When do you know when it’s time?

[Nocturne]

Not sure anyone would remember me here. I posted here maybe 10 years ago when I was 41 and had my first bout of ED. Testosterone was at “near castrate” level - has since been fixed with Clomid. Took maybe three months after the Clomid started to start to get back to normal erections again, with the help of Cialis.
Been on 5 mg daily Cialis plus the Clomid for 10 years. While there have been occasional mishaps and the fear and anxiety of ED never really go away, I’d say I’ve only had an average of - maybe 1-2 failures to make it to satisfactory orgasm for both myself and my wife, per year, in that time. Maybe even less. Today we are 51 (me) and 57 (her).
The last 2-3 months I have noticed a trend towards… not quite PE, but definitely orgasming sooner than I would like. Maybe after she orgasms only once or twice instead of 4-6 times like I’m used to.
Then, maybe a week ago, we tried to fuck standing up in the shower and I couldn’t stay hard. NBD, this was not a usual position for us and TBH it had not been since the first mishap ten years ago.
Now we’re on a trip together and when we went to fuck yesterday morning, I just could not get hard.
We spent the day, had some drinks, came back to the hotel, and I offered to just pleasure her without expecting anything else to happen. As it turns out I got hard enough to enter her, and slowly slide in and out enjoying each other for a while. But when I sped up, I lost it.
I’ve known for years, because of the good people here, that in the end my worst case scenario is an implant, and TBH it doesn’t seem bad at all. I’m not sure I’m at the point of needing one yet - think I might try losing weight first, as I lost 60 pounds after the first time ten years ago and have been slowly regaining it all this time since (still down 15 from where I was then). My guess is the recent troubles started with the last 5 or so pounds regained.
But… I sure would love to be able to fuck in the shower again, or anywhere really with zero anxiety about losing it. Seems to me the worst part is the time leading up to making the decision and getting it over with.
I’m rambling. But I’m curious - when did you decide it was time? What happened to make you come to that conclusion?
I’m in pain right now - mental and emotional pain - but it’s good to know that I’ll ultimately either get better, or not get better and then get REALLY better. No one wants to be the guy who had to get a penile implant, but from what I read here, once it’s done, it doesn’t sound like a bad guy to be.
Thanks for keeping this forum running. You’re a great bunch of guys, gave me a lot of hope 10 years ago when I really needed it.

[Gt1956]

I sure wish that I knew how to tell you when you need an implant. The very best that I can tell you. Once you do decide & actually get an implant. Literally ever man ends up saying that he should of got it sooner.
Thus if you follow that common feeling. If there is some way that you can decide for an implant earlier than the average man does. You'll be a winner because you'll have less of a regret of waiting too long.
Eh, its a decision that only you can make. In my case, I wish that I had done it sooner. Even if it meant paying cash for it. Yea, that level of a regret.

[wolfpacker]

For me it was when I felt I had nothing left to lose. I really couldn't have any meaningful sex for more than a minute before going soft. It was time, and I wouldn't miss much even if it the surge went horribly wrong

Side question for you OP: you've been on clomid for a long long time, any side effects? How is your vision? I've read about vision related side effects with clomid.

[Mark1974]

For me mild ED hit in the early 30's, but it wasn't until I was 45 that tolerable doses of Viagra and Cialis wouldn't maintain a strong erection. I think at that point I was at the right point biologically for an implant.

I wasn't, yet, at the right point psychologically though and I am scheduled to get the operation in 3 weeks at 50 years old. I probably have lost half inch or so due to atrophy in that time. So that is something to consider.

You say no-one wants to be the guy with the penis implant and that is true, but I have found accepting after 50 more easy. I suppose I always associated being over 50 with getting old and the image of the old perv with the implant was both comical, but laudable in my mind.

One thing I tell guys in my age range to consider is that once you get in your 50's we are at much higher risk for terminal illness, so taking a bit more risk to improve quality of life makes more sense.

In summary if sensible doses of Viagra or other PD5 inhibitors aren't working adequately then I think an implant is on the table.

[LGXDownunder]

I suspect the answer will be different for everyone. It will probably depend on what level of natural and/or aided functionality you still have, and how well that works for you. And that's more than just a physical thing; how ED affects your mental health and quality of life is equally important. My own decision ultimately became very easy. I had put up with absolute zero erectile function for 3 years after prostate cancer surgery. Nothing provided a satisfactory solution and the chance of recovering any erectile function was near zero. The quality of my sex life went downhill significantly during that period and made me feel inadequate and miserable. Once I committed to getting the implant I was excited about it rather than apprehensive. Even though I'm still early in the post op recovery process my self esteem has improved greatly. I'm really happy to be "that guy", and I wear the implant like a badge of honor.

[Old Guy]

I knew it was time when pills did nothing but give me a migraine, and injections became painful and useless. Maybe once a month I'd wake up with morning wood, but it wouldn't stay hard to do anything. I knew nothing going into surgery except that it would allow me to get erections again. I had not found FT. It was my first ever surgery as an adult. I am definitely on the team of I wish I had done it sooner.

[Oren8888]

Obviously it's individual, each one has their own reasons. For me, the pills worked fine until I was 50, then they had less of an effect. At 53.5, I decided to do it, only 9 days after the surgery. So far, it's going well and I'm satisfied with the feeling that remains good.

[Nocturne]

Thanks everyone. Part of me wants to just get it over with and enjoy life, part of me feels that I probably have enough functionality that if I lose some weight I won’t really need it for another few years. I remember the mental mess it was getting out of this state last time, and I do not look forward to it again.
Probably plan to lose 10-20 pounds, give it a few months, see where that goes. It might right me. But if it doesn’t… I’m not wrong to just skip past the pumps and injections, am I?

[Nico_from_belgium]

For me it was when my wife told me that the first was shrinking. I had and have already a kind of erection but not as hard as I would like and hear my wife tell me that, was a kind of revelation. I knew I had a problem but refused to admit it!
So I'm planned for next Thursday

[Nocturne]

For me it was when my wife told me that the first was shrinking. I had and have already a kind of erection but not as hard as I would like and hear my wife tell me that, was a kind of revelation. I knew I had a problem but refused to admit it!
So I'm planned for next Thursday

Best of luck, sir! Please tell us all how it works out!