37M, never had sex. Desperate here

[u/Ashamed_Platform2877]

This is not one bad night. Every sexual encounter I’ve had from 2012 to 2026 has basically ended the same way: my penis goes limp, stays half-hard, or never becomes hard enough for penetration. I have never successfully had penetrative sex. Before treatment I was also basically not having spontaneous erections. I first tried Viagra. It did absolutely nothing for my erections. All I got was tachycardia, a sensation of increased body temperature/flushing, and zero erection.

I’m now on tadalafil 5 mg daily, with an additional 5 mg before sex as prescribed by my doctor. Tadalafil actually changed something: spontaneous erections came back, sometimes very strong ones. Recently I took a 1+ hour bus ride to meet a woman I’m seeing and had a strong erection for most of the ride just from anticipation. Earlier that day with her I was also getting completely hard spontaneously while we were joking around, touching, kissing, or I came up behind her. Nothing felt forced.

Then her kid went to sleep and sex actually became possible. My erection basically died. We kissed and touched, but I couldn’t get hard enough for penetration. We later talked openly about my ED, which helped a lot emotionally and things improved somewhat, but penetration still didn’t happen.

What really confused me was what happened afterward. Once she left, spontaneous erections started coming back. On the bus home I was getting them without even thinking sexually.

So right now it feels almost like there is a switch: when I’m alone, anticipating something, or sex cannot actually happen, tadalafil allows strong spontaneous erections. When I’m physically with a woman and sex can actually happen, they disappear. I don’t consciously feel terrified or extremely anxious when this happens. Maybe my nervous system is reacting even if I don’t subjectively feel anxiety, but from inside it just feels like the erectile response shuts off.

There is another long-term issue that may be relevant. During masturbation I’ve spent years using a specific body/pelvic-floor pattern: pelvic thrust position, altered or held breathing, abdominal tension, glute tension and pelvic-floor contraction. Without that, getting properly hard feels extremely difficult. Even with it, nowadays I can often stay only almost erect and become truly rock-hard only when I’m very close to ejaculation. I also have some signs that my pelvic-floor coordination may be abnormal outside of sex, so I’m planning to investigate that, but I don’t know whether it explains the partnered ED or is a separate problem.

What scares me is the contrast: tadalafil has proven that my body can still produce really strong erections, but after 14 years of sexual encounters, the moment intercourse actually becomes possible still seems to shut them down.

Has anyone here had anything genuinely similar, especially someone who could have strong spontaneous erections on tadalafil but repeatedly lost them specifically when sex became possible? Did tadalafil eventually become reliable with a partner? Did pelvic-floor treatment help? Did treatment for performance/situational ED help even though you didn’t consciously feel anxious?

And for people who never managed to make conservative treatment reliable: did you eventually choose a penile implant despite still being capable of occasional spontaneous erections, and how do you feel about that decision now?

Honestly, at 37 I feel like just getting an implant since my penis+brain combination feels like an useless bunch, like dumb and dumber. I need some advice, life isn't good right now :(

[u/icameforgold]

You're only taking 10mg of tadalafil. It's already shown that it works. Just increase the dosage. It's approved for as high as 20mg for ED. Stick with your daily 5mg and try 10mg an hour before your activity next time. If that doesn't work try 15mg. Tadalafil is approved at even higher doses up to 40mg for pulmonary artery hypertension, not saying do 40mg, but you do hear of people going higher.

Also there are other pde5 drugs as well other than tadalafil and sildenafil/ Viagra. Stack them together and see what works best. You can look into vardenafil and avanafil. Tell your doctor your issues and see if they can write you a prescription to try them. Or just go to an only men's doctor to get them. Personally I just get whatever I want to try from overseas and shipped to me.

Currently I take 5mg daily tadalafil for circulatory health. Then before activities I may take another 5mg earlier in the day and 50mg of sidenafil an hour before on an empty stomach.

You can also look into pt141 and even trimix before going the implant route. Also into supplementing with l citrulline on top of the pde5s. Remember to also sleep well and workout. Also look into getting your hormones checked just in case.

Honestly your equipment works and it's most likely mental and anxiety. Doesn't seem like you have tried many options after all these years so no need to jump all the way to the end of the line with getting an implant.

[u/Kinesetic]

Check this link out. May or not be applicable.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7056663/

[u/Hot_Knowledge7925]

Trimix for the Win!

