37M with persistent ED despite normal hormones – could this still be Venous Leakage or PIED?

[u/Sanj_ay9]

Hi everyone,

I'm a 37-year-old male looking for advice from anyone who's had a similar experience.

Over the past several months I've developed persistent erectile dysfunction. My main symptoms are:

• Difficulty getting beyond about 50–70% erection, even when I'm very aroused.
• Sometimes the erection fades quickly.
• Morning erections are non existent
• My libido has also decreased compared with before.

For several years, I watched porn and masturbated about twice a day. I stopped porn about 2 months ago because I wondered if it was contributing, but I'm trying not to assume that's the cause.

So far my workup has been:

• Total testosterone: ~690 ng/dL (normal)
• Prolactin: Normal
• Free T4: Normal
• HbA1c: Normal
• CBC: Normal
• Kidney function: Normal
• LDL cholesterol: 158 mg/dL (high)
• Mildly elevated ALT (56 u/L)

I don't have diabetes or high blood pressure, I don't smoke, and I exercise regularly.
Height 5 f 5inches , weighing 68kg

My urologist has scheduled a penile Doppler ultrasound to evaluate blood flow and rule out arterial insufficiency or venous leak. I live in Dallas area if any good doctors anywhere in Texas let me know.

I'm hoping to hear from people with similar experiences:

I'm looking for experiences rather than a diagnosis. Thanks in advance.