Sesame ED Review 2024: Expert Insights

Key Takeaways 

• Sesame Care is a telehealth platform that offers virtual appointments with providers, available as soon as the same day. 
• Sesame Care doesn’t take insurance, and the costs for a virtual session can range from as low as $37 up to $385.
• SesameRx is a medication delivery service offered by Sesame, but it doesn’t deliver all medications, and there is a delivery fee.

Erectile dysfunction (ED) is a common health concern among people assigned male at birth. ED may impact a person’s sexual health and intimate relationships. It’s estimated that 52% of men age 40–70 have ED. Causes of ED include heart conditions, metabolic disorders, mental health, and medications. Fortunately, ED treatment is available, and there are many ways to connect virtually to health care providers who can recommend treatment options for you. 

Justin Houman, urologist and medical director at Bastion Health, said that ED can often be diagnosed and treated through virtual medical visits. “Telehealth consultations allow for a detailed medical history to be taken, which is pivotal in diagnosing ED. Treatment plans, including prescription medications, lifestyle modifications, and counseling, can be effectively managed through telehealth platforms. However, certain diagnostic tests or physical examinations would require an in-person visit,” he said. 

Online ED consults make it easier to connect with a licensed health care provider and get the help you need. Sesame Care (Sesame) is a telehealth platform that offers online ED consults. We reviewed it to find out what it’s like to receive ED treatment on Sesame.

Sesame Care

Sesame has general and specialist providers offering online appointments for erectile dysfunction concerns. It doesn’t take insurance, but it has upfront pricing for provider visits, and same-day appointments are available.

Sesame

8.7 Very Good

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Same-day appointments available

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Choice of telehealth provider

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Optional medication delivery

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Option to add on provider messaging

8.7 Very Good

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Features

• ED meds available: Sildenafil and tadalafil
• Price range: $2.40–$6.30 for 30 tablets
• Consultation price: Varies by provider
• FDA-approved: Yes
• Shipping time: Four to five business days

Pros and Cons

Pros Licensed general and specialist providers to choose from in every state Upfront pricing and availability Same-day appointments available Optional add-on to message with your provider after your session Cons Doesn’t take insurance Number of licensed providers varies by state Delivery fee for medication delivery through SesameRx

Our Sesame experience

On Sesame, users see a health care provider online and then receive ED treatment. You don’t need to choose your treatment before you see a provider; rather, your provider recommends one for you if you are eligible for ED medication treatment. Booking a virtual appointment on Sesame is straightforward. We liked that you don’t have to sign up for an account until you’ve chosen your provider. 

When our Reviews Team surveyed 600 people who used online ED platforms, 65% of respondents shared that they had a strong motivation to get their ED treated as soon as possible. We found that Sesame providers often had day-of availability so our testers could get started with ED treatment the same day. Platforms such as Hims and Roman may take up to 24 hours for a provider to review your health assessment. Our Reviews Team reviewed these platforms for their online ED treatments. Read our Hims ED review to learn more. 

Sesame offers price and availability transparency with provider visits. However, we had to call Sesame customer service to learn more about SesameRx and other features on the platform because these were not clearly explained on the platform’s website. We share what we learned about these options offered by Sesame below. 

Our expert opinion

Sesame can be a good option for people who want to see a provider about their ED symptoms and get timely treatment. Users can choose their provider and attend a virtual appointment with them on the same day. Medication delivery on the platform can take a few days to process, ship, and deliver, so we recommend getting your ED medication prescription sent to a local pharmacy for pickup if you’d like to start your treatment sooner. 

Compared to other platforms, scheduling a virtual ED consult on Sesame means you’ll attend a video appointment with a provider. During the online appointment, you can ask your provider any questions about your ED treatment options, and your provider can make an assessment to determine the best ED treatment plan for you. Although online visits on Sesame may seem more comprehensive than on other platforms, we still recommend talking to your primary care provider about ED treatment first. If you’re on multiple medications or have complex health concerns, they may be better informed to prescribe a treatment option that doesn’t negatively interact with your current medications or health conditions. 

Special considerations: Erectile dysfunction medication for older adults

Viagra and Cialis may be ineffective or dangerous based on your health history and current medications.

Some of the most common chronic conditions affecting older adults—including high blood pressure, high cholesterol, heart disease, and diabetes—can damage penile blood vessels and nerves, leading to new or worsening ED that doesn’t respond to Viagra or Cialis. Fortunately, several other ED treatments are available, including penile injections, vacuum erection devices, and a discreet penile prosthesis. 

