Hi, I hope other doctors also reply to your situation. The reason is we are getting increasing number of people who are taking Viagra (PDE5 inhibitors) medicines and the sad story is _ _ but now without viagra i can not get hard erection _ _ _ . It is difficult to regain normal erectile function in such cases. I take this opportunity to warn people not to take Viagra (PDE5 inhibitors) medicines for recreation or quick fix to boost confidence and bravado. I also request health care professionals to use Sex Therapy whereby without Viagra (PDE5 inhibitors) medicines the person can get his erections. Don t rush to prescribe Viagra (PDE5 inhibitors) medicines. I know it is easy to prescribe and the patient is thrilled. Among the side effects of Viagra (PDE5 inhibitors) medicines, the most important side effect that is not mentioned in literature and text books is, habit formation , which eventually makes the person lose his ability to get physiological erection. I would begin with Sex Therapy in your case. It helps us immensely if the female partner participates in the therapy. Along with this I would evaluate your general health and with appropriate medicines, exercise, diet and relaxation techniques rectify your basic parameters to restore robust physical health. Mood (affective) disorders are frequently associated in this situation. This will have to be treated. Having regained reasonable emotional and physical well being I would investigate to ascertain sexual function (dysfunction). Then oral medicines, M.U.S.E., intracavernosal injection of vasoactive drugs and vacuum device will be administered as appropriate. Both the doctor and the affected man have to have tremendous patience. Best wishes, Dr. Ashok Koparday