Brief Answer:
Cialis still the best bet
Detailed Answer:
Hi, What you have recounted is almost the classical story of a man having ED, and while it is easy and say if Cialis works, continue it, we also could lose sight of another issue which crops up in men entering mid-life.
Testosterone deficiency is a possibility, and I suggest that if you can, confirm that Serum Total testosterone is in normal range, and this test should preferably be done at around 8 AM. Considering that you still have normal erections at night as earlier, it is unlikely but some of the features of late onset
male hypogonadism is a depressed, edgy, irritable middle age male who also has some degree of loss of erections.
If it turns out that testosterone is indeed in normal range, I would suggest that you take Cialis as earlier, probably 10 mg on an on-demand basis, preferably not more than 3 per week, but if things need to get better, may be make it 5 mg once every night irrespective of need. The side-effects you have already encountered, but believe me, there are other drugs which might give you some sort of an erection but may put you to sleep before you actually can achieve an erection. I really doubt if any of the other herbal supplements give even one per cent benefit, but if you are comfortable using them, I will not dissuade you from them.
There is a drug called
Dapoxetine which is available by prescription at 30 mg and 60 mg, which can reduce the tendency to
premature ejaculation. Most of our patients who take Cialis with a combination of Dapoxetine have reported significant benefit, and can hold their ejaculation till an appropriate time.
Hope I have been able to help you. If you can avoid
stress, that might be the best medicine of all.
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