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Hi everyone. I'm a 40 yo male with good health but have had ED in different seasons of my live due to depression and ED has caused me more depression in a very ugly vicious circle. Every time I was having ED problems I used Viagra and it helped a lot, but my ED has gone worst during the past 2 years. Last year I was on my lowest point mentally speaking. I was not even able to masturbate. I needed to use Viagra just to masturbate and feel that not everything was lost and I could still orgasm. Getting familiar with that "new me", has been very difficult to cope with. My wife has handled the situation with patience and love, but of course, she is not happy about it and it has set us in the route to a dead bedroom given that sex has become awkward.

Since I learned that there was a permanent solution with the implants, hope came back to me somehow. Today I think I have overcome depression to a great extent, mostly thanks to that light at the end of the tunnel. However I'm in a very confusing situation. I have morning woods almost every day, except when I can not sleep well. They have a good quality between 80% and 100% of rigidity. But when it comes to real sex, it is really hard for me to get aroused by my wife, who is beautiful and sexy (sometimes 50mg of Viagra wouldn't do the trick) and in solo mode I still struggle to get hard for masturbation. I tried surrogate sex partners therapy with a few girls and it was the same (super unreliable viagra-fueled dick), so my wife was ruled out as the problem. I think the brain system that is related to arousal is f**ked up in me due to years of depression and trauma related to ED. Is as if the possibility of sex if too damn stressful that my unconscious mind has archived it and labeled as dangerous and it doesn't see a way coming back.

I have asked myself if I'm gay or asexual, but I still see women and feel aroused and fascinated by them, but my dick just doesn't respond or it requires hard work for it to respond. I even tried to have sex with a male friend of mine in one of my ED episodes to rule out any sexual orientation confusion that I may have. I still prefer women in many senses. I don't think I am asexual because certain female images from real life or on screen (not necessarily of sexual nature), trigger sexual urges in me. With Viagra, it may respond immediately or not respond at all, which makes it super unreliable and causes a lot of stress in me and my wife.

I used to have a strong sex drive so in the past (lowered becasue of ED stress). I complemented sex with my wife with masturbation and porn, because she didn't want to have sex as often as I did. As the ED worsened I researched and found that porn may have a role in my condition. However, I was not too addicted to it and I completely quit porn about 3 months ago. I still masturbate, though. Is it porn to blame? Is it depression? Any any case, is it curable?

I fantasize about an "always ready dick" I visualize my life in the future and If I had my implant and everything went well, I would feel invincible and I would be the happiest man on Earth (among many of you). However, if I still have my morning woods, it seems that I wouldn't need the implant, would I? So I have this conflict... I have a shitty sex life and my wife is frustrated too, but the implant is a big leap of faith and it may go wrong. I'm looking for some advice here... Is psychological or neuro-chemical imbalance ED a good reason to go for the implant? If not, how many more years living this incomplete life should I wait before I decide? If I get the implant and things go wrong, wouldn't I be stupid for throwing to the garbage my mediocre functioning system? Wouldn't that lead me to an unavoidable suicide?

If I decide not to do it? Is there a woman on Earth that would fall in love so bad for me that would have the infinite patience that it is required to make love to a man in my condition? I think this is hard and off-putting for them too.

PS. I have gone through therapy several times and it has not worked for me (not even the surrogate sex partners one). The only thing that has worked is Viagra, but now it is unreliable.

Thanks for reading! I'm planning on writing a more complete personal story soon.

Welcome to the forum.

If you're having some success with pills, have you tried adding cock rings to your repertoire? If not, see the "Cock Ring" thread in the "Members Only" sub-form.

Why don't you try injections. They should allow you to perform and should give your wife a good time. You might even find that the hard dick gets you aroused. I'd recommend starting with alprostadil mono-mix if possible but give injections a trial. You'll probably want to go solo with them a few times until you get the bugs worked out.

As for your mental/depression issues I have no input of any value. Sorry.

Anyhow, good luck.

ED is often multi-faceted.
Since pills have been somewhat successful. And you wake with morning wood. That is a good sign.

If you haven't I would suggest an appointment with a urologist that specializes in men's sexual health.
Someone that has treated hundreds of men with issues like you are experiencing.
Get an ultrasound, to rule out (or confirm) a venous leak and general health of your penis.
For the ultrasound, they likely will give you an injection that will force an erection. They can then track the blood flow into and out of the penis.

Regarding psychological ED. That is definitely a real thing. I did sex therapy for several months. Although that did not fix my ED. But I did find it helpful.
Regarding PIED, some people say the root of many men's sexual problems, However, the medical community is divided on the issue.

As Dldoink mentions, Try using a cock ring. I've used one for 20 years. And found it helpful even when using pills and injections.

Again for many ED is multifaceted,
In other words at this stage of the game, likely there's a psychological component, where you are constantly wondering what if.
There may be a blood flow issue.
Sounds like you know (most) all possible reasons. That is why I suggest seeing a urologist that specializes in men's sexual health. Someone that has seen it all.

John9Kings wrote:(edited for focus)
I think the brain system that is related to arousal is f**ked up in me due to years of depression and trauma related to ED.

Is psychological or neuro-chemical imbalance ED a good reason to go for the implant?

Welcome to the forum, John9Kings.

Did you/Are you taking any drugs for the depression? Many psychotropic drugs affect libido, erectile funtion, etc. And some have lingering effects that can take a long time to go away.

Checking with a urologist who specializes in sexual health would be a step to take LONG before going to a surgeon. There are many causes for ED and if you can avoid an implant, it is in your interest to find out what else you can do before you do the "nuclear option". Implant permantently destroys erectile function and precludes any other less-invasive treatments.

I dont know if I am in the truth. When you mastubate, do you see porn? It is posible that the porn have something related to the excitation.

When you see so much porn, it is harder to excitate with real girls, specially because when you see porn, you see the girl that you like and it is posible that this make you hard.

Ánimo!

All good advice. But how's your testosterone? If you don't know, go to an endocrinologist immediately. It's a simple blood test, and if it's low, he will find the reason faster than a urologist. (In rare cases it's due to a brain tumor! )

Low T inevitably causes depression, not just ED. See my signature.

bldoink wrote:Welcome to the forum.

If you're having some success with pills, have you tried adding cock rings to your repertoire? If not, see the "Cock Ring" thread in the "Members Only" sub-form.

Why don't you try injections. They should allow you to perform and should give your wife a good time. You might even find that the hard dick gets you aroused. I'd recommend starting with alprostadil mono-mix if possible but give injections a trial. You'll probably want to go solo with them a few times until you get the bugs worked out.

As for your mental/depression issues I have no input of any value. Sorry.

Anyhow, good luck.

Thanks for your answer! I haven’t tested cock rings, but that sounds… complicated? And I’m afraid of injections and the scarring tissue that it may leave in the long run. I also wonder how would you manage it? Would you go to the bathroom right before? Does your partner knows about it? How does she takes it?

But maybe that’s better than going bionic, right?
Do you have experience with any of the two methods? Have you gone bionic already? If so what has been you preferred method or status?

Thanks again for sharing your thoughts with an unknown bother.

As for depression, I think that’s gone, but the performance anxiety still remains.

I know I asked too many questions, I just feel confused with all this.

John9Kings wrote:Thanks for your answer! I haven’t tested cock rings, but that sounds… complicated?

No, not complicated at all. There is perhaps a little learning curve but nothing to speak of. Besides, with the right outlook experimentation can be fun. Just go for it! You need to know and remember that attitude is a big part of dealing with this ED stuff successfully.

John9Kings wrote:And I’m afraid of injections and the scarring tissue that it may leave in the long run.

Try starting with straight alprostadil mono-mix if you can. There is evidence that it is less likely to cause scaring and fibrosis although it's not totally risk free. In your case trying injections may give you back that confidence you need. Many men can use injections for many years without problems. But there's a chance you won't have to use them for an extended time if it gives you your confidence back.

John9Kings wrote:I also wonder how would you manage it? Would you go to the bathroom right before? Does your partner knows about it? How does she takes it?

If you're married, and I think you mentioned that you are, then there shouldn't be a problem. Depending on your wife you can include her in your injection experience as much as she would like. Talk to her. No need to hide or be secretive about it. My wife knows and just accepts my need to inject as just a part of life. I'm sure she would prefer it wasn't necessary just like she would prefer she didn't suffer some neuropathy from her back surgery. I inject while sitting on the couch. Whatever works for you and your wife.

John9Kings wrote:But maybe that’s better than going bionic, right?

I don't know. Everybody's has their own best path. What is best for you only you, your wife and your doctor can figure that out. I personally don't think rushing to the final option is a good idea. However, that may be where you end up. I just wouldn't know.

John9Kings wrote:Do you have experience with any of the two methods? Have you gone bionic already? If so what has been you preferred method or status?

I'm not sure of your question. I've used pills. I've used a VED with medical grade constriction rings. I've used injections. Now I use injections combined with novelty/sex shop cock rings and very often also supplement with 50mg of sildenafil. I still use a VED for therapy mainly but not as often as I should.

John9Kings wrote:Thanks again for sharing your thoughts with an unknown bother.

As for depression, I think that’s gone, but the performance anxiety still remains.

I know I asked too many questions, I just feel confused with all this.

I'm glad to help if I can. Just remember I'm not expert on anything and I have absolutely no medical training. I'm just another bubba on the internet so use plenty of salt.

I'm glad to hear your depression is diminished. Unfortunately I think we all suffer depression at times. A trial with injections may help with the performance anxiety.

Ask all the questions you want. This ED crap can be a bit confusing.

sogwap wrote:ED is often multi-faceted.
Since pills have been somewhat successful. And you wake with morning wood. That is a good sign.

If you haven't I would suggest an appointment with a urologist that specializes in men's sexual health.
Someone that has treated hundreds of men with issues like you are experiencing.
Get an ultrasound, to rule out (or confirm) a venous leak and general health of your penis.
For the ultrasound, they likely will give you an injection that will force an erection. They can then track the blood flow into and out of the penis.

Regarding psychological ED. That is definitely a real thing. I did sex therapy for several months. Although that did not fix my ED. But I did find it helpful.
Regarding PIED, some people say the root of many men's sexual problems, However, the medical community is divided on the issue.

As Dldoink mentions, Try using a cock ring. I've used one for 20 years. And found it helpful even when using pills and injections.

Again for many ED is multifaceted,
In other words at this stage of the game, likely there's a psychological component, where you are constantly wondering what if.
There may be a blood flow issue.
Sounds like you know (most) all possible reasons. That is why I suggest seeing a urologist that specializes in men's sexual health. Someone that has seen it all.

Thanks sogwap! I think 80% of it is in my head and 20% is my 40 year old body. I wake up every morning with a strong boner and I have somehow "recovered" the ability to enjoy myself without porn, but sometimes I struggle. I will eventually rule out as much as possible physical causes, though.

However when it comes to intimacy with my partner, I'm always too anxious. This may sound stupid, but sometimes I think that all my anxiety, depression, insecurities, etc. would be gone if I had an erection on command. For me it's like: Should I resist a few more years in this situation and let my middle age years go until there is nothing else left to do? Or should I take a shortcut, have an implant and feel better about myself starting now?

It is a big question. If I was sure that it is going to work and I am not going to get an ugly infection like others have mentioned, that'd be a no-brainer to me. I have dragged a sentiment of inferiority since my teens due to this crappy conflict between myself and my penis. I wish I could get an implant and reborn, but there is another part of me that says: No! Resist with pills or you may lose your penis forever with a bad surgery!

Anyway, thank you for taking the time to write. I guess I will be writing here from time to time to share my views. This is kind of therapeutic for me