Roman Review: All about Roman’s health services and products

Sometimes, you don’t want to go to the doctor as a matter of privacy. Other times, it’s a question of convenience. Modern telemedicine has been able to address both concerns by offering online consultations and prescriptions for an enormous variety of conditions.

Roman has quickly become one of the big players in men's telehealth, offering many convenient ways to access healthcare online and get health products discreetly in the mail. While the company initially focused on sexual health, its reach has grown to include treatments for various problems, from hair loss and erectile dysfunction to weight management and skincare.

We thoroughly tested Roman, getting hands-on with numerous products. In this review, we'll lay out the pros, cons, and all the details to help you decide if Roman is right for you.

Increased services and decreased prices have improved Roman's standing. It can be an invaluable resource for men seeking help with various issues, and it provides a free consultation for most products and services. Competitors sometimes have it beat in terms of the cost of certain products, but we’ve uncovered areas in which Roman’s prices are the lowest.

At Innerbody Research, we extensively test each health service we review, including Roman. All told, our team has spent over 470 hours testing and researching the products and services of Roman and its chief competitors in order to provide you with detailed accounts of our experiences.

We tempered that extensive hands-on research with deep dives into published scientific articles related to Roman’s various products and the conditions it seeks to treat, including human clinical trials wherever possible. Additionally, like all health-related content on this website, this review was thoroughly vetted by one or more members of our Medical Review Board for accuracy.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions to live healthier lifestyles.

When we set out to evaluate a multifaceted service like Roman, we divide our attention across several critical criteria to determine the company’s overall score. In Roman’s case, these included cost, treatments and services, customer support, and privacy protections. Given that some of Roman's competitors offer similar treatments, customer service, and privacy protections, the cost quickly became the most important criterion of the bunch, and it offered the most weight to our overall estimation of the company.

Cost

Roman's product lines often cost a little more than its most direct competition's least expensive high-quality offerings. Over the years, those discrepancies have waned, and Roman now has a handful of treatments that are significantly less expensive than what others charge — if those competitors offer them in the first place.

The best example of Roman’s recent improvements in both pricing and treatment availability is in oral minoxidil. This is a drug that’s only garnered serious, widespread attention as a hair loss treatment in the last couple of years, and competitors like Hims and Keeps don’t offer it yet. The only other provider offering oral minoxidil is Happy Head, but Roman has a far superior price and a more robust telemedical infrastructure to address any potential side effects. Roman’s rating improved since the company waived a $15 consultation fee that was standard for receiving any prescription through its platform.

Still, there are instances where Roman’s pricing just doesn’t compare to what certain competitors offer. This is most apparent in the company’s erectile dysfunction treatments.

Here’s a quick look at the best available prices for daily tadalafil (generic Cialis) from some of the top ED medication providers online:

For a daily medication, going with a company other than Roman can save you over $1,000 yearly. Promescent is a recent entry into the ED medication space, having offered treatments for premature ejaculation for years, as well as various sexual wellness items. We haven’t had a chance to test Promescent’s interface for ED medication yet, but if it’s anything like the other experiences we’ve had with the company through the years, its prices will be a serious threat to Roman and similar companies.

One thing we can say about Roman that few other companies can boast: Roman is transparent about its pricing. It even maintains a complete price list for its products with a dedicated button across the banner on every page, so you can quickly find the cost of almost anything. As the company’s catalog has expanded, some products haven’t yet made it to this pricing page. This may also have to do with variations in cost associated with potential insurance coverage or customized dosages for newer prescription treatments.

Treatments and services

Roman’s range of treatments and services continues to expand. Men’s sexual wellness and hair loss support are among its most abundant and popular programs, and the available treatments are well-known products and prescriptions most men would encounter in their search for solutions.

For hair loss, treatments include oral versions of finasteride and minoxidil, as well as topical minoxidil in solution form. That oral minoxidil sets Roman apart from the likes of Hims or Keeps, neither of whom offer oral minoxidil at this time. But Hims and Keeps both offer topical finasteride and a foam version of minoxidil that’s more tolerable to sensitive scalps. Roman has not come out with similar treatments.