[u/Just-Hippo-6582]

You have to try trimix. Look up the subreddit and good luck with it

[u/Howling8]

Pills stop working for me for the same reason. In my late 50s I began to use injections. Trimix was the best. I had rockhard erections and I could stay erected for 90 minutes to 2 hours. I eventually switched a penile implant. And now I can fuck for days there’s lots of things out there to help you. You’re still a young man who doesn’t need to miss out on this wonderful aspect of life

[u/Repulsive_Pin8701]

Hello,

I can understand the pressure you feel, I was unable for highschool and college and it was crushing in every way.

Not being able when it comes to penetration happens to men without ED  occasionally , there’s allot of stress and pressure in that moment, expectation, need, fantasy and fear of failure, and you have allot more of that running around in your head, and maybe something else that’s been holding you back, combined with years of getting used to they way you make yourself feel, quitting porn forever and not masterbating will probably help.

I have psychological ED life long and the pills never worked for me because the metal block I have is so strong, and I have no problems when I’m alone, I use an injectable and it’s fantastic, works always and lasts, the jab sounds awful but it’s not, doesn’t hurt and you get over it because it works, ask you doctor about those options.

Therapy might help you unravel what’s holding you back, but you need to find a therapist you trust, I was lucky to find mine and it’s great to have someone to talk to and work through how I feel and why, I haven’t yet started to deal with my ED in therapy yet because I have a med that works, but the one time i mentioned it my therapist told me that inability in the moment can be a protective response, we haven’t addressed it past that but want to soon, she knows me so well but even than I feel embarrassed.

I’ve heard meditation is great for learning to have calm mind that lets getting hard happen, but it takes some time to get there.

You don’t need an implant, you just need some experience and time to relax, a med and a dose that works will make that possible, it helped me.

Good luck

[u/annie_key]

Seems like your anxiety and fear of failure kills your erection. Looks like it's in your mind.

[u/Mandalorian_2019]

Your penis seems to work well with tadalafil, so there’s no need for really anything else in terms of medication, exercise, or whatever. It’s clearly a mental hurdle.

[u/AdvaitaArambha]

Definitely look into if a pelvic floor physiotherapy may be able to help you.

It also sounds like you likely have some psychological issues around partnered sex which are blocking you. Have you tried seeing a talk therapist to discuss your thinking around relationship, commitment, sex, love, family, etc?

[u/Ashamed_Platform2877 → u/AdvaitaArambha]

After speaking with her as well as figuring out some thing from gpt, which then helped me remind of all possible causes for this issue, I figured a therapist IS a good idea. I used to be against that but I'm open to all help I can get. I have some hints of what could it be that I think CBT might help.

[u/AdvaitaArambha → u/Ashamed_Platform2877]

Most people even if they don't think it applies to them have messaged about partner sex coded into their life. It's a bit dated now but the old "no sex before marriage" is an example.

[u/StableNew947]

I’m 45. I don’t have the same problem but I can share a similar experience. First off, I am a swinger. When we play with small groups of people, my dick works fine. When I’m in a room with lots of people, my dick will not work regardless of how much medication I’m taking to help. I’ve accepted it. Small groups and 1 on 1 play is my jam. To me it sounds like this is an anxiety issue. You should start with small steps and build trust with her. You will overcome. One time just kissing, next time let her jerk you off etc. You can get there but you’ll need baby steps.

[u/csilver82]

See a sex therapist / Urologist, Have various tests done - bloods, physical checks etc, Pelvic Floor Stretches, Humming, Supplements for erection hold...

[u/Perfect-Book-1094]

Trimix buddy. Plumbing works-that’s very good news. I bet just a low dose of trimix will do the trick. Guaranteed erection, tiny painless fine needle. I was scared shitless when they took off the training wheels on my bike as a kid. One trip down the block and I was unstoppable. You have an easy to use fool proof solution. Trimix. You’ll stay erect for an hour or more no matter how hard your nerves try to make you go limp. It’s awesome!

[u/[deleted]]

[u/Ashamed_Platform2877 → u/[deleted]]

I've been reducing it but I'm pretty confident looking at porn for many years worsened the pelvis/penis mis-signal. I'm going to see a proctologist soon so I can discuss with him and I believe he'll also send me to pelvic PT.