Hello thanks for asking from HCM for your health related queries I can understand your concern. ED or erectile dysfunction is a very distressing problem. You have tried a lot of medicines like Sildenafil, Tadalafil etc with not relief. For the persisting symptoms you should get yourself evaluated from a good sexologist doctor. Get your total testosterone, free testosterone levels done to rule out any low testosterone levels. Get your prolactin levels checked as high prolactin levels are common cause of impotence in males. Also get total blood work up and blood sugar levels checked. Diabetes and hypertension are known cause of erectile dysfunction. If anything comes abnormal then visit your doctor for treatment. For persistent ED apart from the treatment you have taken I d advise you to take yohimbin supplements. This will help a lot to supplement the actions of the drugs you are taking. Some antidepressants like Trazodon have good efficacy in resistant erectile dysfunction. Visit a psychiatrist for prescription. Thanks, Hope this helps you. Take care Dr. Seikhoo Bishnoi, Psychiatrist.