Why Do Pills Stop Working? Any Way to Get Them to Work Again?

[kinggg]

Why do pills like viagra and cialis stop working after a while? I've been using pills for 10 years until they stopped working in 2016. I've tried upping the dosage but that doesnt work. I have low T so maybe thats the reason? Why does that happen and is there a way to get the pills to work again?

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[68CatFan]

From what I've researched the blood flow through your penis continues to worsen as we age. Hence stronger doses of Cialis, Viagra, etc.. are needed. Unfortunately, I haven't seen any way to reverse time. Shock wave therapy and stem cell shots did not work for me and from what I've read they are just cash grabs from desperate men. Low T can decrease energy and libido but doesn't affect blood flow.

[jimmyd24]

I have the same Problem.
Viagra worked for me for about 12 years, I did have to up the dose as I got older.
then it just stopped working.
My uro put me on injections, Edex.
It got me hard but made my penis ache.
then he put me on trimix, WOW it was great.
got me hard in 10 Mins. stayed herd for 2 hours even after cumming.
After about 8 years now Trimix is failing me, I can only stay hard foe a few mins, and go soft during intercourse.
I have tried Quadmix, it dose work a little better but it also makes my penis ache.
Now I am looking into an Implant that my uro told me when I started on injections I would eventually need to do.

[kinggg]

I have the same Problem.
Viagra worked for me for about 12 years, I did have to up the dose as I got older.
then it just stopped working.

After about 8 years now Trimix is failing me, I can only stay hard foe a few mins, and go soft during intercourse.
I have tried Quadmix, it dose work a little better but it also makes my penis ache.
Now I am looking into an Implant that my uro told me when I started on injections I would eventually need to do.

Hi jimmy24,

Wow... appreciate your reply dude. Very sorry to hear what youre going through as we're in the same stupid boat. I havent tried trimix in 4 years. I want to try it to see if it still works. But because of the outbreak I have to put that on hold until corona disperses enough from society since I'm now focusing all my resources in getting myself and family safe.

When did you think of getting your implant?

Hows your libido now? How old are you?

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[Simbarn]

Why do pills like viagra and cialis stop working after a while? I've been using pills for 10 years until they stopped working in 2016. I've tried upping the dosage but that doesnt work. I have low T so maybe thats the reason? Why does that happen and is there a way to get the pills to work again?

.

How are your nocturnal erections?
How often do you take the above PDE5 inhibitors? Only for on demand use?

[kinggg]

Why do pills like viagra and cialis stop working after a while? I've been using pills for 10 years until they stopped working in 2016. I've tried upping the dosage but that doesnt work. I have low T so maybe thats the reason? Why does that happen and is there a way to get the pills to work again?

.

How are your nocturnal erections?
How often do you take the above PDE5 inhibitors? Only for on demand use?

After I fall asleep I notice nocturnal erections when i wake up in the middle of the night. I dont take any pills since they dont work as I mentioned in my original post.

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[niarceel]

The penis is essentially a balloon. It must be inflated and not deflate for a man to have a good, sustained erection when sexually aroused.

There are 2 factors at work that allow this to happen:
1. Vasodilation - dilation of the small arteries going into the penis which engorges it with blood, and
2. Vasoconstriction - constriction of the small veins going out of the penis to restrict blood from leaving the penis.

Assuming you have a healthy, strong cardiovascular system with plenty of blood flowing, the usual cause of ED drugs no longer working is venous leakage. It could be any number of things, including something psychological, but from what the original poster said, I don't think so. Still, don't take my word for it. See a good Urologist who specializes in treating ED.

I used Viagra and Cialis for almost 10 years before their desirable effects began to fade. I have a great cardiovascular system (I was a runner for decades), normal blood pressure, no arterial plaque or deposits, in overall good health, so, I asked my doctor (my PCP), "What could be the problem?"

His answer: "Venous leakage". He explained to me that our veins have tiny check valves in them to prevent the back flow of blood in our bodies during the heart's diastolic (resting) phase of a heartbeat. As we age, these tiny valves fray around the edges and start to leak, causing some back flow.

That back flow out of the penis is enough to interfere with/ruin an erection.

If what I've written applies to you, your urologist will most likely recommend penile injections. I recommend that you start with Bimix. Then, as you need to, go to Trimix. It contains prostaglandin, a powerful group of chemicals that are responsible for both blood vessel dilation and constriction. In most men, Trimix causes pain as well as good erections.

I find the pain intolerable so I experimented with blending just a little Trimix with a larger dose of Bimix in about a 1/10 ratio. This has worked very well for me. I have the hardness of Trimix with only some discomfort, not pain.

https://www.franktalk.org/phpBB3/viewtopic.php?f=5&t=14553&p=128338#p128338 - My Bimix/Trimix experiments.

