Out of everything I'm seeing here, I don't see any reference to what the real issue is for ED. I'm seeing a lot discussed about what may help libido, but not ED. What you want to look out for (if your sex drive is okay) is what is affecting you via either a vasoconstrictor or vasodilator. This is the reason why we use Viagra or Cialis to treat ED--because they are vasodilators. If there is any malfunction of the adrenals related to ED, it is adrenalin that is the culprit, not cortisol because adrenalin is a vasoconstrictor. I'm 47, same age as EMW14. I've been on TRT since I was 30 (that's 17 years). Doesn't matter what the estrogen levels are or the SHBG. If you don't have enough vasodilation going on, you will not "keep it up." I've used Viagra, Cialis, and even PGE1/Caverject/Trimix. I've found the best to be a daily dose of 5-10mg of Cialis for ED.
I have tried cialis, both in 20 mg "as needed" dose and as a daily dose (5 mg, I think is what that was). For me, the only thing I ever got from cialis is wicked heartburn. It did absolutely nothing for my limp dick problem.
I don't know why this is the case, but it sure is. I've tried it several times, always with the same result.
A good friend of mine, who is 57 and also on TRT at 200 mg per week (one injection, 200 mg once per week) swears by cialis. For him it works like a champ. "All you gotta do os touch it and it comes right back up".
Believe me, if this worked for me, I'd be all over it. Of all the vasodilators, amd I've tried them all, viagra is the only one that works for me. It will give me heartburn also if I haven't used it in a while, but as long as I take one say once a month, I don't get the heartburn.
Knowing this, I've tried to stick with cialis daily, thinking maybe the heartburn would stop amd maybe the hardons would come, but it didn't work. The heartburn got progressively worse and it never did anything at all to improve the ED.
Viagra has its issues, too: it works best when taken on an empty stomach. This isn't usually a problem, a lot of times it works fine when taken just before or after a meal, but not always. Also, it takes 15 to 30 minutes before it starts working, sometimes longer. My wife and I have found sex to ne most enjoyable when it's unplanned. When the mood steikes, if I have to take a Viagra and then wait, this can sometimes kill the mood. We can usually recover, but not always. If a quickie is what's in order, forget it.
What's most frustrating for me is knowing that none of this is mecessary when I have the testosterone and wverything related just right. When that's right, I don't need viagra or anything else. I get it up no problem, get hard while sleeping, it comes right up when my wife and I get together and stays up, all is well.
What's driving me fucking nuts is that it's been 2 fucking months that I've been trying to get back to that "all good" position and so far haven't been able to. And trust me, when you know your dick just isn't going to work, or even wonder if it will or won't, that kills the libido, too. Meaning sex drive, interest.
So, here I sit, taking the very same dose I was taking when all was well, and it's not working. Worse, everything I've tried has failed. I just took my 100 mg shot this morning. I'm going to stick with this cortisol inhibitor experiment until my next shot is due Monday. If it doesn't work, I'm dropping that. I will most likely skip my Monday shot and see how I react. What usually happens is, my dick will start to work a few days later as my testostwrone and whatever related hormones start to come down. Once I start getting the night time hardons, I'll wait a few more days and get back on the shot schedule. That has worked in the past.
One time, I fucked around for a few weeks thinking I was too high and progressively lowered my test dose to no avail. I knew I was low enough that I was TOO low. So I went back up at that point and got it just right.
So, like I said, if this doesn't get resolved by Monday, that's what I'm gonna do.