I haven’t read through this entire thread, but just wanted to add my 2 cents here.
I’ve had mild to moderate ED for 5 years now…since I got divorced. I started just using 20mg sildenafil on nights we were going to have sex, and then slowly worked up to 40mg and sometimes 60mg. After I started PE, I found that I definitely needed more, likely due to overtraining. I also have some blood pressure issues starting and an enlarged prostate. I heard that low daily dose of tadalafil could help with those prostate symptoms, and a BP lowering med would be good for me too. So I started on 5 mg tadalafil/cialis daily, and found that it sort of help with ED, but not enough to have really good sex. I started supplementing with sildenafil as well, given that I’m in pretty good shape, and not in danger of getting low blood pressure. Well, I thought it was working, but never seemed as good as years ago. Then I read somewhere that with tadalafil in your system, those receptors are already bound, so sildenafil might not be as effective. My EQ has been shit lately, so I went on a decon break starting last week, and didn’t take any meds at all this week, and no sex. My wife and I had a rough argument last week, so I was nowhere near interested in having sex with her, but did masturbate twice this week. We worked things out and saturday night I went back to just sildenafil, and everything worked much better. So, I’m not sure if it was the decon break, less alcohol, , PT-141, or getting off my meds for several days that worked, but I think there is something to the competition between sildenafil and tadalafil that creates an issue, at least in me.