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This post is not a happy post.

I've had some form of ED for quite a few years.
About 12 years ago I started using Viagra. It more or less worked.
The biggest problem with Viagra is the lack of spontaneity. Both my wife and I felt neither of us could initiate sex. Viagra requires 30-60 to start working.
Often by that time, the sexual energy would fade away. She has often said a flaccid penis is not sexy.

Then I developed a pretty bad case of PE (Premature ejaculation). I would ejaculate in 1-2 minutes or less.
Leaving my wife unsatisfied and not wanting sex.

About four years ago I started Paroxetine (SSRI) which helped with the PE. Since one of the side effects of Paroxetine is delayed or inability to orgasm.
(Side note: if you or your partner are taking SSRI and not able to orgasm, It's likely the meds.)
If I practice slow sex (limited) thrusting. I usually could last until she came with the use of a vibrator.
However this created two additional problems. My wife said she could not feel anything because of my limited thrusting.
Plus it made my erections weaker. I could only do sex in one position.

About a year ago I started using Trimix. The thought was Trimix would (hopefully) make for a strong erection and would not go away after ejaculation.
Trimix works very well. I am hard from the start of foreplay to well past the sex act. I still ejaculate fairly quickly. But can continue intercourse until my wife has an orgasm.

Unfortunately, the story does not end there. Earlier this year In January 2023 I got Pneumonia. And could not do sex for 2 months.
During that time I developed Peyronies Disease. Peyronies is where the penis develops scar tissue that can shrink the penis and often causes a curvature.
I lost an inch in girth as well as an inch in length. Plus I have a noticeable upward curve. Before all of this, I was never huge but above average.
Now as my wife said I'm average. Yep 5 inches in length which includes 2 inches fat pad and 4.5-inch girth. A year ago I could not pass the toilet roll test (I was too big). Now it easily fits with room to spare.

In my case, the scar tissue is not caused by the 40-50 penile injections. Since the scar tissue is on the very top (dorsal side of penis) where you would never inject.
In talking with the urologist he offers Verapamil injections. Which he said has 70% success rate.
In looking up the drug Verapamil, it does not work with beta blocker drugs. I've been taking beta blocker since 2015, And beta blockers are known to cause Peyronies Disease.
I see my cardiologist next week. I don't have high BP. But I do have a heart arrhythmia which the beta blocker keeps in check. This past week I stopped the beta blocked.

To top things off, because of the Peyronies Disease. My wife said she's not interested in sex.
She told me, how disappointed she was since things were finally getting better with Trimix injections. And now this.

I can still do sex with Trimix. But she has been so disappointed over the years. First with my ED, Then my PE, Then my weak erections,
Even Trimix had some issues. So now with PD its like ED 4.0

It sounds to me that an erection produced by a Vacuum Erection Device (VED) and kept erect with a constriction ring might work for you. It does interrupt the spontaneity, though. I tried it a couple of times and used the VED only for therapeutic purposes to maintain the elasticity and size of my penile tissues.

But more than that, an implant sounds like it might be the appropriate solution for you.

Have you investigated the inflatable penile implant (IPP)?

Keep hard-to-please wife happy with dildo play while you get FT advice and find a way forward. I've been your new size for a lifetime, and my wife gets dildo orgasms from her "boyfriends" and never turns me down for sex afterward.

Sounds like the same progression into ED like I had.
Mid-50's is when mine started. How frustrating when suddenly you can't maintain an erection long enough to orgasm or please your partner. Once it got bad enough it took a big gulp of courage to ask my female primary doc for Viagra. Hot damn did that stuff work, at first. Hassle was scheduling sex, talk about killing the mood. Or when I'd take one and come to bed 45 minutes later to a sleeping wife. Then it quit working even with a double dose. ED #2.
Found a doc who offered injections. Same story, amazing results, at first. Couple years of injections continually increasing the dose or strength to maintain our intimate times. Although scheduling sex or getting in the mood then interrupting to go inject just killed all spontaneity. Then even Quadmnix at 60 units had little effect. ED #3.
Figured my sex life was over. Pills or injections wouldn't produce any kind of usable erection. Depression made me be an asshole to my wife. I hated myself.
Vacuum pump and rings would get me up enough to masturbate, as long as I was quick after removing the pump. ED# 4.
Then while on vacation an ad for an implant doctor gave me a glimmer of hope. Found a local doc who does a lot of implants, saved money for 2 years to afford the surgery. Ever since I've healed from the implant surgery all I can say is thank goodness there is medical science to help the poor guys who suffer from this nasty thing they call ED.

