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All Protocols  ›  Sexual Health  ›  The DESIRE Protocol
The DESIRE Protocol
Sexual Health · Performance

The DESIRE Protocol

Sildenafil + Tadalafil · Combo Troche Tadalafil · Daily
  • Sildenafil + tadalafil in one troche
  • Dissolves under the tongue — fast acting
  • Use as needed, physician-prescribed

As-needed, sublingual · Room-temperature shipment

Format
Combo Troche
Sildenafil + Tadalafil
$99 / 10-pack
Prescription only Free shipping Provider review in 24h US-licensed pharmacy
  • Low-dose tadalafil for daily readiness
  • One tablet, every day
  • No timing required

Once daily, oral · Room-temperature shipment

Choose your starting dose
2.5 MG
Starter dose
5 MG
Standard
$112 / month
Prescription only Free shipping Provider review in 24h US-licensed pharmacy
What It Is

Performance support — two compounds designed for performance.

  • Two options — one for the moment, one for every day
  • Works fast when you need it most
  • Up to 36-hour window with the daily option
  • Supports confidence and spontaneity
Compare Your Options

Combo Troche

Sildenafil + Tadalafil
Best for

Maximum strength when the moment calls for it

What's good
  • Two active compounds in one dose
  • Dissolves under the tongue — fast acting
  • Works in 15-30 minutes
  • Use only when you need it
Price$99/10pk
Onset15-30 min
FreqAs needed
FormatSublingual
$84/10pk (save $15)

Daily Tadalafil

Tadalafil 5mg
Best for

Always-on confidence with zero planning

What's good
  • One small tablet every morning
  • Always ready — no waiting
  • No timing pressure
  • Steady, continuous support
Price$99/10pk
OnsetAlways active
FreqDaily
FormatOral tablet
$84/10pk (save $15)
Featured Image images/protocol-desire-hero.jpg
The DESIRE Protocol
How it works

How Desire actually works.

Desire relaxes the blood vessels that fuel sexual response. You can choose on-demand (sildenafil + tadalafil combo troche) or always-ready (daily low-dose tadalafil) depending on how you want it to fit your life.

The on-demand version starts working in thirty to sixty minutes. Daily dosing reaches full steady-state within about a week. Your provider helps you pick what fits.

Desire Protocol · Sildenafil + Tadalafil
Board-certified physicianslicensed in your state
Compounded by a US pharmacylicensed, audited, traceable
Free, discreet shippingincluded in your subscription
What You’ll Take

On-demand or daily.

Combo troche for on-demand use, or daily low-dose tadalafil. Your provider matches the format to your lifestyle.

Why This Protocol

Two compounds, one goal — your confidence.

Sildenafil for the moment, tadalafil for the lifestyle. Your provider helps you choose.

About this protocol

Mechanism and clinical context our providers reference when evaluating intake.

The DESIRE Protocol clinical context
How combination PDE5 therapy works
  • Two ED medications in one dissolvable troche — sildenafil for fast onset (30–60 min) + tadalafil for extended window (up to 36 hrs)
  • Sublingual, not swallowed — bypasses the stomach for faster onset and fewer side effects
  • Or skip the timing entirely with a daily low-dose tadalafil (2.5–5 mg) option
  • Provider matches dose to your situation. Follow-up review as needed.
  • For men who want one medication that covers both planned and spontaneous moments
The DESIRE Protocol — Combo Troche The DESIRE Protocol — Daily Tadalafil
Storage & handling
  • Store at controlled room temperature (68–77°F / 20–25°C).
  • Combo troche: dissolve under tongue 30–60 minutes before activity.
  • Daily tadalafil: take once daily at the same time.
  • Do not combine with nitrates or alpha-blockers.
  • Compounded in a licensed US 503A pharmacy.

Your Performance Arc

First use

Effects begin within 15-30 minutes for the troche, or continuously with daily tadalafil.

Week 1-2

Confidence builds as you find the right timing and dosing.

Month 1

Consistent performance. Your provider checks in to optimize.

Ongoing

Use as needed or daily — your protocol adapts to your life.

Your timeline to treatment

From personalized intake to ongoing support, we help you get — and stay — on track.

Start The DESIRE Protocol in 5 simple steps

Answer a few questions about your health, goals, and history — all online, no in-person appointment needed. You'll find out if you're eligible within 24 hours.

Take your online intake on your phone

A US-licensed clinician reviews your intake, follows up on anything that needs clarification, and signs your prescription — typically within 24 hours.

A licensed clinician reviews your intake

Your Rx is compounded in a US-licensed 503A pharmacy, lab-tested, sealed, and shipped — never sitting on a shelf.

US-licensed 503A pharmacy compounds your Rx

Your shipment lands at your door with everything you need to start — troches or capsules, step-by-step guidance, and direct access to your provider.

Your shipment arrives at your door

Ongoing care from our medical team — quick re-checks, dose adjustments when needed, and 24/7 access to your provider whenever a question comes up.

Ongoing care from your provider

Peer-reviewed research and regulatory documents our medical team consults when evaluating intake for this protocol.

U.S. Food and Drug Administration (DailyMed / NLM)

Viagra (sildenafil citrate) — Full Prescribing Information

Official FDA prescribing information for sildenafil citrate, a PDE5 inhibitor indicated for erectile dysfunction. Provides pharmacology, dosing, contraindications, and drug interaction data referenced by our clinical team.
DailyMed / NLM

View source

U.S. Food and Drug Administration (DailyMed / NLM)

Cialis (tadalafil) — Full Prescribing Information

Official FDA prescribing information for tadalafil, a PDE5 inhibitor indicated for erectile dysfunction and BPH. Covers on-demand and daily dosing, pharmacokinetics, contraindications, and interaction profiles.
DailyMed / NLM

View source

Journal of Sexual Medicine (Wiley / ISSM)

Comparative efficacy and safety of PDE5 inhibitors — systematic review

Systematic review comparing the clinical efficacy and safety profiles of approved PDE5 inhibitors for erectile dysfunction, informing selection of sildenafil and tadalafil for combination use in the DESIRE Protocol.
Journal of Sexual Medicine

View source

European Urology (Elsevier)

EAU Guidelines on Male Sexual Dysfunction

European Association of Urology evidence-based clinical guidelines on male sexual dysfunction, covering PDE5 inhibitor therapy, on-demand vs. daily dosing strategies, and contraindication management.
Hatzimouratidis K et al. — European Urology 2010

View source
Medical notice. The DESIRE Protocol is a physician-prescribed medication dispensed only after clinical evaluation. PDE5 inhibitors are contraindicated with nitrate medications and may cause headache, flushing, nasal congestion, or visual disturbances. Not appropriate for patients with unstable cardiovascular disease, recent stroke, or severe hepatic impairment. Discuss all medications with your provider. Statements on this site have not been evaluated by the FDA.
Pairs With

What Desire stacks with.

The protocols our providers most often add alongside this one.

Enclomiphene · Hormone Optimization

Apex

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→
Hormone Replacement · TRT

Drive

Fuel the fire that makes you, you.
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Hair Loss · Restoration

Crown

Keep what's yours.
→