I m in my mid 40s and have had erectile dysfunction problems over the past several years. I m in very good physical shape with below average body fat and a muscular build as I body build regularly. I also eat health over 90% of the time. In the past, I would just take some viagra and that would produce amazing results but that seems much less effective than it once was. I saw a urologist and my testosterone is just fine according to him. He prescribed Cialis which helps but my erections are not as hard or as long lasting as several years ago. Using a condom is particularly problematic as it reduces stimuli and sometimes it makes it difficult to stay hard. I d say that I have to issues that may be contributing factors. 1) My job is very stressful. 2) I watch a lot of internet porn every day and masturbate.