Tolerance to cialis.

[thanos]

Hello, I have been diagnosed with purely psychogenic ED (after doing multiple tests such as blood tests, doppler etc.). Cialis works for me but I have read many "horror" stories about losing its efficiency after a certain amount of times and that scares me. Can somebody answer these 2 questions (by knowledge or experience)? First of all, can psychogenic ed turn to organic if left untreated (the use it or lose it principle)? And secondly, does cialis lose its efficiency or not? I have seen many doctors and read many articles and I am confused because others say yes and others say no (to both of the questions). Please only serious answers, this is very important to me...I repeat, I am talking about PSYCHOGENIC ED.

[Lost Sheep]

Almost any drug, if used repeatedly over time can lose efficacy. User builds up a tolerance. Essentially the cells or tissues that respond to the drug get "used to" a certain level of the drug and requires more and more to achieve the same effect. Ultimately, side effects of the drug dictate you have to stop using it.

That's the bad news.

The good news is that discontinuing use can often restore the lost sensitivity

(Be aware that I am not a medical professional).

Other erectile drugs can substitute for Cialis in the meantime, perhaps.

Other methods of producing erections can also be used. Constriction rings (with or without the aid of a vacuum erection device - V.E.D.), injections and suppositories are also effective. Each have their shortcomings and virtues. Implant (a radical solution for psychogenic E.D.) is also available if psychological therapy is ineffective. Expensive and irreversible, it is the current "gold standard" for impotence. But it is NOT A CURE!. In fact is renders the patient permanently and 100% impotent for the rest of his life. He can get erections (wonderful erections) that depend completely on the prosthetic. Not a step to be taken lightly.

I admire your candor in asking your question and urge you to pursue the least invasive solutions and pray that you find a cure or treatment that restores you.

I do not know if psychogenic E.D. can induce physical E.D., but do know the "use it or lose it" principle applies. This can be mitigated effectively by repeated erections at regular (daily) intervals. The easiest way to accomplish daily erections is inside a V.E.D. applied once or twice daily. The most effective protocol seems to be vacuum for a couple of minutes, then release and repeat for about 30 minutes. This brings blood flow through the penis, oxygenating the tissues and retains elasticity and size. The oxygenation is not as efficient as a natural erection by your own blood pressure, but is at least partially effective.

[Denoz34]

It seems we have quite similar situation.I just today visited another urologist and he says he is so sure my problem is psychogenic.just same as you many blood,hormonal tests,penil doppler etc and they cant find any organic problem..When I first visited doctors 3 years ago they suggested me to take cialis 5 mg daily and it worked for me very well for a while.some days I could not even walk on street coz of instant erections but unfortunately after some months it became less and less efficient..Now I can get hard no more than 60% with cialis 20 mg.I did also use many other drugs during these years and some worked good but again for just a while..what I noticed is that body/brain get used to it and after a while dont react..Now I can get semi hard only while I lie down.. And the moment I stand up I lose the erection in few seconds..And I think its because I used to masturbate only while I lie on my bed or while sitting and watching porn..I told about it to my doctor today and he says its another sign that my problem is organic,he says if it was a problem based on veins etc it should be same for lie down or standing.Now I am thinking about to forbid myself to masturbate in bed or while sitting,only in shower while standing.I hope it will make some good changes.And also today the first time I started to seek for a sexual therapist.Have you ever visited one? sorry my bad english,its not my native language,hope you understand me)

[60s_surfer]

I am confused that your urologist says that a problem with veins is not organic. Maybe this is a translation issue from your original language to English. To me, veins are part of the body and, hence, are organic. The fact that you can get a better erection in some positions than in others sounds to me like a venous leak, which is definitely an organic problem, not a psychological one.