ED can also appear as one of the first symptoms of cardiovascular disease, hypertension, anxiety, and other chronic health concerns. If you haven’t had a physical exam within the last year, don’t try to get ED medication online. Visit your doctor in person to ensure underlying conditions are diagnosed and treated alongside ED. 

Who shouldn’t take Viagra or Cialis

Viagra and Cialis shouldn’t be taken with some of the medications that are used to treat chest pain, high blood pressure, or lower urinary tract symptoms. Viagra should also be avoided in people taking protease inhibitors—a specific class of medications used to treat HIV. 

Combining nitrates or alpha-blockers with ED pills may cause a severe, life-threatening drop in blood pressure, which can be associated with feeling dizzy, fainting, falling, and even death. This is not a complete list of medications that should not be taken with Viagra and Cialis. Talk to your provider about everything you take—including recreational drugs—when discussing potential ED treatments. 

Cialis and Viagra also shouldn’t be taken by people with low resting blood pressure, uncontrolled high blood pressure, inherited disorders of the eye or retina, recent heart attack or stroke, or uncontrolled heart disease. Cialis and Viagra may exacerbate abdominal pain in people with stomach ulcers. 

What is Sesame Care?

Sesame is a telehealth platform offering virtual visits for urgent care, primary care, specialist care, and therapy. It has providers in every state and often has same-day appointments, especially with internal medicine and family medicine practitioners. 

We reviewed Sesame for its online therapy offerings. Read our Reviews Team’s review of online therapy on Sesame.

Sesame erectile dysfunction treatment

When searching for an online ED consult on Sesame, the platform offers visits with family medicine, urgent care, and internal medicine professionals. Sesame also has urologists on the platform; however, we noticed that urology specialists weren’t available in every state. For example, there weren’t any urologists available in Louisiana at the time of our search, but there were 10 general providers to choose from for an online ED consult. 

During your visit, your Sesame provider will assess your case. If ED treatment is appropriate for you, providers could prescribe any of the following common treatments for ED, but Sesame’s medication delivery service only fills prescriptions for tadalafil (generic Cialis) and sildenafil (generic Viagra).

Table 1 Prescription erectile dysfunction treatments

Source: National Institute of Diabetes and Digestive and Kidney Diseases 

If prescribed, you can choose to fill your prescription anywhere. Generally, you can send your prescription to a local pharmacy for pickup or delivery, or you can send it to a mail-order pharmacy that can deliver it to your door, such as Amazon Pharmacy or Cost Plus Drugs. 

After your online ED visit with a Sesame provider, you can activate a post-visit messaging service for $19. This service gives you four days of access to a messaging portal on Sesame with your provider should you have any questions about your treatment. We liked that you didn’t have to activate the provider messaging service right away, which means you can get support from your Sesame provider after you start your ED treatment. 

SesameRx

SesameRx is Sesame Care’s medication delivery service. You can request that your prescription be sent to SesameRx to be delivered to your door or sent to your local pharmacy for pickup. There are some drawbacks to using SesameRx: 

• Doesn’t deliver all medications: We didn’t like that you can only get some medications through SesameRx. Out of the many possible ED treatments, SesameRx only offers sildenafil and tadalafil delivery. If you are prescribed any other medications, you won’t be able to use SesameRx to get it delivered. Rather, you have to pick it up at your local pharmacy.
• Limited quantity: SesameRx only fills prescriptions up to 90 tablets before you have to see a prescriber to get a refill. It is standard for providers to ask for a check-in appointment after 30 days before they will order additional refills, and whether more than a 30-day supply is refilled is ultimately at the discretion of the provider.
• Doesn’t take insurance: If you have insurance coverage, you won’t be able to use your pharmacy benefits to pay for SesameRx, unless you have your prescription sent to your pharmacy.
• Fees to fill prescriptions: In addition to the cost of your medication, SesameRx charges $5.99 for each prescription filled through the service. So if you’re getting three different medications filled through SesameRx, it could cost an additional $17.97 to get them filled and delivered. 
• Can take time for delivery: When we spoke with Sesame customer service, we were told that it could take up to 48 hours for the prescription to be sent to their pharmacy and up to another 48 hours for the medication to be prepared for shipment. Then, it can take four to five business days to ship via USPS. In total, medication delivery on SesameRx can take up to eight days. Compared to other options, such as picking up at your local pharmacy, eight days can be a long time to wait for ED treatment. 