On the sexual wellness side, Roman offers many of the same treatments as Hims, BlueChew, or Promescent, but its prices are noticeably higher, as we discussed above. Those treatments include branded Viagra and Cialis and their generic equivalents.

Digging deeper into Roman’s catalog reveals a significant amount of variety that might make it a superior one-stop shop for those seeking multiple treatments. Other treatments and services include:

• Herpes medication
• Premature ejaculation treatment
• Fertility support
• Hair and skincare
• Weight loss support
• Anti-smoking therapies
• Testosterone support
• Nutrition supplements

Roman’s rating in this category has declined a bit in recent months, as the company has removed its mental health care platform and its program to deliver allergy medications. It has added a few products, including a selection of fertility tests and treatments, as well as an increased catalog of weight loss drugs, but the loss of the mental health platform is disappointing.

Similar telehealth companies like Hims offer many of these same treatments, though Hims notably lacks the diversity of nutritional supplements, weight loss support, and the anti-smoking program you can find from Roman. Hims also offers a similar custom skincare product, and it has a few more treatment options for hair loss and sexual health, including chewable mints for erectile dysfunction and several sex toys.

Customer support

One of the best things about care through Roman is its simplicity. Consultations are fast and minimally invasive. Follow-ups are helpful and reliable. Best of all, Roman allows you regular access to your doctors through a simple messaging system. Combine those features with friendly customer support and speedy shipping, and you'll see how Roman offers value in its quality of care.

Ultimately, these aren’t wildly different aspects of telemedicine than you’d get from Hims or Keeps. In testing, we got great phone support from both Hims and Roman, even when our questions went far beyond what the call center operators encounter on a typical day.

One thing that sets Roman apart in customer support is its shipping system. We’ve routinely received shipments from Roman in two days or less without paying anything extra for expedited shipping. That includes shipments to both U.S. coasts. This efficiency is consistent and remarkable.

Privacy

Roman's privacy protections are middle-of-the-road. It has strong safeguards in place to protect any medical information you might share, and it also offers the opportunity to opt out of the sale of personal information to third parties. But its default mode is much like any other site looking to monetize their very presence online — whether or not you buy anything from them. It uses cookies for tracking and doesn't recognize Do Not Track signals from any browser.

Still, as a telehealth provider, you’re going to experience a higher degree of privacy from Roman than you would if you walked into a doctor’s office or sexual health clinic and sat in the waiting room. And shipments from Roman don’t contain any details on the packaging that give away the contents inside.

Founded in 2017, Roman is the men's health offering of Ro. This telehealth company also owns Zero, a telehealth service focused on helping people quit smoking, and Modern Fertility, which specializes in fertility testing and treatment.

Roman lets you tap into Ro's network of licensed U.S. doctors to access an array of quality treatments for men's sexual health, allergy, hair loss, weight management, mental health, and more. Typically, men’s health products that don’t require a prescription will bear the Roman name, while prescription medications come from Ro. That might seem confusing, but you can access all of these treatments and services on a single site, so the distinction is ultimately meaningless to the average consumer.

The rise of high-quality, trustworthy telehealth companies like Roman and its siblings has provided a way for people to access prescription drugs like Viagra without the stigma or embarrassment they might feel in seeking the medication or going to the pharmacy. It also ensures that the pills they receive aren't counterfeit, which some studies have shown is a real threat.1

After you get started with Roman, if your consulting Ro doctor prescribes you a medication, you can reach out to get help and answers from Ro doctors and pharmacists throughout your treatment. Roman provides unlimited messaging to its members.

Roman online reviews

Roman has an outstanding reputation online, but its rating with the Better Business Bureau isn’t as stellar. It’s an accredited business with BBB, but its rating here is only a 1.38 out of 5 at the time of this writing. However, that only accounts for 26 reviews. Most complaints seem to arise from miscommunications around subscription cancellation or potential insurance coverage.

