Chronic Erectile libido issues for 30 year old male

Hello!

My info:

– Age: 30
– Sex: M
– Height: 5’8″
– Weight: 175lbs
– Race: White/Caucasian
– Duration of complaint: 12 years for the original issue (ED), 2 years for intermediate issue (libido), 3 days for the newest (adverse Cialis reaction)
– Location (Geographic and on body): Chicago area, groin/chest(?)/ear(?)
– Any existing relevant medical issues (if any):
– Obesity, but I’ve been working on this. I’ve lost 5 inches off my waist since 1/1/18, and I’m continuing to powerlift and generally work out to try and boost my testosterone. I started at about 215.
– I’m not sure what it can be attributed to, but I have absolutely no sexual drive since age ~28
– I have a great deal of difficulty sleeping (sometimes falling asleep, sometimes staying asleep), unless I use cannabis edibles.
– I sometimes have difficulty urinating. It’s never painful, but sometimes there is a pressure I can feel as I’m trying to start. I typically have issues with starting to urinate (even at home alone), but other times I have problems with weak stream.
– Current medications (if any): None, although I am a cannabis user. I only use edibles, never smoked. I use it as a sleep aid in the evenings. Otherwise I just take:
– A generic Walmart multivitamin
– Calcium-Magnesium-Zinc supplement
– Maca supplement

**My story**:

I’d always had difficulty getting erections, from the time I was ~18 or so. I’d get them, but they wouldn’t be full, or last as long as necessary. I also would never get morning wood. When I discovered you could order Cialis on the internet, all that changed. I had the sexual drive, just not the ability to satisfy it. For a long time, this situation worked great. I took a 20mg Cialis every 3-5 days, my wife and I had our fun, and then would stop until the next time. I never had any side effects besides an occasional light headache, which I’d take ibuprofen for, and be fine. It seemed like something great that would just work forever.

Fast forward to today, age 30. I’ve not had the drive *at all* since age 28. I had labs run for myself 1/1/18, measuring total/free testosterone, as well as a smattering of other readings (TSH, estradiol, insulin, glucose, etc etc..please take a look, it’s 3 pages long). I had been having more and more issues recently with general pain and inflammation, and I was taking ibuprofen almost every day (~400mg, usually in the evening), which I made sure to always eat with. I’ve since completely stopped taking it, for fear I was somehow aggravating the issue.

I started power lifting 1 year ago in April to try to fix my problem, and I am the strongest I’ve ever been in my life. Sex still just feels like a chore, if I can even manage to do it. I never have the urge to masturbate, either. I rarely ever have sexual thoughts on my own, it’s typically my wife saying something that gets me started thinking about it, but it usually passes really quickly and I have no ability or desire to stay focused on it.

Recently I’d been noticing the Cialis seemed to be working less and less, and then 3 days ago, I took it and it didn’t seem to work at all. Not only that, but I began having a ringing in one ear that I hadn’t experienced before. I also had a strange heartbeat for part of the first night, but that passed. The hearing issue is still present today, but it’s much less severe than it was. I’m hopeful I haven’t done any permanent damage.

**My questions**:

1. Do you think my testosterone is low? Does that speak to my basically nil sexual drive?
– 1a. I made an appointment with a urologist for April. I’d mentioned my fear that my testosterone was low, and I’m somewhat hopeful he’ll try either TRT or some aromatise inhibitor at least. I planned to do another one of the lab readings that I linked above on 4/1, just to have a before/after picture from militant dieting/exercising for the Doctor when I go.
2. Should I be worried about my reaction to the last Cialis I took? I threw the rest out, and won’t be taking any more unless ordered by a doctor.
3. What else do you recommend I do? I’ve tried every natural thing I can think of, eating right, exercising, supplementing important vitamins/minerals, and nothing seems to help. Losing a good % of my body weight doesn’t seem to have done anything so far either. I have built visible muscle, and lost enough fat that it shows, but I haven’t experienced *any* improvement at all in either sexual desire or my erectile issues. Before I changed to keto on 1/1, I’d been eating decently since 4/1/17, just with lots of fruit / other natural carbs. I was still eating sugar then, but I’ve completely cut it out since 1/1, with no change.

Thank you, I greatly appreciate your time, and any help you can provide.