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Hello everyone, been lurking on Frank Talk for a while now trying to gain as much knowledge about ED and possible solutions as I can. My trouble started in my late 30s. Cialis 5mg daily came to the rescue but as many of you have experienced every couple of years I needed a stronger dose. Now I'm almost 50 and I need 20mg for everything to work properly. My fear, of course, is that it won't be long before 20mg is no longer effective. Hence my nightly Google searches for ED treatments available now and in the pipeline.
I tried the shockwave therapy at two different men's clinics and then I tried the Stem Cell therapy last fall. Unfortunately neither helped. Wasn't surprised. There seems to be no solid statistical research that proves that either is effective. Just claims by the doctors trying to promote these procedures.
I have no underlying health conditions. I am a healthy, fit and active 49 year old male with a strong libido. The wife and I have been together for 30 years now. She still looks good and we have a fantastic relationship.
Relying on medication brings challenges I know many of you have faced. I can still get a natural erection but spontaneity (week day sex) is pretty much gone. I usually take 20mg of Cialis on Friday afternoon. It does last a good day and a half so I've become a weekend warrior. However, during the week my penis gets cold and retracts. Even when I'm not sexually stimulated it feels like there's much less blood flow. I'm always reaching down my pants and pulling it back out and trying to warm it up with my hand. Initially I tried to take 20mg every other day to help with the spontaneity but I'd lose track and then freak out when I struggled to get an erection. Was I unable to get an erection because it's been too long or is 20mg no longer working?
I feel like I'm headed for an implant somewhere down the road so I've been acquiring as much information as I can. I've become very interested in a new heat activated penile implant pioneered by Brian Le. The last I read it was successfully tested in a corpse in May, 2019. If anyone hears more about this please let me know.
Thanks to all of you for sharing your experiences. It helps to see that I am not alone and the more educated I become the more "confident" I feel about the future.

Welcome to the forum.

Take 20mg daily, you can easily up the dosage.

E.g. I take 20mg of Tadalafil daily, 200mg of sildenafil and 200mg of avanafil before action.

you have to keep the blood flow going down there.

You can combine Trimix with Cialis. I currently combine Trimix and sildenafil (generic Viagra) and it works very well. (Sildenafil is much cheaper than brand-name Cialis.) Injecting your penis is not so unnerving or painful as it may sound. For some guys and their gals it becomes a part of foreplay. Find my injection recommendations here on FT.

50 is about the time I had to start using Viagra. Yes, it doesn't last long until you need to increase the dosage, then before long it becomes unreliable regardless of the dose. Trimix is an option, but I found the same thing, worked for a while, go to higher dose, then it also became unreliable even with higher doses. The thing I didn't like about Trimix was having to plan sex. You just don't inject for the heck of it. After a while I also developed bruising that has yet to go away.
Having an implant is a big step. As you may have read some men have big issues with the surgery, others have little pain and heal fast. In my humble opinion I say go for the surgery before you get into injecting drugs into your penis.