On Trustpilot, the picture is very different, with Roman receiving a 3.9 out of 5 after a little over 300 reviews. This is more in line with our experiences with Roman through the years, where we’ve encountered good customer service, fast shipping times, and well-made products.

As mentioned above, the main focal points for men's health via Roman right now are sexual health and hair loss. Roman’s selection of options here is consistent with major competitors for sexual health and hair loss, though its oral minoxidil offering is rare and a potential game-changer for many. Your doctor consultation will determine which treatment would serve you best.

Roman offers a few other health products, as well, from skincare to weight loss support. And that weight loss offering has expanded recently with the arrival of GLP-1s like Ozempic and others.

Let’s take a closer look at Roman’s treatments for specific health concerns.

Sexual health treatment is the cornerstone of Roman’s service. Medications are available for ED, herpes, and premature ejaculation. Roman struggles to compete on price with its competitors for ED meds, but its premature ejaculation wipes are a great choice for a specific niche of men with PE and sensitive skin.

Roman's ED treatments

More than half of all men may deal with ED at some point in their lives, so Roman offers three different pathways to treat ED.2 All of these ED medications are PDE5 inhibitors. That means they combat ED by preventing the release of an enzyme typically responsible for the cessation of an erection after climax.3 That allows the body’s signals that create an erection to pile up and keep an erection in place. The medication also has a cardiovascular effect that increases blood flow, improving erectile strength and reliability.

Pricing depends on the medication and dosage, which you and your Roman doctor will determine together. You also have the option to purchase branded or generic forms of the drugs, depending on your budget and preference.

Here's a breakdown of how the treatment costs compare per dose:

PDE5 inhibitor treatments are effective for most men with ED, helping about three in four men achieve erections in studies.3 However, experiences can vary from treatment to treatment, which is why having options and doctor access is so valuable. Physicians prescribe these drugs widely, but some common side effects of PDE5 inhibitors may include:

• Facial reddening (flushing)
• Headache
• Nausea
• Diarrhea
• Congestion and flu-like symptoms

PDE5 inhibitors also have potentially dangerous cardiovascular side effects, especially for men with blood pressure issues and those on blood pressure medications.3 If you notice any adverse reactions to the medication, we recommend temporarily ceasing treatment and contacting your doctor.

Sildenafil and tadalafil are also older PDE5 inhibitors, and they can collaterally affect other PDE enzymes.4 There are some newer medications, like vardenafil, that more directly target PDE5 and result in fewer side effects as a result. Roman does not offer such alternatives at this time. You’d have to go through a company like BlueChew or Hims to access these medications.

Premature ejaculation

Premature ejaculation (PE) is a common thing, though its clinical definition is somewhat vague.5 Essentially, if you last less than a minute from the beginning of penetrative intercourse or you don’t even make it that far, you’re a candidate for diagnosis. The same can be said if your ejaculation latency time (ELT) is more than a minute but sufficiently short that it impacts your relationships or your mental health.

Roman offers a discreet way for men to get PE treatment. There are two treatment options for PE: an over-the-counter topical and a prescription pill.

First, let’s explore the OTC treatment. Roman's Swipes for PE act by slightly dulling the sensation of the penis. The effect is strong enough to delay orgasm without being strong enough to reduce pleasure. The active ingredient in these wipes is 4% benzocaine, a topical anesthetic. This treatment is excellent because:6

• It's safe. Side effects are rare and not severe, though some men are allergic. If you experience a topical allergic reaction, you should stop using it and contact your Ro doctor. Some rare contraindications also exist, so talk to your doctor about any other medications you take.
• It's discreet. The swipes fit in your pocket and are odorless once dry.
• It's fast-acting. Just swipe over sensitive areas and let dry for 5-10 minutes.
• It's effective. After two months of use, men with a baseline sexual endurance of 165 seconds improved to 5.5 minutes.7

Roman sells its Swipes for $27/month if you subscribe monthly. Each monthly kit contains eight Swipes. However, if you commit to a 3-month supply (24 wipes), your monthly price comes down to only $22.

