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Hi... I’m a 49 year old that is starting to ‘lose it’ down there. It’s taking way longer to get an erection (through masturbation or with wife) and often it’s not happening at all. (I DO get morning wood ) I’m fit and active (CrossFit, mountain biking, skiing) But with a history of high blood pressure. Right now I’m on 20 mg of lisinopril. I’m very slightly overweight... maybe 15 pounds. I don’t smoke and maybe only a few beers per week. I have had some marital issues over the last year and my wife has lost interest in sex and there is some anxiety on my part with that. I’ve finally spoken with my doctor about it and am going in for blood work this week. But my doctor is female and I feel like it’s hard to communicate. So... is it anxiety over my relationship? Blood pressure medication? Cardiovascular from my history of high blood pressure? Should I try out medication and if I do... is it worth going through Roman or some other online company?

I think your answering your own questions. Not having an interested partner creating anxiety, blood pressure issues, etc... Most likely your doctor will want to get your health issues under control first. Your wife's libido, assuming she's the same age, will probably start to feel like a rollercoaster ride. My wife goes back and forth. For a couple weeks I'll get repeatedly molested and then she turns into a nun. You also need to see if your doctor can write a prescription for 5mg Tadalafil (generic Cialis) daily. This may help you get an erection quicker and easier.

I’m hoping to learn what is more behind the issue. I’m aware that it could be a little of all of this but my fear is that if it’s cardiovascular then it could be permanent. The fact that I get erections throughout the night is good news, right?

So do most people go through their doctor and local pharmacy for medication? I looked at the 5mg daily Cialis through Roman and it was very expensive.

Also... I hear various things about Lisinopril.... could this be the culprit?

I was about 50 when I began to lose it. Between wife being hot & cold, getting older, a smoker and injecting Imitrex for migraines I didn't know what to blame either. I went the whole route, Viagra to Trimix to Quad Mix. Same thing with all of them, it would work for a while then become unreliable. Even right before my implant I was still getting night erections on occasion, but before I could do anything with it down it went.
First get your health in order, then discuss an implant with your wife. You want her in with the idea and to support you through recovery. Skip the pills and injecting drugs, they are costly and interrupt the mood or you have to plan when to have sex.

Old Guy, will a experienced implant surgeon even do an implant on a man who has health issues, admits to anxiety and hasn't tried medication first?
5mg tadalafil is the Cialis generic that you can take once a day with other vitamins. It's not until you get to 10mg that it is recommended to take "as needed" two hours before sex. At that point I agree that it does start to weigh on your mind. When 5mg worked for me I'd just take one with my Mens one-a-day. Never thought about it during sex and was always ready 24/7.
Mossanimal type "tadalafil" into goodrx.com. There you will find a list of pharmacies that carry it. It's quite cheap now. Cialis IS tadalafil. Don't pay for the brand name.

Seems premature to think about an implant! Man Old Guy... that post is not filled with hope but thank you for the honesty.

So 68Cat... what do you consider in expensive. Just now looking at Lemonaid Health it’s looking at like $100/month for daily Cialis. Less if I just get a few for the month.

I have excellent insurance but I have a feeling this isn’t covered by insurance??

Mossanimal- Yes I do have to say that is my honest opinion. I know it's not very promising, but after all the side effects I've had from using Viagra and Trimix I wish I would have found an urologist first. Unfortunately like a lot of men I tried the band-aid fix first, Viagra. Worked for a while then even with increased dosage it would be unreliable. The next morning I would have a severe migraine. I still knew nothing about implants, and headed to an ED doctor. That's where injections came in. It sure was tough getting used to sticking a needle into my penis, and the interruption to go inject killed any romance. When the Trimix started failing I went to Quadmix. By the time I finished the first prescription of that it was already starting to be unreliable. With increased dosages the pain afterwards was getting worse too. Still have bruises on my penis from those injections.
As far as I know no insurance covers any male sexual drugs. When I started Viagra I could get 3 pills for $60, then insurance stopped paying and my last prescription of generic Viagra was $199 for 3 pills. I paid around $150 for 5ml of Trimix/Quadmix delivered to my door, and could get maybe 7-8 doses from it. My implant surgery was $17,000, insurance covered all but $2,800 of it. I know that's a ton of money for anyone, but if I could have saved all the money instead of buying drugs that eventually failed I probably spent that much or more.

I'm assuming you are here in the States. I just looked at goodrx.com. $26.29 for 30 5mg tablets at Walmart pharmacy. 88 cents per tablet. I call that cheap. Before the patents expired and the generics came out Viagra and Cialis were stupid expensive.

Just buy 20 mg tablet and split in 4, thats what I do and a lot cheaper.

Thanks for the advice folks. I’m hoping that as things improve with my wife that I won’t have to travel too far down this path anyway.