Early 30s considering implant - MANY questions

[awf_1993]

Hey all,

32 year old straight guy here. I've suffered from and struggled with ED since I was 20 years old, and I basically don't even know what it feels like for my dick to be fully hard/erect. Even when masturbating solo, I can get to, like, *maybe* 60% hardness? It's hard to even know. I can get some blood to flow down there, and it gets larger, but not hard. The absolute hardest I can possibly get myself is still bendy and soft, often takes 5-10 minutes of zen-like concentration to achieve, and soon as I stop masturbating, it'll go right back down.

Sex is extremely difficult for me, and the few times I find myself in the situation, it becomes a stressful chore and a mental puzzle to figure out how to get juuuuust hard enough to enter. I do not know what actually satisfying sex feels like, and it's been like this since the beginning of my sex life - I can't tell you how many excuses and lies I've had to improvise an excuse/explanation in the moment as a young guy utterly perplexed why I wasn't getting hard *any* of the times I was getting intimate with women.

I've been on pills since 2016 - mostly daily tadalafil, generic viagra when needed - with diminishing returns over time. At this point the pills give maybe like a 10% boost, if they have any effect at all. Doc says it's my nervous system in a permanent state of fight or flight, and as such, my body is unable to allocate the resources and bloodflow to getting and sustaining a hardon since I'm always in survival mode.

However, this is all I know, and after a lot of researching and soul searching, it seems like biting the bullet and just getting an implant is actually the more reasonable solution to my dilemma than trying another decade of trying to somehow fix it naturally.

It's obviously a difficult problem to talk about, and even at urologists, I haven't been able to demonstrate, like, how quote-unquote "hard" I'm able to get, the circumstances needed to even get that hard, etc. If anyone is willing to talk and hear me out, that would be incredible. I have photos and videos that show the maximum "hardness" my still-not-rigid penis can achieve (but not maintain), and I'm basically wondering if my dreadful quarter-hard "erections" are similar to what those of you had before you were implanted, or if I'm still getting "hard enough" to technically not qualify for an implant.

I just can't fathom the prospect of living the rest of my life the same way the past 12 years have gone and I dream about the one day I'll actually be able to just enjoy and fully immerse myself in sexual pleasure without any of those other thoughts and stresses that have dictated the course of my love life.

So I ask you all, members of this forum, for help determining if I'm actually the kind of person these implants are meant for, even though I'm on the younger side, or if I'm way overthinking all of this. I have so, so, so many questions that I would love community input on.

Thanks to all for reading and for all who respond! This forum is a lifesaver.

[NYCGay]

Based on your description of the situation: No, you’re not just overthinking this. It’s not supposed to be “a stressful chore and a mental puzzle to figure out how to get juuuuust hard enough to enter.” You’re not having the sex life you would like to have, and it sounds unlikely that it will suddenly get better on its own. You have tried the pills, and they no longer work for you, so it’s time to explore other options. That probably means injections or an implant. I never liked the injections, but I do think it makes sense trying them before deciding to get an implant.

You probably also want to try to find out if your problem is psychological or physiological (or a combination). The Doc who said that you’re in a permanent state of fight or flight (psychological explanation), did he examine you to check if perhaps you actually have a veinous leak or some other physiological problem?

Even if your ED is psychological, an implant might still be the best solution, but it’s probably good to find out. Whether it’s psychological and physiological might also affect insurance coverage (if that is an issue).

Find an implant surgeon. Have a consultation. Suggest that he prescribes injections for you. Try them, see if they work for you and how you like them, and then take it from there. But don’t just keep suffering year after year from not having a satisfying sex life. Sure, there are some downsides to having an implant, if you compare it with a perfectly functioning natural erection – but it’s infinitely better than never being able to get hard.

[LetoMan]

Just here to endorse NYCGay’s response. An implant might be right for you. You just want to make sure you understand what you are getting into before going through that door. My story is a lot like yours, had ED my whole life, wish I had gotten implanted a lot sooner.

[1984ptc]

Im about a decade older than you. Dealt with ed since my 20s. Tried pills, combo of pills, ved, shockwave, p shot, bimix then trimix, even pt141. Im on trt too. Also got tested for sleep apnea.

Glad i didnt stick too long with the needles as i had legit peyronies inside my right chamber but not to the point it was too obvious outside. I got implanted 7 weeks ago. No regrets. Find a reputable implant surgeon. If atlanta or in the southeast, see dr hakky. Hes only 5 yrs older than me and hes a really great guy. He wont push you to an implant, but if combining pills dont work with you, an implant may really be an option. Sex should not be too stressful and should be enjoyable. Yes ill need 3 revisions at least in my lifetime.. but its something im willing to do than stress about an erection all the time. There have been several moments when everything was perfect and boom my trimix did not work.. it sucked.

[GoodWood]

From your description, this sounds like classic ED, and the treatment path is usually fairly straightforward: pills, then injections, then implant if needed. Since the pills are only giving you a minimal improvement, it makes sense to start thinking about the next step.