Promescent, Hims, and VigRX are the other big players in the delay scene. Each of those companies also offers a delay spray, whereas Roman only offers the wipes. The wipes from Hims and Promescent are also stronger, boasting a 10% solution to Roman’s 4%. That might not always be a good thing, though. If you find the 10% solution to take away too much sensation (like the difference between a thin condom and a thick one), a 4% solution may be superior. There is also reason to believe that Roman’s Swipes are a better choice for men with sensitive skin, as a lower concentration of benzocaine should reduce the intensity of any potential allergic reaction.8

As for Roman’s second, prescription option for PE, Sertraline (generic Zoloft) is what's referred to as an off-label treatment for premature ejaculation because it wasn't designed or approved to treat PE. It’s traditionally used as an antidepressant selective serotonin reuptake inhibitor (SSRI), but it can delay orgasm for some male patients.9 Sertraline won't be suitable for everyone; it's a daily medication, and there are contraindications, drug interactions, potential side effects, and health risks for the doctor to consider.

Common side effects of sertraline include:10

• Changes in mental status
• Muscle twitching or rigidity
• Nausea or vomiting
• Sweating
• Headaches
• Weakness

A Ro doctor will decide whether such medication is proper for you based on your health and medical history.

Roman sells a one-month supply of sertraline for $24.

Can ED medications treat premature ejaculation?

There is some evidence to suggest that ED medications can help treat premature ejaculation.11 This evidence is compelling enough that Roman and some of its competitors list these medications under their PE headings. However, unless you suffer from both PE and ED, we recommend starting elsewhere first.

This recommendation is based on the comparably high side effect risk of PDE5 inhibitors, especially in men with cardiovascular conditions and relative to less intense but equally effective OTC treatments like delay wipes. Some research also points toward an onset of psychogenic erectile dysfunction in men who take ED medications recreationally or as part of their jobs (typically adult entertainers).12

Genital herpes and cold sores

Valacyclovir (generic Valtrex) is Roman's medication for cold sores or genital herpes. Valacyclovir is an antiviral medication that works by interrupting the herpes virus' ability to replicate its DNA.13 It's FDA-approved to treat cold sores (oral herpes) and genital herpes (HSV-1 and HSV-2).

Valacyclovir won't cure you of the virus, but it effectively suspends the activity of a herpes virus that is actively trying to replicate. If you take it when you sense an outbreak is about to happen, the drug can significantly reduce symptoms and possibly prevent the attack. In terms of side effects, Valacyclovir can cause headaches, nausea, and abdominal pain.

Valacyclovir is available as a daily preventative treatment or as something you take as needed.

Here’s how the dosage and pricing work out:

Hims also offers valacyclovir, with nearly identical pricing for as-needed treatment but more expensive pricing for preventative treatment, even if you’re willing to subscribe at a semi-annual billing rate. That works out to $33/month compared to Roman’s $29 at 500mg. Hims does not offer a 1,000mg suppressive treatment.

Hair loss is a close second to sexual health in importance for Roman’s business. Like the follicles undergoing treatment, it’s a constantly growing field. We’ve recently seen a resurgence in the oral form of minoxidil, which may prove to be a game-changer for certain patients. Let's explore Roman’s hair loss offerings, starting with finasteride.

Roman offers a 1mg prescription for oral finasteride (generic Propecia) to tackle androgenetic alopecia (AGA), the most common form of hair loss.14 Finasteride is a 5-alpha reductase inhibitor.15 This means it blocks an enzyme called 5-alpha reductase, which converts testosterone into dihydrotestosterone (DHT). DHT plays a direct part in AGA (also typically called male pattern baldness), and a reduction in DHT causes a cessation and, in many cases, a reversal of hair loss.