If you prefer medication delivery, SesameRx could still be a good option. The cost of 30 tablets of sildenafil or tadalafil is less than $10, so depending on your coverage, your total cost can still be comparable to a pharmacy co-pay. 

Sildenafil

Sildenafil is the generic form of Viagra, a medication used to treat ED. It works by increasing blood flow to the penis in response to sexual arousal. 

Sildenafil is typically taken on an empty stomach about an hour before sexual activity. The drug can cause side effects such as headaches, nose congestion, flushing, sensitivity to light, and nasal bleeds in rare cases. You shouldn’t take sildenafil if you’re taking certain medications, such as nitrates for chest pain, as both medications can lower your blood pressure. Talk to your doctor about whether sildenafil is appropriate for you. 

Here’s what it costs to get 30 tablets of sildenafil from SesameRx:

• 20 mg: $4.50
• 45 mg: $5.40
• 50 mg: $6.00
• 100 mg: $6.00

Tadalafil

Tadalafil is the generic form of Cialis, another popular medication used to treat ED. It works the same way as sildenafil, by increasing the blood flow to the penis in response to sexual arousal. 

Unlike sildenafil, tadalafil can be taken daily and works for a longer period of time. Tadalafil can cause side effects such as headaches, flushing, and changes in vision. Like sildenafil, you shouldn’t take tadalafil with certain medications, such as nitrates for chest pain. Talk to your doctor about whether tadalafil is appropriate for you. 

Here’s what it costs to get 30 tablets of tadalafil from SesameRx:

• 2.5 mg: $2.40
• 5 mg: $2.40
• 10 mg: $5.40
• 20 mg: $6.30 

Sildenafil and tadalafil are both part of a class of medications called phosphodiesterase 5 (PDE5) inhibitors. PDE5 inhibitor drugs have some common side effects and some more rare but serious ones you should know about.

Jamin Brahmbhatt, a urologist at Orlando Health in Clermont, Florida, advises looking out for common side effects such as headaches, flushing, and dizziness, but paying particular attention to “symptoms that might require immediate medical attention, like severe low blood pressure, priapism (a prolonged, unwanted erection), or sudden changes in hearing or vision.” In these cases, contact your health care provider or call 911 immediately.

Sesame erectile dysfunction treatment cost

The cost of online visits with prescribers varies by provider and your location. When we tested the platform searching in the New York area, we found that ED consults can range from as low as an insurance copay ($37) up to a typical out-of-pocket cost for a specialist visit ($385). Each provider has their own visit cost, and provider availability varies by location. For someone searching in Massachusetts, for example, we found online ED consults between $46–$122. 

Sesame offers Costco members $29 virtual visits with primary care providers who are licensed to practice online in your state. If you’re a Sesame Plus member, you can also get $10 off your online ED visits on Sesame. We explain more about Sesame Plus below.

The cost of ED treatment through SesameRx depends on the medication and dosage that you’re prescribed. We learned that 30 tablets of sildenafil can cost between $4.50–$6.00, and tadalafil can cost between $2.40–$6.30.  

It costs an additional $5.99 per prescription that you fill with SesameRx. 

Table 2 Cost of sildenafil and tadalafil from SesameRx

* Doesn’t include the $5.99 delivery fee

Sesame Plus

Sesame Plus is Sesame’s membership program. You don’t have to be a member to book appointments on Sesame, but Sesame Plus members get $10 off all telehealth appointments and a free blood test per year. 

Sesame Plus costs $10.99 per month or $99 per year.

How to sign up for Sesame erectile dysfunction treatment

Book an appointment for online ED treatment by following these steps:

1. Use the search bar on the Sesame website to search for “erectile dysfunction” to find online ED consults with general practitioners such as family or internal medicine providers. You can search for “urologist” to find urology specialists, however provider availability may vary by state.
2. Enter your email to view your search results.
3. Browse provider profiles and availability. Choose an available time slot with the provider of your choice.
4. To check out, you’ll need to create a Sesame account by providing your email, password, and phone number. Here, you will also enter your personal information, the reason for the appointment, the state you live in, and your payment information.
5. You’ll receive an email confirmation with instructions for attending your virtual appointment. This could take place on a third-party conference application such as Doxy.Me or Zoom. 

