@rlpostrp A lot of my issues were self imposed. My wife was diagnosed with cancer 5 months after surgery. We had not tried to have sex. I then became a caretaker for the next 4.5 years. I never tried self stimulation, never took any medications. I thought I was done with that part of my life. My wife passed and I found I was still very interested. That's when I went to Mayo clinic for some help. The urologist told me it really is true that you use it or lose it. Not only do the nerves scar over but the cells in penis for erection become atrophied. He felt I would be lucky to have any erection without an implant. The Cialis gave me some life which was encouraging but really just occasionally during the middle of the night. I then tried trimix and it worked. I only need 5 units for 2.5hr erection. It is penetrable most of that time.