But the injections have a price: The risk of the formation of fibrotic scar tissue which can lead to Peyronies Disease in 1 out of 7-8 men who inject. Because of this, I am planning to have a IPP (Internal Penile Prosthesis) this year.

[Simbarn]

I used Viagra and Cialis for almost 10 years before their desirable effects began to fade. I have a great cardiovascular system (I was a runner for decades), normal blood pressure, no arterial plaque or deposits, in overall good health, so, I asked my doctor, "What could be the problem?"

His answer: "Venous leakage". He explained to me that our veins have tiny check valves in them to prevent the back flow of blood in our bodies during the heart's diastolic (resting) phase of a heartbeat. As we age, these tiny valves fray around the edges and start to leak, causing some back flow.

That back flow out of the penis is enough to interfere with/ruin an erection.

I was intrigued by your urologists possible explanation of the cause of venous leakage in your case.

His explanation of the degeneration of the valves in the veins of the penis facilitating venous leakage did not make complete sense to me. With all due respect, that theory does not hold up very well to others that I have researched.

Let’s take a closer look at erectile function:
Blood enters the penis via the cavernosal arteries. When in the flaccid state these arteries are constricted by tonic sympathetic influence. This lessens arterial inflow. The helicine arteries in the corpus cavernosum (CC) and the smooth muscle in the trabeculae amongst the sinusoidal spaces are also contracted by the same influence. The emissary veins on the outside of the corpora and the subtunical venous plexus are fully open(not compressed) so outflow is at full capacity. A minimal amount of blood is entering the penis and maximal outflow is permitted in this state.
Before we go further we need to understand that there are only valves in the veins leaving the penis, not in the arteries suppling the penis. There is however, something like a valve in the helicine arteries called “intimal cushions”, these are actually smooth muscle similar to what is in the trabeculae(structure of the corpus cavernosum). The helicine arteries are a complex network of smaller supply vessels the feed into each of the CC from the main cavernosal larger artery. There are many diagrams on the internet where you can sight all these elements in the penis if interested.

When tumesance begins from either tactile or mental stimuli, the various pathways involved (I won’t go into this) initiate relaxation of the smooth muscle in both the cavernosal arteries and the helicine arteries and the smooth muscle in the trabeculae. This allows a much greater in flow of blood into the penis. If relaxation is adequate in all three components, blood inflow is sufficient to cause the CC to expand greatly in size and stretch the tunica albuginea (TA). The veins that leave the CC pass just underneath and through the TA, are compressed during this process causing venous occlusion, out flow has been severely restricted. Inflow continues to be exaggerated due to the continued relaxation of the above mentioned vessels/structures.
Arteries generally do not need valves as pressure from the heart is usually strong enough to not cause back flow. Thus if the vessels into the penis are fully dilated from healthy amounts of active smooth muscle being relaxed, constriction of the emissary veins and the venous plexus leaving the CC will be optimal. Back flow from these veins is unlikely as they are in highly compressed state! Even if there was a small amount of backflow due to aging, it would not compromise the erectile process as in essence it would be further supplying the penis with blood from the other direction!
For an erection to fail there needs to be an avenue for the blood to escape from the penis via the vein network leaving the penis. It could do this in two ways, failure of relaxation of the above mentioned components involved with relaxation, or possible failure of the tunica albuginea itself to compress the veins that pass through it. I cannot see how the valves in the veins further down the track could be implicated in this. But if so I would like to know!
I have read many possible explanations, hypotheses on the causes of venous leakage, but not this one. I tried to search for this possible cause of ED and I found no published articles or studies on the subject.

I feel the following is a more likely scenario of what could be occurring. There has been a considerable amount of research into the loss of smooth muscle in the arteries and penile tissues due to the aging process. For venous occlusion to occur there needs to be sufficient relaxation of the supply vessels and the structure of the corpora cavernosa occurring for an erection to happen. If this is compromised by any of these possible aetiologies: sympathetic hyperactivity, endothelial dysfunction, oxidative damage, smooth muscle degeneration, fibrosis, atherosclerosis to the cavernosal arteries; pressure in the penile tissues will be insufficient to expand the CC to compress the veins close to and in the TT. We then have venous leakage, as blood can escape through the vein network. Much research has shown that smooth muscle can deteriorate and lessen with age and one of the main ways this happens is via oxidative damage. Research has also shown that this also occurs due to the loss of androgen's, in fact, it has been shown that penile health can be substantially compromised by the lack of androgens.