Thanks guys.

Lost Sheep wrote:It sounds to me that an erection produced by a Vacuum Erection Device (VED) and kept erect with a constriction ring might work for you. It does interrupt the spontaneity, though. I tried it a couple of times and used the VED only for therapeutic purposes to maintain the elasticity and size of my penile tissues.

But more than that, an implant sounds like it might be the appropriate solution for you.

Have you investigated the inflatable penile implant (IPP)?

I have VED, I could never get an erection suitable for intercourse using VED. The times I could it was Viagra at which point VED was not (really) needed.
I can still get erect with Trimix and even with Viagra. Actually, I'm harder now than for a number of years. My problem is I still suffer with PE.
Regarding implants, I want to try Verapamil injections that are designed to break up plaque.

Martin6469 wrote:Keep hard-to-please wife happy with dildo play while you get FT advice and find a way forward. I've been your new size for a lifetime, and my wife gets dildo orgasms from her "boyfriends" and never turns me down for sex afterward.

When I first met my wife she had a vibrating dildo. She never used it internally.
But to be honest, because I've had so much trouble before using Trimix. I'm hesitant to bring up anything new. As she said why try anything new when what we do does not work.

old Guy wrote:...Then while on vacation an ad for an implant doctor gave me a glimmer of hope. Found a local doc who does a lot of implants, saved money for 2 years to afford the surgery. Ever since I've healed from the implant surgery all I can say is thank goodness there is medical science to help the poor guys who suffer from this nasty thing they call ED.

At this point I'm looking at Verapamil injections. If they don't work I will consider Implant. I'm curious what my wife will say.
When I started Paroxetine four years ago for PE, She said no. As a nurse, she knows the side effect. I used paroxetine for three years with moderate success...

We'll see I have an appointment this week with the urologist to further discuss Verapamil injections.

Since Viagra and Trimix became ineffective, a “medical grade” VED with Osbon tension bands is the only way I can obtain and retain an erection. One of the short comings of a constriction band is that it reduces sensitivity, which could be a plus if you are suffering with PE. It could also help reduce the PD angle.

sogwap wrote:When I first met my wife she had a vibrating dildo. She never used it internally.
But to be honest, because I've had so much trouble before using Trimix. I'm hesitant to bring up anything new. As she said why try anything new when what we do does not work.

(ediited for focus)Gee whiz, that sounds like an argument FOR trying something new.

Definition of insanity is said to be doing the same thing over and over and expecting a different result.

My definition of defeatism (off th etop of my head) is refusing to try new things that might hold a promise of a better outcome.

So, I will make a speculative suggestion (in hopes that this post is helpful rather than a downer) is to simply open up a conversation with your wife (or if she won't talk/listen, a professional counselor - with or without your wife accompanying you) about what she hopes for regarding intimacy, pleasureing, communication, etc for the rest of your lives together. And what you hope for, as well.

Lost Sheep wrote:So, I will make a speculative suggestion (in hopes that this post is helpful rather than a downer) is to simply open up a conversation with your wife (or if she won't talk/listen, a professional counselor - with or without your wife accompanying you) about what she hopes for regarding intimacy, pleasuring, communication, etc for the rest of your lives together. And what you hope for, as well.

I know what she wants. She wants the full erection I had a year ago.

sogwap wrote:

Lost Sheep wrote:So, I will make a speculative suggestion (in hopes that this post is helpful rather than a downer) is to simply open up a conversation with your wife (or if she won't talk/listen, a professional counselor - with or without your wife accompanying you) about what she hopes for regarding intimacy, pleasuring, communication, etc for the rest of your lives together. And what you hope for, as well.

I know what she wants. She wants the full erection I had a year ago.

Sure, it is understandable that your wife wants what she had in the past. But women are often practical in these matters and your penis is only one part of your relationship. Does she want NOTHING else (which might partially make up for lost size)? Like loving touches (with or without a sexual component) or just paying attention to her day-to-say activities and interests?

This is indeed a sad post.
A wife, who after years (i suppose, considering your age) of life together, is acting like that is a sad sight.
Sex is not all about dick dick dick, there are things to do and compromises to make when things are out of your control.

About the PD - how bad is the curve? An "upward" curve is generally considered normal in humans, it's the other way around that's usually "strange". Unless you have a very high angle curve, it shouldn't be such a big deal... ?