Roman has the best price for finasteride. Here’s how it compares to the lowest prices available from its top competitors, Keeps and Hims:

As you can see, even though the initial costs from Keeps seem lower, over time, Roman’s pricing wins out. However, if you’re interested in topical finasteride (which is typically compounded together with topical minoxidil), you can’t get that from Roman. You’d have to go through Keeps or Hims. (We recommend Hims for this combination.)

Finasteride FAQ

Topical minoxidil (often known by the brand name Rogaine) was one of the earliest treatments for male pattern hair loss. Originally an oral blood pressure medication, minoxidil was remarketed as a topical solution for hair loss, specifically at the crown (or top of the head).20 It wasn't a popular prescription for high blood pressure because the oral version caused too many side effects — among them, unwanted hair growth.

Roman ships minoxidil in 3-month supplies and bills you quarterly at $16/month. This is a bit more expensive than the competition. Roman is also the only one of the three companies we often pit against one another for hair loss (Roman, Keeps, and Hims) that doesn’t offer a foam version of minoxidil. Minoxidil solution contains propylene glycol, a known irritant that’s responsible for many of the adverse reactions people using minoxidil will experience. Switching to the foam, which doesn’t contain propylene glycol, solves this issue for many.

For both its pricing and foam availability, we typically recommend Keeps for those seeking topical minoxidil.

Oral minoxidil may be just as effective as topical minoxidil or oral finasteride.21 And its side effect profile is preferable to oral finasteride for men concerned with sexual or depressive side effects.

For oral minoxidil, we highly recommend Roman. It’s one of two reputable companies offering the drug to men. Happy Head is the other, but its prescription is more expensive. Hims’ sister company, Hers, offers oral minoxidil for women, but Hims hasn’t added it to its catalog for men yet.

Minoxidil FAQ

Roman offers this combination hair loss treatment, which may maximize your results.23 If your Roman doctor concludes you're a candidate for both, this is the most potent hair loss treatment the company offers.

What makes the combination better?

The underlying cause of hair loss isn't the same for everyone, and it isn't always clear which treatment will be most successful for a particular person. So, by taking both, you increase your chances of stopping hair loss and regrowing hair. Minoxidil's effectiveness at preventing a receding hairline isn't as well-documented as its success in growing hair at the crown. Meanwhile, finasteride can pick up the slack with your receding hairline, making an effective combination of hair loss treatments.

The drugs don't interact, so there's no safety risk from taking both as long as you can tolerate each one individually.

These drugs are sometimes combined in a topical application, which can avoid potential sexual or depressive side effects associated with oral finasteride. At this time, Roman does not offer any form of topical finasteride, though you can get it from Keeps or Hims.

In addition to prescription and OTC drugs like finasteride and minoxidil, Roman offers three supplemental products for hair care that can help fight hair loss.

You can get Roman’s supplemental hair care products from the company on a recurring basis or from the company’s Amazon store, where they’re significantly less expensive. Here are the differences:

We reached out to Roman to inquire about the differences in price between the company’s website and its Amazon store. They told us that the price difference reflects the added value of access to doctors and customer support, as well as the convenience of a subscription platform.

We can’t help but disagree with that assessment. If you’re using the shampoo and conditioner on their own, you likely don’t need to talk to a doctor on a regular enough basis to justify the equivalent of an extra $9 or so per month. And if you’re using the shampoo and conditioner in conjunction with something like finasteride, then your finasteride prescription will grant you the same access, and you can just get your shampoo and conditioner from the Amazon store.

Roman’s Skincare lineup has grown a bit recently, adding three new products to its custom skincare prescription service. Let’s take a look at each.

Custom prescription skincare

Whether you've always struggled with skin problems or you're just worried about the effects of aging, Roman has a tailor-made prescription skincare treatment that can tackle everything from dark spots to fine lines and wrinkles.

The online consultation is free, and a dermatologist will formulate a skincare treatment for your specific skin type and goals. The active ingredients from which they will assemble your formula include:

Custom skincare treatments cost $58 and ship every two months. Hims offers a similar custom skincare cream but divides its offering between anti-aging and acne-fighting creams.

