38 yr old male, long time Erectile Dysfunction, need help/guidance

[BillKeel]

I could use advice on where to turn for help with my long time ED issues. I'll try to keep it brief and yet detailed:

First had sex when I was 17 with a year long high school girlfriend. Couldn't get an erection hard enough for penetration. I had to manually stimulate myself until hard enough for penetration, but the effort brought me so close to climax that by the time intercourse started it made the time very brief. I dated her for several years after, and rarely had an erection good enough for penetration.

Every women that followed was the same issue, and almost always required heavy foreplay, or manual stimulation before achieving and erection good enough for penetration. This erectile issue was not only with partners, but with myself during masturbation. Usually, my erection would fall flaccid seconds after getting fully hard. I always needed continuous manual stimulation to keep it hard. This, of course, was incredibly frustrating and depressing. I could never keep a woman around very long partly because of my erectile dysfunction.

When I was 25 I finally starting seeing a urologist for help. He dismissed me saying it was psychological and that I was too young for ED. He suggested I see a therapist for sexual help. I tried therapy for awhile, but none of the suggestions helped. I finally convinced the urologist to give me Cialis. Bam! It was a night and day difference. I was finally able to have stronger erections, good enough for penetration, probably 60% of the time. It wasn't perfect, but it was better than nothing.

Now, I'm 38. I still take 5mg Cialis daily. Sometimes I go to masturbate, and my erection is difficult to maintain (while watching porn usually), and then I will realize I forgot to take the medication for a couple days. When I go on a date, I take 10mg just in case. But recently, I met a woman who is wonderful, and I want to make her happy. So I've taken up to 15mg of Cialis sometimes. My erections with her have been decent, but not perfect. We use condoms, which reduces sensitivity, and one time I went flaccid during intercourse. It was incredibly embarassing, and disappointing. I don't think I should continue escalating my Cialis dose. Additionally, I just gave myself vision loss in my right eye from so much Cialis in a short amount of time; a condition they diagnosed as "central serous chorioretinopathy". It might be permanent. I'm very upset about this too.

One morning, I tried having sex with this woman, (having taken 15mg Cialis night before), but I couldn't maintain an erection for penetration. She tried giving me oral sex, and I went flaccid during that too, which has never happened before. I tried manually stimulating myself to orgasm with her help, but I couldn't get hard. It was like my penis was dead. This has never happened before. I blamed my issues that morning on my anxiety about not having much time before I went to work, but I know it's because something is wrong with me; whether it's venous leak, or anxiety, or nerve damage, or whatever. I fear I may lose this really good woman soon just like the others in the past. =(

Since 25 years old, I have tried multiple medications, diet changes, psychotherapy, pelvic floor therapy (they said I have a tight pelvic floor. I now use a device to stretch my internal pelvic floor muscles through my anus weekly) Recently, I stopped looking at porn pictures or porn videos (18 days as of this writing, no noticeable difference). Has anyone ever tried Dynamic Infusion Cavernosometry or Doppler Ultrasound to diagnose venous leak? Do my issues relate to you? Any suggestions would be appreciated. Thank you for reading!

[Baseballfan11]

Bumping up this thread. Curious if you have considered the implant?

[BillKeel]

Bumping up this thread. Curious if you have considered the implant?

To be honest, I am very concerned about an implant due to it's permanent feature. Also, no more nocturnal erections or natural erections. It's quite a commitment to make to get an implant. I suppose I fear that I would be dissatisfied with it, and then unable to undue.

[Grayfox]

First of all find a good Urologist who knows ED. It doesn't sound like your current doctor is particularly interested. He should have tried a number of things by now. He has let you down.
When the pills stopped working for me, I had excellent results using a vacuum erection device (VED) for several years. Its a bit of a pain to use, but it does work.
To be honest, the best solution is an implant. I got mine 3 years ago and have never regretted it one bit. Its the best thing that ever happened to me.

[wolfpacker]

Have you tried Viagra? I find that Viagra has a much stronger effect than cialis

[Lost Sheep]

I could use advice on where to turn for help with my long time ED issues. I'll try to keep it brief and yet detailed:

First had sex when I was 17 with a year long high school girlfriend. Couldn't get an erection hard enough for penetration. I had to manually stimulate myself until hard enough for penetration, but the effort brought me so close to climax that by the time intercourse started it made the time very brief. I dated her for several years after, and rarely had an erection good enough for penetration.
(edited for focus and brevity)

Your symptoms mirror mine almost 100%, but much more severe. Stimulation during coitus. Enough to maintain an erection would quickly bring about an orgasm (before she could have herfs). Not enough stimulation to maintain erection resulted in erectile collapse. Eventually the window between "not enough" and "enough" narrowed until it closed entirely. I got an implant. Problem solved.

Viagra, cialis and levitra eacy were tried in turn and worked for a while but each lost effectiveness.

Injections or suppositories probably would have worked but I had the opportunity for an implant and chose that route at the age of 67-68.