The other plausible suspect of venous leakage is as I mentioned above is the tunica albuginea, which may suffer from atrophy or a change in its structure so that it cannot compress the veins directly underneath as effectively as it once did. It is mainly composed of collagen and elastin. Studies have shown degenerative changes in specimens from some men suffering with venous occlusive dysfunction. Atrophy of the collagen fibres was seen, with their arrangement being irregularly orientated and the elastin fibres were scarce compared with controls. The integrity of the fibrous tissue of the TT appears to play a significant role in maintaining an erection.
There is also one other interesting possible cause of venous leakage and that is the formation of adipocytes (fat cells) in the subtunical region of the penis, which is directly adjacent to the CC. This is where the venous plexus veins lie and where the emissary veins leave the CC. Any change in structure in this section could affect the ability of the CC to compress these veins. It has been seen by research that these adipocytes form in this area due to possible androgen (testosterone) insufficiency and other causes such as oxidative stress and aging. Fat cells in this critical area could adversely affect venous occlusion.
The above makes sense to me.
It also makes sense that fraying or decay to the small valves in veins in the legs can cause varicose veins as blood has more of a tendency to pool rather than be pumped back to the heart.

The observations that have been made with regard to the loss of smooth muscle in the penile tissues and arteries would also help explain why the effectiveness of PDE5 inhibitors wane over time. PDE5 inhibitors work directly at helping the smooth muscle to relax. If the quantity and quality of smooth muscle is slowly decreasing it stands to reason that the effect of the inhibitors will also lessen. This does not take into account fibrosis and the deposition of collagen that also occurs with this loss of smooth muscle, which hinders penile elasticity and compliance. It also does not take into account the increase in sympathetic activity in the penile tissues as we age also. Both of which possibly contribute to venous leakage simply by not allowing the penis to expand enough to enable venous occlusion.

[niarceel]

Interesting. You're telling us things no physician has ever said to me.

I am 71 so the ravages of age are starting to effect me. I am certain that I've had deterioration of the interior of my penis due to years of insufficient oxygen; I stopped having nocturnal erections about 5-10 years ago. As my research discovered, nocturnal erections are key to maintaining penile health.

It wasn't until the last year+ that I learned of this age related damage. I've been able to compensate for it by doing 2 things:
1) Taking half a Cialis every night,
2) Ingestion of pine pollen as a food supplement.

Before you say "snake oil" about the pine pollen, read my story.

I'm a skeptic when it comes to "miraculous" food supplements (especially if any claims for them come from China, the world's living repository of mystical medicine myths). My wife has probably done over a thousand hours of research on food and food supplements that will help us both stay healthy. Her research never found pine pollen.

I found it while casting a wide net for a sudden onset of severe ED. I stumbled onto an article (which I now cannot find) on the Lost Empire Herbs website https://lostempireherbs.com/ about phytoandrogens and the benefits they produced for the human penis, especially with regard to helping to keep the penis appropriately oxygenated, and their effect on the production of nocturnal erections.

https://www.drelist.com/blog/phytoandrogens-male-sexual-health/ - a different article on phyandrogens.

The article was convincing. I bought some pine pollen and started taking 3 capsules of pine pollen per day. Within a few days, I suddenly resumed having nocturnal erections, which had completely ceased for the previous 5-10 years. This one thing seems to have been a turning point in the health/rehabilitation of my penis.

Consider these things:
1. I'd already been on testosterone replacement therapy for several years.
2. I'd already been taking Viagra and Cialis for several years.
The thickness of my flaccid penis had noticeably thinned during the previous 5-10 years.

The addition of pine pollen to my diet, with no other changes in diet or behavior, began the rehabilitation of my penis. It noticeably thickened and became darker (blood flow) when flaccid.

Subsequent research on ED and penile deterioration/health led to where I am now. I take a nightly dose of half a Cialis every night. I wake up with a swollen penis every night, which means a good flow of blood containing oxygen is going into it. And, most recently, I began using a VED in preparation for IPP surgery, which has further increased the engorgement of my flaccid penis.

My penis is currently, consistently larger when flaccid then it's ever been.

Did any of what I just wrote improve my ability to have an erection for sex without either Viagra/Cialis, or penile injections (Bimix/Trimix)?

Not exactly. But occasionally, when awake, lying horizontal on our bed, I have a pretty good spontaneous erection, most often for no reason at all. If I move around on the bed or stand up, these erections quickly fade. But having one at all is new behavior.

But when I do create chemically induced erections, they are glass cutters, and this has been a significant improvement.

[erik821]

I was told by both a local uro who has been in practice over 30 years as well as two different NP's from TRT clinics that PDE5 inhibitors do no stop working. The mechanism of action does not slow down or cease due to tolerance. For the body to build a pharmacological tolerance or resistance would take a ridiculous amount. 1000mg a day of Viagra would literally take a century for the body to start building up any sort of tolerance.

What happens is that the brain stops making the synapse that you are aroused and/or diminished penile sensitivity.

Think of this way if you were on a drug that you had to take in order to stay alive and that drug just stopped working then you just die and that's it? The docs would just say "sorry, your body built up a tolerance."