Roman also offers a hydrating face cleanser with green tea and vitamin C, an SPF 28 moisturizer fortified with coconut oil and vitamin E, and an enriching cream containing phytosterols and shea butter. These treatments cost $12, $12, and $16, respectively, and they ship every two months alongside your prescription skincare treatment.

Unfortunately, you can’t purchase these extra products without an ongoing prescription treatment, as well. If you want the SPF, for example, you have to be a prescription skincare customer to get it.

Hims offers a similar lineup but with the addition of a wrinkle cream. They’re a bit more expensive, but you can buy them without needing the other prescription subscription to be active.

Eczema and hyperhidrosis

Roman's product line also includes treatments for eczema and hyperhidrosis (excessive sweating).

Eczema sufferers can receive a prescription for 0.1% triamcinolone cream (generic for Kenalog).34 This cream is a steroidal spot treatment for areas where your eczema flares up. You can use it to treat active flare-ups or as a preventative in known problem areas. Just be aware that one possible side effect of long-term use is a thinning of the skin.

Triamcinolone cream through Roman costs $15/month.

Most hyperhidrosis sufferers have normal sweat glands that merely overact due to the nervous system's activity. Roman's prescription antiperspirant works by physically blocking those sweat glands. This product, known as Drysol, contains 20% aluminum chloride hexahydrate.35 Aluminum compounds are typically used in antiperspirants to plug up sweat glands and reduce perspiration.

You can apply Drysol to your armpits, palms, and feet. Roman recommends using the product at night and washing off any excess the next day. Over time, the barrier it creates should take hold and significantly reduce your sweating.

Drysol through Roman costs $13 monthly but is billed and shipped quarterly. That means a single Drysol container costs $39. The product is widely available at retailers like Amazon and Walmart, where it sells for closer to $30.

Remember that sweating is a natural and essential process for regulating body temperature. If you're merely on the cusp of a hyperhidrosis diagnosis, or you're thinking about using Drysol for convenience's sake, we'd recommend you think twice. Not only are itching and burning sensations common side effects of Drysol, but some studies also suggest a link aluminum-based antiperspirants with some forms of cancer.36 At this point, that link has yet to be verified, but it gives some consumers pause when selecting products.

Roman has added a pair of products to its lineup intended to treat eye problems that will be a cosmetic concern for most customers, though a clinical issue may be involved with one. Let’s look at each.

Eye drops to treat ptosis (drooping eyelids)

Roman is the only company in its class to offer a prescription eye drop intended to reduce the symptoms of ptosis, or drooping eyelids. The condition may be caused by genetics, nerve damage around the eye, or other conditions.

The drops contain oxymetazoline under the brand name Upneeq. This drug was previously used as a nasal decongestant but has recently gained favor as an eye drop. Users can expect to see wider, brighter eyes within an hour or two. The effect should last 6-8 hours.

Common side effects included blurred vision and eye pain, but in phase three clinical trials, these occurred at rates similar to a placebo vehicle.37 Potential long-term effects have not been established.

Upneeq isn’t cheap, either. A three-month supply costs $495, or $5.50/dose. The monthly plan may be more manageable for some at $199/month, but that brings the cost per vial up to $6.63. While some insurers will likely regard this as a cosmetic treatment, it’s possible that severe cases of ptosis — ones that impair vision — could qualify for insurance coverage. That won’t help you if you’re buying through Roman, though you could apply for an out-of-network reimbursement and cross your fingers.

Eyelash growth serum

Roman is our top recommended purveyor of Latisse, a prescription strength serum that can help you grow thicker, fuller eyelashes.38 It’s suitable for use by anyone concerned that their eyelashes are too thin.

Latisse was developed as an eye drop to treat glaucoma, but the lengthening and thickening of eyelashes was a common side effect. It remains a glaucoma treatment but has been repurposed as a topical serum for lash improvement.

You can get Latisse from Ro, Roman’s parent company, in a 5mL bottle shipped quarterly at $159 or in 3mL bottles shipped monthly at $110.

