How COVID Accidentally Normalized This Entire Industry
A regulatory shift that had nothing to do with ED specifically ended up building the infrastructure this entire category runs on.
Reviewed by the EdClinic Editorial Team · our research standards · not a substitute for professional medical adviceThe entire online ED telehealth category exists in something close to its current form because of a regulatory shift that had nothing to do with erectile dysfunction specifically. Here's the actual history.
The pre-2020 baseline
Telehealth existed before 2020, but adoption was gradual — most healthcare, including sensitive conversations like this one, still defaulted to in-person visits. Federal rules like the Ryan Haight Act (2008) had specifically required an in-person evaluation before prescribing certain controlled substances remotely, part of a broader regulatory caution around remote prescribing generally.
What changed in 2020
When COVID-19 became a declared public health emergency, waivers allowed clinicians to conduct initial evaluations via real-time video instead of requiring an in-person visit first. Adoption of telehealth broadly spiked dramatically during this period — by 2021, the vast majority of physicians were using some form of telehealth, according to industry tracking at the time.
The years since
The COVID public health emergency officially ended in May 2023, but regulators have repeatedly extended telehealth prescribing flexibilities rather than reverting fully to pre-2020 rules — multiple temporary extensions have kept expanded telehealth prescribing in place well past the emergency's end. Worth noting: most standard ED medications like sildenafil and tadalafil aren't DEA-controlled substances, so this specific regulatory framework applies more directly to certain other prescription categories — but the broader cultural and infrastructure shift toward telehealth as a normal, trusted way to get care applies across the board, including to this entire industry.
MadeMed
Compounded tadalafil through a licensed pharmacy network, positioned as a lower-cost alternative to brand-name treatment for people who qualify after evaluation.
Compounded medication notice: compounded formulations are not FDA-approved. Compounding pharmacies prepare medications under a licensed clinician’s prescription; effectiveness and safety have not been independently evaluated by the FDA.
View Offer Paid LinkWhy this history is worth knowing
The providers on this site aren't operating in a regulatory gray area — they're operating in an infrastructure that a genuine, well-documented public health emergency response helped build and normalize, and that regulators have continued extending rather than walking back.