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30 yo with severe ED here. (No definitive cause found)

I did 6 shockwave sessions last month, my doctor put me on cialis 5 mg daily along with shockwave therapy and told me to wait 3 months for results and use cialis 5 mg daily regularly during this time.
Daily cialis helps, i can have sex (restricted to some positions) but my rigidity is not %100, i need constant stimulation, erection quality worsens progressively during sex and i lose my erection sometime. (Once it is lost, it is hard or sometimes impossible to regain it). So even though i can have sex sometime it is a subpar experience because 1-there is still chance for failure, 2- Rigidity is not complete thus orgasms are harder to achieve 3- need constant stimulation and i am only able to do the positions which is best for my erection quality, even than keeping my erection is not certain)

I have number of questions for more experienced members:
1- In my situation, can i say pills are not working and i should go for the next line of treatments?
2- What should i try next? Are on demand pills (50-100 mg viagra, 20 mg cialis, 10-20 mg levitra) more stronger than cialis 5 mg daily protocol? Or should i just go for the injections?
3- Anyone experience some tolerance pattern for daily cialis? When i start cialis, i see more significant benefits from it for the first 1-2 weeks and then efficacy drops a little bit. There is no huge drop in efficacy but since it barely works even little drop in efficacy change my experience a lot. Anyone else noticed same type of tolerance to ED drugs when they are used on a daily basis? Is it possible to overcome the tolerance issue by using drugs only on demand? (I have sex twice a week at most usually)

Viagra 100mg is a lot stronger than daily Cialis 5mg. You should definitely try this. Also I don't think it's possible to build a tolerance to the pills. Your ED will worsen over time however, which will give the appearance of the pills not working as well.

wolfpacker wrote:Viagra 100mg is a lot stronger than daily Cialis 5mg. You should definitely try this. Also I don't think it's possible to build a tolerance to the pills. Your ED will worsen over time however, which will give the appearance of the pills not working as well.

Thanks again wolfpacker!
It is first thing i will try when my 3 months daily cialis regimen finishes. I added 50 mg on demand viagra on top of daily cialis once, and the results were better than only daily cialis. I hope I can get similiar or better result with 100 mg viagra only.

PSSDorAmINormal wrote:Don't move too fast with the increasing dosages. Daily cialis at 5mg builds in your system over time; that's why it is taken daily because it builds and sustains a certain level over time. I would take the advice of your doctor and wait the 3 months and try not to injure yourself through failed attempts at sex. If you're not properly erect you could bend or snap something and that would be bad. Plus it seems like you would defeat the purpose of the shockwaves.

In my experience when I combined Viagra and Cialis it just increased the negative side effects more dramatically and even added a new one of heartburn for me. I never have that problem and I would like to avoid it. Very unpleasant feeling.

Thanks, did you also experience ondemand pde5s are more stronger than daily 5 mg cialis?

They are not all the same. For me the other PDE-5s provide(d) fuller erections than cialis. For example even when it was working reliably for me cialis wouldn't really fill the glans. The other ones inflated my whole dick including the head, and gave me more bang for my buck.

I understand where you’re coming from, but I’ve found that Cialis works really well for me. It’s not just about the size; it’s about the overall experience and how it helps me feel more confident during intimacy. While some may prefer the other PDE-5 inhibitors for a fuller feeling, I appreciate how Cialis provides a more consistent and natural response without feeling overly inflated. It enhances my experience by allowing for spontaneity and a longer duration of effectiveness, which I find beneficial in my intimate moments. Of course, it is important to take only high-quality Cialis for the best effect and minimize side effects.

I believe these PDE5i's work differently for every man so my experience may not apply to anyone else. I was fairly successful with 100mg Sildenafil. My doc initially prescribed daily 5mg but it did nothing. Then, my doc said he typically does not see much response to 5mg (mostly a placebo effect in younger men who just need a psychogenic boost) and he upped me to 10mg. I still do the 10mg daily but I always supplement with 50 or 100mg Sildenafil. But, honestly, my best response is to increase the refractory period to 4 - 5 days. If I'm really going all out, I wait 5 days, inject Bremelanotide, fast that morning, and take Sildenafil 45-90 minutes before sex.

I saw a report on another forum from a gent who takes Tadalafil 40mg daily, under his doctor's supervision, and that works well for him. I'm going to ask my urologist about this and may try it myself.

I've been on a daily 10mg Tadalafil for about 15 years and I’m lucky to say I haven’t had a bad side effect. I did try 20mg daily at one point, but it just gave me headaches. Turns out, 10mg daily is my sweet spot.

Daily cialis gives me less side effect for me. If I start having neck or back pain I stop 1-2 days then restart.
10mg or viagra gives me better results but the side effects are too much. I tried 10mg levitra it also works good but the side effect are worst.