[thanos]

Guys my situation is not that bad...so penile implants, injections etc. are out of the question. I can actually produce and maintain a solid erection on my own without any drugs, it just needs constant manual stimulation. I can have great sex with the aid of cialis (and spontaneous erections as well), that is why I am asking if you develop tolerance to it. I actually believe I can have sex without it but I am too scared to try it now because I am not in a relationship and also because that is how I developed psychogenic ED in the first place (repeated failures). It is more a "safety" for me if you know what I mean. And I really don't care if I have to pop a little pill every morning (cialis 5 mg) in order to keep my mind in ease and have a fulfilling sex life for the rest of my life. My only fear is that it will eventually stop working. Most doctors say this doesn't happen, they say that if cialis stops working it means your ED got worse and they obviously mean ORGANIC ED. I don't know what to believe anymore. As for the "use it or lose it" principle I am also not sure...M y psychogenic ED used to be pretty severe before I got better and had not erections for years. But when I started having them again i didn't notice any difference in length,girth etc. So I believe (by experience) that having no erections yes, it can damage in a way the penile tissue but it is reversible. Think about it this way. It is like your muscles. When you don't train them they become weak, but if you start lifting weights they get strong again. Of course this is just my opinion and what I have noticed in myself, taht is why I am answering for more scientific and valid information from others.

[AnotherOldMan]

I can actually produce and maintain a solid erection on my own without any drugs

I totally get your worry about developing a tolerance to Cialis.

Have you tried experimenting with various kinds and sizes of cock rings?
Sometime in the 70's my wife and I fell into a similar rut. I had no problem getting hard. Only when attempting entry did I deflate.
A "simple" adjustable leather cock ring was a game changer for me.

Today there is a ton of different types and sizes available.

[Flavio]

Cialis is very effective and I've been taking it for many years. No tolerance in my case.

I combine it with oral phentolamine and results are excellent, both drugs work sinergistically. There is, however, an increased risk of side effects, e.g. headaches, nasal congestion.

[Flavio]

[...] The good news is that discontinuing use can often restore the lost sensitivity
[...]

Yes, I was thinking the exact same thing.

I guess the wisest thing to do is use it in moderation. If you overdo it, there will be an increased risk of tolerance.

[once a writer]

There's no easy way to know if we developed tolerance to a drug, or if the condition that caused our ED in the first place is now worsening.

[Lost Sheep]

Guys my situation is not that bad...so penile implants, injections etc. are out of the question. I can actually produce and maintain a solid erection on my own without any drugs, it just needs constant manual stimulation. I can have great sex with the aid of cialis (and spontaneous erections as well), that is why I am asking if you develop tolerance to it. I actually believe I can have sex without it but I am too scared to try it now because I am not in a relationship and also because that is how I developed psychogenic ED in the first place (repeated failures). It is more a "safety" for me if you know what I mean. And I really don't care if I have to pop a little pill every morning (cialis 5 mg) in order to keep my mind in ease and have a fulfilling sex life for the rest of my life. My only fear is that it will eventually stop working. Most doctors say this doesn't happen, they say that if cialis stops working it means your ED got worse and they obviously mean ORGANIC ED. I don't know what to believe anymore. As for the "use it or lose it" principle I am also not sure...M y psychogenic ED used to be pretty severe before I got better and had not erections for years. But when I started having them again i didn't notice any difference in length,girth etc. So I believe (by experience) that having no erections yes, it can damage in a way the penile tissue but it is reversible. Think about it this way. It is like your muscles. When you don't train them they become weak, but if you start lifting weights they get strong again. Of course this is just my opinion and what I have noticed in myself, taht is why I am answering for more scientific and valid information from others.

During those years of no erections, you MAY, MAYBE, have had erections during the night without being aware of them. Usually a man will awaken with one, but not always. Those erections bypass psychogenic blocks. But they may provide a way of protecting a man from the "use it or lose it" loss of elasticity and size.

I had the same situation as you

I can actually produce and maintain a solid erection on my own without any drugs, it just needs constant manual stimulation. I can have great sex with the aid of cialis (and spontaneous erections as well)

for years. But, as time (and my aging) went on, I required more and more stimulation to stay erect. Before long, the stimulation to keep my erection became more than enough to produce immediate orgasm, ejaculation and commencement of the refractory period (post-orgasm collapse of the erection) Before long, then, my erections became short-lived to the extreme. Ultimately, getting an erection became problematic and I sought an implant (bypassing VED, suppositories and injections).