You can cancel your online ED appointment up to three hours before your appointment time for free. If you book a same-day appointment, you can cancel for free within one hour of your confirmation.

After your visit has concluded, you will receive an email with an option to activate your provider messaging service. The post-visit messaging service costs $19 for four days of messaging. Once activated, you can message your provider for up to those four days about any questions you may have about your treatment. 

Sesame contact and payment information

Customer service

You can reach Sesame customer service by:

• Phone: Call 877-947-6411, available seven days a week from 9 a.m. to 9 p.m. ET 
• Chat: Live chat via the bottom right corner of the support webpage, available Monday through Friday from 9 a.m. to 9 p.m. ET
• Email: support@sesamecare.com

Payment options

Sesame does not take insurance for its telehealth visits or medication delivery. Credit card payment options include Visa, MasterCard, American Express, and Discover. Sesame also accepts FSA and HSA cards as payment.

How we research and evaluate erectile dysfunction platforms

Based on our expert consultations, research, and testing, we determined the following factors to be essential for our readers when signing up for an erectile dysfunction medication platform:

• Costs for medications and consultations
• Ability to conduct live calls (video or phone) with prescriber
• Users must complete a health questionnaire when signing up
• Name-brand and generic prescriptions available
• Ability to message prescriber through the platform
• Ability to get an ED diagnosis through the platform
• Shipping options and costs
• Customer service

We had all of our reviews medically reviewed by an expert in the field to ensure the information was appropriate for NCOA readers’ needs.

Bottom line

Based on our Reviews Team’s experience and research, we found Sesame to be an easy-to-use telehealth platform that can connect you to an online ED provider as soon as the same day. We liked that you can choose the provider that you’re comfortable with to get assessed for ED. If you have insurance benefits, you won’t be able to use them on Sesame for its telehealth visits or medication delivery through SesameRx. Medication delivery comes with extra fees, so if you prefer to have free ED medication delivery, other online ED platforms like Hims may be a better option. You can also have your Sesame provider send your prescription to your local pharmacy if you want to use your insurance benefits to help pay for your medication. 

Consider coming prepared for your Sesame visit with any current medications or health concerns. If you haven’t been diagnosed with ED before or it’s your first time taking ED medication, you may want to ask your primary care provider whether online ED treatment is appropriate for you. 

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

1. Leslie SW, et al. Erectile Dysfunction. StatPearls. Jan 9, 2024. Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK562253/ 
2. Ziegelmann, M. Mayo Clinic. Erectile Dysfunction. March 29, 2022. Found on the internet at https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
3. McMahon CN, et al. Treating Erectile Dysfunction When PDE5 Inhibitors Fail. British Medical Journal. March 11, 2006. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1397768/
4. Capogrosso P, et al. Erectile Dysfunction in Young Patients is a Proxy of Overall Men’s Health Status. Current Opinion in Urology. March 2016. Found on the internet at https://journals.lww.com/co-urology/abstract/2016/03000/erectile_dysfunction_in_young_patients_is_a_proxy.5.aspx
5. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for erectile dysfunction. July 2017. Found on the internet at https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
6. Mayo Clinic. Erectile Dysfunction. March 29, 2022. Found on the internet at https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/diagnosis-treatment/drc-20355782 
7. Medline Plus. Sildenafil. Aug. 15, 2023. Found on the internet at https://medlineplus.gov/druginfo/meds/a699015.html 
8. Medline Plus. Tadalafil. April 15, 2023. Found on the internet at https://medlineplus.gov/druginfo/meds/a604008.html 

Vanessa Ling Author

Vanessa Ling is a health writer and licensed health care practitioner. As a naturopathic doctor, she advocates for life-long, whole-person health through simple, accessible, and evidence-based interventions.

Kevin Campbell Medical Reviewer

Dr. Kevin Campbell is a board certified urologist in Gainesville, Florida. He trained at the University of Florida with subspecialty training in Reproductive Medicine and Surgery at Baylor College of Medicine.

Susan Stiles Reviewer

Susan Stiles, PhD, provides leadership in the design and development of consumer products that inspire, educate, and activate older adults. She’s been instrumental in bringing the Aging Mastery Program® to market and scaling it nationwide via strategic alliances and business partnerships. Stiles has 20+ years of experience in design thinking, multimedia, strategic communications, and management consulting.