Need to be careful with blanket statements like this. ED issues are insanely complicated due to how many factors at play in this system. I can take 20mg and it only has minimal impact. Some people solve everything by quitting porn, for others it does nothing or makes things worse. I found amazing results from PT141, but there is a swathe of people it does absolutely nothing for. There are no blanket solutions that work for everybody. Try everything, play around with dosing, take notes about what you felt. No one is going to give you the perfect answer for you. Take ownership of the issue, keep experimenting until you find a solution that works for you. Once you find it, realize your solution is almost definitely not someone else's solution.
It's not "definitely" anything. It *might* be PA, it *might* be generic lack of arousal as a result of never sexualizing these situations before, it *may* be life stress, there could be other psychogenic causes. Some people need combinations of smells, sounds, music, or lighting to create the correct mood. I know I'm harping on this, but the blanket statements in regards to ED are very harmful. There's so many people that try 1 or 2 things, don't get results, then just give up. It may require MANY changes to solve the problem.
My journey was something like this:
1. "Just get cialis" - slightly helpful, but not even close to solving the problem.
2. "Use a cock ring" - ditto. slightly helpful, not even close to solving the problem.
3. "Just no-fap / no-porn" - Moderately helpful. Definitely a requirement in terms of getting to a solution, but didn't solve the problem.
4. "Use these this supplement" - no effect
X. "Despair" - nothing works, there is no solution, be bitter and resentful
Y. "Grow a pair" - Who cares if there is a full solution or not. I've found some things that have made slight improvements, let's take ownership of this problem, try everything possible, the worst case scenario is that it results in only minor improvement.
5. "Therapy" - literally zero help, if anything it made it worse
6. "Creating a ritual" - This involved using specific light colors and dimming, playlists, and process to get into the zone. Actually pretty good at reducing PA, but still didn't solve the issue.
7. "Mindfulness/being in the moment" - Preventing myself from being "in my thoughts", focusing on the moment. Useful, helps with PA, but it takes a lot of consistent practice to maintain this state for long period of time. Definitely improved the experience, but wasn't a solution.
8. "Start using every possible fucking supplement" - I tried fucking everything here. Minor help only, weirdly makes me both very horny but without helping me get aroused in anyway.
9. "Physical training/practice" - Start using a fleshlight regularly and never my hand for any sort of physical stimulation. I wasn't masturbating to completion, just getting used to a specific physical sensation as being adequate that wasn't my hand. Minor help.
10. "Psychological/sexual fantasy practice". - Practicing/imagining realistic sexual fantasy (stuff you could pull off on a first date pull) and replaying them over and over in enough detail to where I could get hard. Minor help, but helped me discover #12..
11. "Trying weird/extreme drugs" - Tried PT141 and Caverject. Both work. Caverject is just insanely expensive and requires injecting it directly into your dick. Hard to do it quickly enough in the bathroom that it doesn't become obvious, not pleasant at all. Does work. PT141, moderate cost, some real side effects, needs to be used well in advance. Singularly capable of keeping me constantly aroused + hard, and even makes sex feel better. This was almost a solution in and of itself, but couldn't be used consistently. It was singularly responsible for me being able to actually just enjoy sex and stay hard while moving around or through breaks in the rhythm. Tried weed, makes sex feel better, but makes me nearly incapable of vocalizing, initiating, or being aggressive. Overall made things worse.
12. "Dirty talk / practice" - Found that dirty talk is really capable of getting me and my partner incredibly aroused. However, I was so fucking bad at verbalizing and it was one of the most unnatural, unintuitive, and uncomfortable processes to get better at. Takes A LOT of work to not only get good at it, takes even more work to get comfortable doing it, and takes even more to develop a sufficient repertoire that you can improv/freestyle naturally. Major help. Solved most "pre-game" issues, and is just really hot overall for both people. Probably the best / rarest bedroom skill for anyone to have at a high level too.
13. "Pure physical experimentation". - Trying everything I can think of in terms of positions, thrusting technique, hip movement, etc. With the goal of finding things that actually felt good for me. Useful, helped find a couple tricks/moves that keep me going. Still had issues though. This in combination with an epiphany during a blowjob and comment from my partner made me realize there really is only a handful of spots on my dick that actually produce much of a positive effect.
14. "Physical experimentation part 2". - Still doing this now, but basically repeating the previous tests and focusing on ways to stimulate that part of my dick in particular. Realization that this was the "missing piece" the entire time and why I couldn't stay hard. Further realization that all the previous steps were both necessary to get to this understanding and were pre-requisite requirements that were going to need to be implemented anyway.
15. "Passion/lust/aggressiveness training - Just started working on this. Had realization I'm missing something here that's critical. Reading reports of other people's burning lust/need to fuck and complete inability to understand that experientially. Still in early experimentation, but focusing on trying to tap into animalistic needs, impulses, removing as much of the intellectual component and thinking as possible. There's really something here, but I haven't been able to get to the bottom of it.