Many men are confused when tadalafil or sildenafil works physically but fails during real sex. Erections may appear during masturbation or with porn, yet disappear with a partner. This leads to frustration and the belief that the medication is ineffective. In reality, the issue is not the drug. It is the type of erectile dysfunction being treated. What Is Porn‑Induced Erectile Dysfunction (PIED)? PIED refers to erection problems caused by long‑term exposure to high‑stimulat