Roman’s weight loss program used to consist of a single product called Plenity. The company has recently added GLP-1s (like Ozempic) to its catalog, which we’ll cover first, given their popularity. It’s worth noting that Hims and similar companies typically don’t offer this kind of treatment.

Roman’s Body Program

Roman offers GLP-1s under the banner of its Body Program. This program gives you one-on-one support from a healthcare provider along your weight loss journey, as well as a concierge service to work with your insurance regarding medication costs. The costs of those medications aren’t provided by Roman due to the differences among insurance providers and the fluctuations in GLP-1 prices resulting from a national shortage.

Available GLP-1s include:

• Ozempic
• Saxenda
• Wegovy

The program has a cost of its own. You’ll pay $99 for your first month, and $145 monthly thereafter. That cost does not cover your medications or any tests your healthcare provider orders.

Plenity for weight loss

Our testers were impressed by Plenity. There are many weight loss products on the market, but Plenity is effective and much safer than most.

• Plenity contains no stimulants or anything that could be habit-forming.
• Its ingredients are primarily just citric acid and cellulose.
• Taking Plenity (pill-form) with a large volume of water before meals will help you feel less hungry, prompting you not to overeat.
• In a clinical trial, nearly 60% of people saw an average weight loss of about 10 percent of their body weight, translating to an average of 22 pounds.39
• Typical side effects were mild and GI-related, including bloating and diarrhea.

Roman also offers several supplements, which are manufactured in the U.S. by NutraScience. The chart below shows the various supplements available through Roman and the prices on one- and three-month plans, as well as the key ingredients in each.

Heart health and stress relief supplements by Roman are no longer available. Still, this is a wider array of options that you’d find from Hims.

Roman's parent company has an offshoot called Zero, which you can access through the Roman website. The program can help smokers quit by combining a drug to help curb cravings with nicotine gum to manage withdrawal symptoms. None of Roman’s competitors offer a similar program.

You will work with a physician to create a 12-week treatment plan with or without the nicotine gum. You'll have several follow-up visits with the doctor to address any side effects or concerns.

Bupropion

The medication at the center of Zero is bupropion (generic for Wellbutrin). This is an antidepressant NDRI or norepinephrine-dopamine reuptake inhibitor, but it can be prescribed off-label for people who need help quitting.40 It has a low side effect profile, with occasional incidents of the following:

• Headache
• Nausea
• Excessive sweating
• Blurred vision
• Insomnia
• Confusion
• Rapid heart rate
• Irregular heartbeat
• Hostility
• Auditory disturbances

In rare cases, bupropion can cause seizures. The dosage recommendation for bupropion to quit smoking is 150mg daily. This is a low dose for the medication. In cases of mild depression, psychiatrists will often start patients at 150mg and go up to 300mg if needed. Dosages above 300mg increase seizure risk.41

Bupropion prescriptions through Roman cost $18 for your first month and $45/month thereafter.

Some patients will get nicotine gum through their program, either on its own or alongside a prescription. On its own, Roman’s nicotine gum costs $30 for the first month and $42/month after that. Together, the gum and prescription cost $60 for the first month and $87/month after that.

Roman recently acquired a company called Modern Fertility, which bolstered its lineup of fertility-related products. These include fertility trackers, prenatal vitamins, and pregnancy tests. While many of these products are intended for women, the category also contains a program for semen analysis and sperm storage.

Analysis and storage are intertwined in this program, so you can’t have your semen analyzed and not include the free one-year storage subscription. Here’s what it all costs:

• Semen analysis: $199
• First-year storage (up to the vials): Free (included in the $199 above)
• Additional storage years: $149
• Withdrawal fee: $299.99

If you’re concerned about the viability of your semen but not interested in storage, we recommend Bird & Be’s At-Home Sperm Test, which costs $80, comes with two tests, and boasts a 97% accuracy rate.

As a telehealth company, your entire healthcare experience with Roman is virtual, either online or via its app. Here's how you can begin.

