licensed provider based on medical necessity. Treatment is not suitable for everyone. Results may vary.
Daily tadalafil (2.5-5 mg). Take every morning. After about a week, tissue levels reach steady state and the medication is continuously effective. Many members find this the most "natural" approach — intimacy becomes spontaneous again because you're not timing a pill to an event.
As-needed tadalafil (10-20 mg). Take 30-60 minutes before anticipated intimacy. Effective for up to 36 hours. Food doesn't significantly affect absorption.
As-needed sildenafil (25-100 mg). Take 30-60 minutes before anticipated intimacy on an empty stomach. Effective for 4-6 hours.
Triple Action Performance Blend ($149). A compounded dissolvable tablet combining tadalafil 10mg + PT-141 2000mcg + oxytocin 100iu. For members where the standard PDE-5 inhibitors alone aren't enough, or who want to address desire and connection alongside mechanics.
Combination protocols. Daily low-dose tadalafil plus situational PT-141 troches. Or tadalafil plus testosterone replacement if labs warrant. Your clinician personalizes the protocol.
Get a fast read on whether this is worth a deeper conversation.
Patients served across the U.S.
Member satisfaction with care team
Average review rating
From visit to medication shipment
We built HealifyNow because telehealth done badly is everywhere — and telehealth done right still feels rare. Here is what makes us different.
No waiting rooms, no faxed forms, no insurance hoops. Quick consults, simple intake, prescriptions handled digitally.
Real physicians, nurse practitioners, and specialists with active licenses. Not chatbots, not offshore call centers.
Medications ship from licensed U.S. pharmacies in plain packaging. Most orders arrive in 2-5 business days.
Reach a real human seven days a week. Most messages get a clinical reply within a few hours, not days.
HealifyNow prescriptions are reviewed and authorized by independently licensed physicians — real doctors with real credentials from top medical institutions in the United States.

A board-certified physician who brings a rigorous, pharmacology-driven lens to longevity medicine and weight management.

A Columbia-trained physician and former collegiate athlete focused on metabolic function, body composition, and healthspan.

A board-certified OB-GYN and ACOG Fellow with more than four decades of experience in women's health.
Real people, real results. Names and details published with permission.
"Started daily tadalafil 5 mg two years ago. The 'on demand' mental shift away from pills-and-performance was the actual win. Intimacy feels normal again."
"Tried sildenafil first — mechanics worked but desire was the real issue. Switched to the Triple Action Blend. The PT-141 component was the missing piece for me."
"ED started after starting an SSRI for anxiety. Tadalafil daily addresses the SSRI side effect without making me stop the antidepressant. Best of both worlds."
HealifyNow makes it easy to move forward with confidence. Here are the answers to what people ask us most.
We require a real evaluation — your medical history, current medications, cardiovascular risk factors, testosterone status when indicated. We don't just hand out PDE-5 prescriptions without context. ED is often a marker of other treatable conditions, and skipping that step is bad medicine.
Not unless you tell them. Shipping is discreet (plain packaging, no labeling on the outside). PDE-5 inhibitors don't have detectable physical effects outside of erectile response.
Yes — our cash-pay pricing is transparent. Generic tadalafil starts at $39/month. The Triple Action Performance Blend is $149.
It can be. ED is sometimes the first symptom of cardiovascular disease — the small blood vessels in the penis are affected before the larger ones in the heart. It can also signal diabetes, low testosterone, or sleep apnea. Your clinician will discuss whether further workup is appropriate.
Depends on you. Daily low-dose tadalafil suits members who want spontaneous intimacy without timing pills. As-needed dosing suits members who have infrequent intimacy or specific schedules. Your clinician will discuss.
Yes — many men on TRT also take tadalafil or sildenafil. The combination is common and your clinician will coordinate.
PDE-5 inhibitors do not affect fertility. Testosterone replacement therapy can — your clinician will discuss alternatives if you're trying to conceive.
Alternatives exist: intracavernosal injections (Trimix), vacuum devices, penile implants for refractory cases, and addressing root causes (testosterone, cardiovascular, anxiety). Your clinician will discuss the next step.
Book a free consultation, complete a short questionnaire, then meet a licensed clinician by secure video or phone. If ED treatment is appropriate, your clinician builds a plan and any prescriptions ship from a licensed U.S. pharmacy.
ED treatment pricing is from $39/month. The first consultation is free, there's no insurance requirement, and your clinician confirms costs before you commit.
ED treatment is typically suited to men with erectile dysfunction; ED pills must never be taken with nitrate medications. Your clinician reviews your history, medications and goals before recommending anything.
Yes, when it's provided by licensed clinicians who evaluate you properly. ED treatment is only prescribed when it's clinically appropriate.
Your clinician reviews your symptoms, medical history, current medications and goals, may order labs, and explains your options and their side effects.
Often, yes. Labs help your clinician confirm what's going on and choose the right dose, and they can be arranged at draw sites nationwide.
Many members see a clinician within a few days of booking. If medication is prescribed, most orders arrive within 2 to 5 business days.
Book a free consultation. Real evaluation, transparent pricing, discreet delivery.