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Irishgirl- Thanks for the thorough history. It's very helpful to get all of that detail. However, since there are still some unaddressed issues let me just throw a few ideas out there. First of all, Mimi had some good ideas and made an important distinction between two different ED drugs. All the ED medications come in different dosages and therefore it's possible that a higher dose could be used safely and might give your husband the response that he is looking for. Please have him consult his physician about that. If your husband had some initial success with Cialis it makes me wonder if he has had any changes in his general health, started any new medications, changed his alcohol consumption habits, or is taking it in a different fashion than he did then. All of those need to be explored. It is also possible that there is now a psychological component to this due to all the frustration and focus that wasn't there originally. He can probably tell you about that himself. Finally, there are some other medical treatment and mechanical options for the ED but that doesn't address the ejaculation issue. The potential risks and benefits of these can be spelled out by his doctor. Hope this helps!   Rick Wirtz