u/DharmaStream

For the last two years, I have noticed slightly worsening erection quality. I'm 40 years old. Here's what I have noticed:

• Erections are like 75-80% quality that they used to be, sporadically 90% quality.
• The final 15-20% of erection quality I'm missing primarily shows up in the glans. It doesn't seem as full as it used to be. However, before orgasm it swells up to normal fullness. If I am VERY turned on, it gets full.
• Erections are more firm standing up vs. lying on my back.
• I still have consistent nocturnal erections, but they also seem like 75-80% of what they used to be.
• My libido also decreased 2 years ago at roughly the same time. I already wasn't insanely high libido (fine with sex every 4-5 days), but it got even lower (fine with sex maybe every 7-10 days). I almost never look at porn or masturbate.
• I have noticed a bit more "pelvic floor" like symptoms. Sometimes I will have spasms after I poop. Sometimes after I pee it feels like a bit of a pelvic spasm. This isn't consistent or even super common but it does happen sometimes.
• I have a desk job where I sit a lot during the day, but I am not overweight and I do lift weights.
• I take 10mg Cialis / daily and have for years.

I was pretty bummed about this. However, it hasn't seriously impacted my sex life. When I'm actually with a girl and very turned on, my erections are sufficient for sex, but I do notice they deflate faster after sex. Like they start getting softer while I'm still inside the girl after I finish but before I pull out. They used to stay harder after sex for longer.

However - this past January (so just a few months ago), I took a very long trip overseas. I was very sleep deprived from jet lag. Suddenly, I got a **very hard** spontaneous erection and had high libido. It was the most normal erection I've had in 18 months at that point. Extremely hard. After I masturbated, it remained hard for a while - I was literally wondering if it was even going to go away.

That night, I got super hard again. Masturbated again. The next day after that I continued having very normal, very hard erections and masturbated twice that day too. Masturbating 4 times over a 2 day period is **very unusual for me**. I haven't had that happen since I was a teenager basically. The 3rd day I still was getting very hard and high libido. In the days that followed, my erections and libido gradually went back to where I am now and where I was before.

I was dumbfounded. It was literally like I was 18 again (I'm 40). To me it's very confusing but also encouraging - whatever is causing my reduced erection quality is theoretically reversible under certain circumstances, but I don't know how to reliably recreate what happened while I was on that trip.

I've chatted with AI and landed on theories around excessive GAGAergenic tone and potentially a dopamine issue that a combination of sleep deprivation and jet lag reversed temporarily and those conditions went away as I caught up on sleep throughout my trip and I went back to how I was.

Another thing leading up to that trip was I had not drank any alcohol for about a month. I am not a heavy drinker usually, but I might drink a few drinks twice per week or something. But, maybe if my dopamine system is already a little messed up that's enough to make it even worse.

Anyone else experienced anything like this or have any ideas?

Other info:

• My testosterone is 700 (I'm on TRT), E2 / estrogen is ~35-40
• I measured prolactin last year at 11
• Thyroid labs normal
• I take 20mg / day Crestor for high cholesterol... on medication my total cholesterol is about 160. I do feel like statins lower my sex drive but I was taking them while I was "cured" so I don't know.