There is light at the end of the tunnel. I would recommend that you consider going to a qualified sex therapist in addition to what you are currently doing. I had a similar pattern, where I would get hard fine but then would start worrying and lose it, even masturbating. It felt like my life was over. Like you, I would use Viagra or Levitra with success but it made me feel extremely bad about myself as a guy around the same age as you are. The whole thing depressed the hell out of me, the anxiety was overwhelming, and I was constantly thinking about it.
Originally Posted by Eisenhower
After suffering like this for too long, I finally went to a sex therapist. Results were not quick and it was difficult at first. It took me about three months of weekly visits, but I have improved dramatically, to the extent that we recently stopped the therapy because I did not need it any more.
In my own inexpert opinion, it sounds most likely that your problem is psychogenic, and therefore amenable to sex therapy (although sex therapy can be helpful even if it is not completely psychogenic). Most men can get good erections even with lowish testosterone, and your nocturnal erections were probably there all the time even if you were not aware of them (I also thought I hadn't been having them for years and only started noticing them this year because I started paying attention to the issue during middle of the night wake-ups).
But you should have a good urologist confirm that there is not a physical problem. If there is a physical problem, you should know of some studies that suggest that ED can be *cured* by *daily* administration of lower dose Sildenafil or Tadalafil for a *limited* period, after which the patient does not need it any more. See article 17187165 on Pubmed (I'm not allowed to post links on here).
Improved spontaneous erectile function in men with mild-to-moderate arteriogenic erectile dysfunction treated with a nightly dose of sildenafil for one year: a randomized trial.
Sommer F, Klotz T, Engelmann U.
which is reviewed in the article with the name
which you can google.
Long-term Nightly Sildenafil Promotes Normal Erectile Function
Paula Moyer, MA
In this study, a group of patients maintained good erectile function for at least six months after treatment. Also, Google for a powerpoint presentation by Yoram Vardi, "Chronic PDE5 Inhibitors use for sexual indication only?",
which has some dramatic graphs from the Sommer study and suggests similar things for Tadalafil (Cialis). In these cases, the important issue was that the dosing be every day (evening in case of the shorter-acting Viagra) so that nocturnal erections would be improved, which caused rehabilitation of the endothelial tissue in the penis. On-demand usage, on the other hand, had no such "curing" effect.
Finally, be careful of L-Arginine. I was also using it for a while, and I thought it definitely helped some, but in the same way as Viagra it was a crutch. I stopped when I got scared off by this study that made me worry that it might possibly cause harm to the erectile tissue in the long run:
L-Arginine Supplementation in Peripheral Arterial Disease
No Benefit and Possible Harm
Andrew M. Wilson, MBBS, PhD; Randall Harada, MD; Nandini Nair, MD, PhD; Naras Balasubramanian, PhD; John P. Cooke, MD, PhD