1. Go to Roman, select which service or product interests you, and start your visit. The virtual doctor's visit is an opportunity for you to answer questions and provide relevant medical information for a doctor in Roman's network. Our testers averaged about 15 minutes for this part of the process. Most of this information is easy to discuss, though some people may not know their recent blood pressure measurement, which is necessary for an ED prescription. You'll also need to provide a photo of yourself and your identification.
2. Wait for the doctor to review your medical information. The waiting period is less than 24 hours. Most of our testers heard back within just a few hours. You may hear from the doctor with follow-up questions about the information you provided. Some states also require a live chat with the doctor before prescribing. If you live in such a state, Roman will inform you.
3. You and your doctor will agree on a prescription if you're a candidate, and Roman will bill you accordingly. Your preferred billing cycle is up to you, but you can save some money by selecting a larger order (i.e., a 6-month supply rather than a 3-month supply) where applicable.
4. The Ro pharmacy network handles your order. This is an added convenience. Roman benefits from its parent company's pharmacy network, so it can fill your order automatically and ship it out to you to arrive in as little as two days.

Roman accepts all major credit cards and takes payment through Google Pay and Paypal.

At this time, Roman does not work with insurance providers to get you covered for the bulk of its products or services. Ro has a concierge service associated with its weight loss program to help you use insurance to cover the cost of tests and medication. In some cases — such as the Zero program to quit smoking — Ro is still working with insurers to offer some form of coverage. At this time, however, no such coverage is available. Roman does not accept payment through HSAs or FSAs.

While this is typical of many telehealth companies, including Hims, some more targeted services may offer FSA or HSA eligibility. And companies like Nurx work with multiple insurers to help provide coverage.

Shipping with Roman is reliably fast. Its shipping times are among the best in the business. Our testers regularly received shipments well within 48 hours of placing their orders. This is much faster than shipments we’ve received from Hims, Promescent, and others. Those shipments did not include delivery confirmation, however. So, if you purchase anything fragile — like prescription skincare products — in the depths of winter or at the height of summer, you'll need to keep an eye out for the delivery.

Roman's two most prominent competitors are Hims and Keeps. Other companies like BlueChew or HairClub offer one or two products that you can also find through Roman (like delay wipes and sprays, ED meds, or minoxidil), but Hims and Keeps are similar in the breadth of their offerings. Keeps focuses solely on hair loss, but Hims covers everything from ED and hair loss to primary care and mental health services.

For ED

From our extensive testing and comparisons among competitors, we recommend Hims more highly than Roman for ED treatments at this time. In addition to the remedies available through Roman, Hims offers an additional pill — a third PDE5 inhibitor called avanafil (generic Stendra), which acts faster than sildenafil or tadalafil. You can learn more about Hims ED treatments in our full review.

BlueChew is another option worth exploring if you think either generic Viagra (sildenafil) or generic Cialis (tadalafil) will be the right choice for your needs. What makes BlueChew compelling is that it’s just as affordable as the other online ED treatment options, but its medicine is chewable, which can be much more convenient than the pills you otherwise swallow with liquids.

For daily tadalafil, Promescent currently has the best prices. Its ED offering is new, however, and we haven’t had a chance to vet the process or the company’s doctors as of yet.

All three companies have Roman beat when it comes to pricing, though not by too much.

For hair loss

Roman's hair loss and hair care products are top-notch, but so are those from Keeps and Hims. In fact, Roman's price for minoxidil is the highest of the three, but its monthly price for finasteride is the lowest.

However, because Roman only offers topical minoxidil as a solution and not a foam, men with sensitive scalps looking to combine finasteride and minoxidil might find a better deal and a gentler treatment through a competitor. That said, Roman is one of the only places where you can get oral minoxidil from an online provider. Happy Head is a competitor with a similar offering, but its prices for oral minoxidil are significantly more than Roman’s.

For other treatments

For other treatments like skin care, weight loss, and supplements, Roman can be hit or miss. Here’s a quick breakdown: