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Hi everyone
i have erectile dysfunction of unknown etiology. my urologist is unsure what caused this
i tried PDE5 inhibitors and I have various results with them:

- sildenafil: works for 4-6h. not more. 60mg works fine. 2nd round hard to ejaculate. sometimes does not work or barely works if I take it near food? side effects mainly flushing and some nasal congestion. I am annoyed by the short duration of its effect and the non spontaneity

- tadalafil (cialis): tried 10mg every 48h instead of sildenafil. First few days had horrible headaches 12-24h after them. no flushing. no major congestion. sometimes i feel "dizzy" or lightheaded for a few hours (hard to explain). I feel for some reason that erections are less firm and "natural" than sildenafil, take more work and their intensity goes down with time (at 12h it's not as good as at 1h, at 24h they sometimes don't work anymore). I also have a hard time ejaculating on cialis all the time. I do not know if taking 5mg daily instead for a few days will help with drug build up and will make it work better or alternating 10-5mg every day.

I am confused as to what to choose and it affects my confidence. I am not sure if i'm gonna be able to deliver every single time. because both have their advantages (sildenafil with efficacy but short activity time) vs tadalafil (long acting but weaker? and sometimes side effects that are not worth it).

Some people just make me feel these pills are miraculous, can turn you back into a god with zero side effects.
I just don't have this fantastic flawless experience.

would love to hear your thoughts.

help?

If the pills don't work reliably for you, there are other options like the implant. Its all about what works best for you.

For sildenafil the effective length of time that it works is generally 4 to 6 hours. Food especially fat laden food effects it.

As far as I know only tadadafil has. A longer effective time frame which I’d guess why they market for spontaneity.

Headaches and nasal congestion are common as they are vasodilators.

From my point of view I used pills for as long as I could the same with injections.

I love my implant but that was after all else failed. I’m still getting used to how my cock feels both “flaccid” and inflated. In my opinion nothing beats a natural erection.

My advise is to do all you can for as long as you can to keep it natural but don’t be afraid if you need a implant.

Sildenafil worked like a miracle for me without any side effects. When I started using it, I did not have problems with erection. I started using it as a booster. However, after several years, it stopped working. I started using cialis with inconsistent results. Right now, I use 20 mg every two days and sometimes I get excruciating headaches for 5-6 hours. I want to rely on it, but I am getting mixed results with cialis as well. It is pretty messed up now. I wish there is another pill that would work like Sildenafil again. One hope would be Avanafil, but I haven't tried it at all..

I’ve been on two pills. So my experience is limited to sildenafil (Viagra) and vardenafil (LeviItra). I liked vardenfil a little bit more as it wasn’t effected as much by food as sildenafil was. But then I had to go with what the VA had on their formulary.

So those who have tried Cialis feel that it works longer but it's less "potent" than Viagra?
I haven't tried 20mg. If Viagra 60mg was enough to get a decent erection you think I need 20mg of Cialis? 10mg is okay but after 8h it becomes less reliable.