So many doubts and frightenings

[Lost Sheep]

No risk no reward. You’re a brave man.

Thanks for the vote of faith, KeithC. But, as I said, it was less courage than desperation. With a modicum of faith in the good graces of women. (Tempered by good judgement in selecting which ones to allow into my life-and bed.)

[Flounder]

……..the fist years I was able to go with Cialis 5mg, but it lost effectiveness gradually. Then I found another urologist, get another Doppler, a complete one, revealing that my penis have a structural issue, the cavernosum arteries are atrophied and don't supply blood as well. Doctor said it's congenital. I have a diagnose, vasculogenic ED…………….

………At this time, I can get hard with pills, using 20mg of Cialis I can get hard but getting stimulated, so much stimulated in comparison with the first years and 5mg cialis. I need to rub my glans and masturbate almost at the point to having an orgasm to get a full erection. Same with 100mg Viagra. It's a very hard erection, but the time it's take make me afraid of try an intercourse with a woman. I have no sex for a year at this point……….

……..So my sexual life is a disaster, I thought about the implant, but the fact I can get a total erection make me doubt. What if I'm wrong? What if I have another problem interfering with the pills………….

I hate to be so blunt but you have Erectile Dysfunction (also called: ED or impotence) and it’s progressing in the typical way that affects millions of men. You meet the definition of ED; The inability of a man to get or keep an erection firm enough for sexual intercourse. You stated you haven’t had that in over a year. Getting hard briefly before ejaculation, after vigorous masturbation with 20mg Cialis, doesn’t mean you don’t have ED. It simply means there is some residual function which will likely continue to deteriorate.

Your progression with ED is very common with older men and I’m sorry it’s affecting you so early in life. None the less, the pattern is identical. Small doses of pde5’s use to work, now larger doses aren’t working. While there are various causes of ED, the conventual treatments are the same regardless of age or cause. Use pills until they become ineffective then move on to injections. When injections become ineffective, you either accept impotence or go for the implant.

You have ED and don’t want to try injections. I get that. But you are basically fast forwarding to a decision of importance for the rest of your life vs an implant. A positive outcome with the implant is largely in your favor but that is something you need to come to peace with yourself. Knowledge conquers fear and doubts. I encourage you to keep an open mind about injections and implants. Read lots of old posts here at FT. The forum is notorious for hijacking and going off topic so many times you will find good information buried in topics you least expect it.

I will close with one nugget of hope. You mentioned a Doppler revealing that your cavernosum arteries are atrophied and don't supply blood well. You might investigate Shock Wave Therapy. GainesWave or SpartanWave are two brand names. It uses targeted sound waves to stimulate penile tissue and encourage blood flow. The literature claims to grow new blood vessels and improve blood flow to the penis. It sounds like low blood flow to penis is the cause of your ED and this treatment claims to target that cause. I have no experience with it and the reviews aren’t great but thought it was worth a mention.

Best of luck to you.

[Rider1400]

I had the same trend you are having but 10 years later in life. Pills worked for 10 years then injections for a little over a year at this point I decided it was time for implant. It’s your decision. Just be committed to doing it before you start process and find a good qualified Dr who does more than a couple a year. Experience is key with Drs.

And how was felt the decreasing effectiveness of pills? You recognize the sensations I described? Maybe some irregular effectiveness before becoming useless? Thanks

Started with 10mg when needed.. after 5-6 years I had to go to 20mg that lasted 3-4 years and then it gets to where it never gets as hard and according to stimulation level it would go soft. Much like initial stages of ED prior to pills. Injections were amazing at first only using 3-4 units of a medium strength tri-mix but in just a few months it started failing just like the pills, so up to 6 then 10 then 20 then 30 units over just a year and it was inconsistent. The worst part was trying to get the right dosage when increasing. Either not enough or too much and dealing with aching hard on for 3-4 hours. I also developed a little scar tissue so decided to go for implants. Asked Dr about this and he said your body doesn’t become immune to shots or pills rather the physical issue that’s causing the ED gets worse. In my case it was veinus leak.