Some men absolutely hate the idea of penile injections and decide to go straight to an implant. I used injections myself for more than 10 years. In reality, the sensation is usually no worse than a mosquito bite, and many times I barely felt it at all. But if injections simply aren’t something you want to do, that’s completely valid.

So yes — despite your younger age, an implant sounds entirely justifiable based on what you’ve described.

The doctor who told you that you’re in a “permanent state of fight or flight” did you a disservice. That’s not really how the fight-or-flight response works. By definition, it’s temporary — your body releases stress hormones to deal with an immediate situation, then returns to baseline. What he effectively did was suggest that your ED is primarily psychological or “all in your head.”

The fact that your erectile dysfunction has been so consistent and long-lasting points much more toward a physical cause — either arterial insufficiency (not enough blood flow into the penis), venous leak (difficulty trapping blood in the penis), or some combination of the two. Venous leak is especially common. But regardless of the exact mechanism, the treatment pathway is generally the same: pills, injections, then implant if necessary.

The important thing is this: there is a solution. You can absolutely get back to having reliable erections without constant stress and uncertainty.

Find a good urologist who truly specializes in men’s sexual health — not just kidney stones and enlarged prostates. Get a consultation with an experienced, high-volume implant surgeon, and keep moving forward until the problem is solved.

[HikerMan]

Hey all,

32 year old straight guy here. I've suffered from and struggled with ED since I was 20 years old, and I basically don't even know what it feels like for my dick to be fully hard/erect. Even when masturbating solo, I can get to, like, *maybe* 60% hardness? It's hard to even know. I can get some blood to flow down there, and it gets larger, but not hard. The absolute hardest I can possibly get myself is still bendy and soft, often takes 5-10 minutes of zen-like concentration to achieve, and soon as I stop masturbating, it'll go right back down.

Sex is extremely difficult for me, and the few times I find myself in the situation, it becomes a stressful chore and a mental puzzle to figure out how to get juuuuust hard enough to enter. I do not know what actually satisfying sex feels like, and it's been like this since the beginning of my sex life - I can't tell you how many excuses and lies I've had to improvise an excuse/explanation in the moment as a young guy utterly perplexed why I wasn't getting hard *any* of the times I was getting intimate with women.

I've been on pills since 2016 - mostly daily tadalafil, generic viagra when needed - with diminishing returns over time. At this point the pills give maybe like a 10% boost, if they have any effect at all. Doc says it's my nervous system in a permanent state of fight or flight, and as such, my body is unable to allocate the resources and bloodflow to getting and sustaining a hardon since I'm always in survival mode.

However, this is all I know, and after a lot of researching and soul searching, it seems like biting the bullet and just getting an implant is actually the more reasonable solution to my dilemma than trying another decade of trying to somehow fix it naturally.

It's obviously a difficult problem to talk about, and even at urologists, I haven't been able to demonstrate, like, how quote-unquote "hard" I'm able to get, the circumstances needed to even get that hard, etc. If anyone is willing to talk and hear me out, that would be incredible. I have photos and videos that show the maximum "hardness" my still-not-rigid penis can achieve (but not maintain), and I'm basically wondering if my dreadful quarter-hard "erections" are similar to what those of you had before you were implanted, or if I'm still getting "hard enough" to technically not qualify for an implant.

I just can't fathom the prospect of living the rest of my life the same way the past 12 years have gone and I dream about the one day I'll actually be able to just enjoy and fully immerse myself in sexual pleasure without any of those other thoughts and stresses that have dictated the course of my love life.

So I ask you all, members of this forum, for help determining if I'm actually the kind of person these implants are meant for, even though I'm on the younger side, or if I'm way overthinking all of this. I have so, so, so many questions that I would love community input on.

Thanks to all for reading and for all who respond! This forum is a lifesaver.

12 years?

Man, I REALLY feel for you guys that have had to deal with this ED issue that long(or longer)
I worked just fine going into my early 50's then that lovely Prostate cancer reared its ugly head and I had to have prostate removed.

This shut-down my erection abilities and it was devastating to say the least.
I only dealt with it for roughly 9 months and
I will state categorically it was the worst 9 months of my life.
The pills, injections ....you name it,... were all just hit and miss in terms of effectiveness
and reliability.
In fact, its the only time of my life where I really felt depression.

DEEP depression.
I literally can't imagine going thru that for a decade and staying sane.

You found the right place to come with your issues though.
To say FrankTalk is a goldmine is the understatement of all time.

Even at your age and the inevitable replacement(possibly 2-3 more) I would seriously
consider going the implant route fairly soon.

The psychological hole you're in isn't going to get any smaller
and the more time passes by the larger that hole is going to get.

I know
I was there.


Brother Bionic Dan is 100% correct
when he says a day without sex is a day lost.

At your age you should be busting bed springs and making ladies walk bow-legged
for a few days or more.

Life ain't no dress rehearsal.
This is it.

You and I may not see tomorrow..
Nobody knows.

Best wishes on your decision.