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Vascular vs. Neurogenic ED: Understanding the Causes

Struggling with ED? Understand the causes of vascular and neurogenic erectile dysfunction and discover how to consult an EU-licensed doctor online for just €25 — prescription if appropriate, delivered in under 24 hours.

6 April 2026
Vascular vs. Neurogenic ED: Understanding the Causes —

DIRECT ANSWER

An online consultation lets an EU-licensed doctor review your case and, if appropriate, issue a prescription that is valid across the EU.

Less than 4 hours on average

Prescription issued in less than 4 hours on average if approved.

EU-licensed doctors

Every case is reviewed by a licensed clinician.

Valid across the EU

Approved prescriptions can be used at any EU pharmacy.

In this article

Erectile Dysfunction (ED) affects millions of men across the EU. If you're searching for solutions, you're likely looking for effective treatment. Hi-Doctor.ai connects you with EU-licensed doctors who can assess your condition and, if appropriate, issue a prescription for ED medication online. Get your prescription within 24 hours for just €25, valid at any pharmacy in the EU. If the doctor determines treatment isn't suitable, your fee is fully refunded. No risk, just clear answers and fast access to care.

How it works — get your ED medication prescription in 4 steps

  1. Fill out our brief online medical questionnaire (2–3 minutes) and pay the €25 consultation fee.
  2. A licensed EU doctor privately reviews your case. If the doctor determines the treatment is not appropriate for you, your €25 is refunded automatically — no risk.
  3. If approved, you receive a REMPE electronic prescription (PDF file) in your Hi-Doctor account and by email within 24 hours.
  4. Print the PDF or show it on your phone — present it at any pharmacy in the EU to collect your medication.

Who qualifies for ED medication

Our EU-licensed doctors review each case individually to ensure your safety and treatment effectiveness. They look for specific criteria, including your overall health, medical history, and any potential contraindications with ED medications like sildenafil (Viagra) or tadalafil (Cialis).

  • Generally, you must be an adult male experiencing persistent difficulty achieving or maintaining an erection.
  • The doctor will assess conditions like heart disease, blood pressure issues, kidney or liver problems, and other medications you may be taking.
  • It's crucial to provide accurate and complete information in your medical questionnaire to allow the doctor to make an informed decision.

What ED medication actually does (and doesn't do)

Most common ED medications, such as sildenafil and tadalafil, are called PDE5 inhibitors. They work by relaxing the blood vessels in your penis, which allows more blood to flow in when you are sexually stimulated. This helps you achieve and maintain an erection firm enough for sexual activity. They do not increase libido or provide an erection without sexual arousal.

  • Sildenafil (Viagra): Typically works within 30-60 minutes and lasts for about 4-5 hours.
  • Tadalafil (Cialis): Can work within 30 minutes and its effects can last for up to 36 hours, earning it the nickname 'the weekend pill'.

These medications are highly effective for many men with vascular ED and can also be beneficial for some forms of neurogenic ED. However, they are not a cure for the underlying cause of ED, and consistent use requires ongoing medical supervision.

Side effects and when to stop

Like all medications, ED treatments can have side effects. Common ones include headache, flushing, nasal congestion, indigestion, and temporary vision changes (especially with sildenafil). These are usually mild and temporary. More serious side effects are rare but require immediate medical attention, such as:

  • An erection lasting longer than 4 hours (priapism).
  • Sudden vision loss in one or both eyes.
  • Sudden hearing decrease or loss.
  • Chest pain or severe dizziness.

Always inform your doctor of any existing medical conditions or medications you are taking, especially nitrates for chest pain, as these can cause a dangerous drop in blood pressure when combined with ED medication. If you experience any severe or concerning side effects, stop taking the medication and seek medical advice immediately.

Why Hi-Doctor vs. walking into a clinic

Choosing Hi-Doctor.ai for your ED consultation offers unparalleled benefits compared to traditional clinic visits:

  • Speed: Get an electronic prescription in under 24 hours vs. waiting weeks for an in-person appointment.
  • Price: A flat €25 online consultation fee vs. variable and often higher private clinic fees.
  • Privacy: Everything happens in your secure Hi-Doctor.ai account — no awkward waiting rooms or reception desks. Your data is RGPD-compliant.
  • Convenience: Complete your consultation from your phone or computer, anywhere in the EU, without travel or time off work.
  • Trust: Join over 50,000 satisfied patients who rate us 4.8 on Trustpilot. All cases are reviewed by EU-licensed doctors.

COMMON QUESTIONS

Frequently asked questions

If our EU-licensed doctor determines that ED treatment is not appropriate or safe for you, your €25 consultation fee is refunded automatically. You pay nothing if the treatment isn't approved.

Licensed EU doctors
Doctor review in less than 2 hours on average
50,000+ patients served
Secure patient account

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