Compounding Issues

42 yo male, healthy.

Married for 18 almost 19 years.

Abot 6 years ago started loosing erections during sex. Dr put me on Sildenafil and it worked great for about 3 years.

Again started loosing erections during sex. Switched to Tadalafil 5mg daily. Seemed to help and was doing alright. Wife wasn’t really impressed with the firmness but it worked better than nothing.

However a couple years ago also started having premature ejaculations. I would maybe last a minute. If I made it 2 minuets or more that was a rarity.

But unfortunately it gets worse. Couple months ago started loosing erections during sex again. Dr increases Tadalafil from 5mg to 10mg and it does not help. Thought to try Sildenafil again. Didn’t help at all.

I don’t know what to do. I’m lost. Pretty sure it’s a psychological issue causing this. I just need help. I want to make my wife happy again.