VED-assisted erections with constriction ring would have worked, but I rejected that as too cumbersome. I did use a VED to maintain penile health and size.

Most important is to level with your girl. Women are incredibly supportive if they feel trusted, respected and safe. Especially if she feels loved. Let her in on your worries. Burdens shared are half as heavy and she will be doubly understanding and want to help if she knows what is going on with you. If she does not know, likely she will feel it is her fault and consequently feel badly about the relationship. Stories abound about women who have left their men because of this. Don't let that happen to you. (If she rejects you on account of your ED after you tell her the truth, you would not be able to trust her to stick arouned when other marital/relationship troubles arise, anyway, so are better off without her.)

Find a urologist who specializes in sexual function. Interview as many as you need to to find one.

[Old Guy]

To be honest, I am very concerned about an implant due to it's permanent feature. Also, no more nocturnal erections or natural erections. It's quite a commitment to make to get an implant. I suppose I fear that I would be dissatisfied with it, and then unable to undue.

Welcome to FT. Here's my 2¢ worth. You said you used to get nocturnal erections but no longer do. You are having a very difficult time maintaining an erection. Pills are not helping any more. You have a very supportive female, for now.
Definitely see a urologist who deals in men's sexual health. They can run tests to discover any physical reasons. However, from what you state it sounds like your next step will be injections or implant. The injection route may work, for a while, maybe for a long time. The downside is the planning. When you want to have sex go draw up the needle, inject, wait a bit. If it works it makes for great sex. The implant is always ready, 20-30 seconds to inflate. No planning, no needles, no pills, but the best part is no disappointments. And if you already have no erectile capabilities anymore, what do you have to lose? 98% of males who have an implant are happy with it. My bottom line? Get fixed while you still have that supportive female around before you lose her.

[Fran4524]

As a cialis consumist, I am very concerned about your one eye blind condition. What did the doctor say about that? Was it happen only for taking cialis or have you got any phisical condition that made it worst?

[Grayfox]

Have you tried Viagra? I find that Viagra has a much stronger effect than cialis

Very good point. When I was on the pills I tried them all. 100mg of Viagra was the only thing that worked for me.

And a huge +1 on having a good woman. When I was going through my troubles my GF at the time was extremely supportive and understanding during the 6 months or so until I could find something that worked. It was her idea that we satisfy each other manually and orally until I could get it up. That wonderful lady saved my sanity.

[AmansinCali]

Bill,

You have come to the right place. Everyone on this forum has gone through, in various degrees, what you are going through. Read as much as you can in each of the forums, your problem is not unique.

First of all, if I were you, I would immediately stop the oral medications! I am a victim of AION and have permanent loss of vision in my right eye and have been told by many doctors, my ophthalmologist, a renowned optic neurologist, my urologist and my internist to never take the oral medication again. AION is Anterior Ischemic Optic Neuropathy, which is loss of the blood supply to the optic nerve, my optic nerve is dead and will never regenerate, I am blind in my right eye. The oral ED meds may or may not have been the cause, but statistically this happens more to men on ED oral medication, I was told it is not worth the risk of losing vision in my other eye. I am so thankful it only happened to one eye. I was on 5mg Cialis daily when I lost my vision. Please take this advice seriously.

Now, the advice you have been getting above is good, you must find a urologist who specializes in men's sexual health, someone who does a lot of implant surgery, not some guy who just takes care of kidney stones.

If you have this dream woman who you would like to build your future with and you don't want to lose her, start by being completely honest with her. Lost Sheep is correct, a good woman will understand and help you through this, if she bolts, let her go, she was not the right woman for you.

As you become more educated here on Frank Talk, you will see there is a solution for every ED problem. Each of the solutions, mainly oral medication and injections, will stop working at some point which only leaves an implant. If you find you need an implant, don't fear it, it is a solution that works every time, the sensations are the same for both men and women, my wife says she can't tell the difference, but she has become even much more orgasmic which is not a bad thing.

You are a lot younger than I am, I have a son who is 12 years older than you are, but I understand what your concerns are. I highly recommend you read Minnesota#2's post, "IMPLANT JOURNEY of 27 & 78 Yr Old: Same day Surgery 9/20/2022" in the Implant section. I am the 78 year old in this thread and Minnesota#2 and I have become friends, we had our implant surgery on the same day and our recoveries were remarkably alike. Minnesota#2 is 27 years old and within 2 months of his surgery he had been with 6 different women. He says not one of them has made a comment on his new dick, he hasn't told, and they haven't asked.

If you have the conversation with this woman you admire so much, you might go as far as reading Minnesota#2 post together. I can almost guarantee your girlfriend knows nothing about penal implants.

I am sure you will be posting further questions in FT, I would suggest you fill out your Signature in your FT profile so members know what your status is and you won't have to explain yourself every time. You will find the members here are extremely helpful and will give you frank answers to your frank questions.

Best of luck Bill.