OP, if you can last 15-20 minutes with an actual woman, I wouldn't worry. That's better than the vast majority of healthy men. You need to game and foreplay a woman to stimulate her before anyway, so you don't need to be pounding her rock hard for 2 hours every time.

I had some issues during covid. Whether it was the virus of the vaccine I took to please a work colleague I don't know but It was quite worrying. I was also not too fit then. Bought dick pills in 2020 -Cialis- but then got fit and never finished the pills.

In terms of a quick fix, nitric oxide boosters. Beets are a good thing to eat and arginine is a good amino to supplement.

Longer term balanced cardiovascular fitness is a great goal. People from a gym background tend to naturally gravitate towards intervals but really intervals are the icing on the cake of cardio vascular fitness. No athlete is complete without some interval training but bear in mind that the scientific studies that tend to back one sort of other of intervals as being the biggest bang for your buck are all short term. It takes many months to make the long term cardiovascular changes and scientists want simple studies with sexy results.

Hard intervals are what coaches use to induce peaking in athletes. So its no surprise that a month or two of hard intervals show up as giving great results in scientific studies -the nerds are demonstrating very well that peaking work outs work -well who would have thought? But you can't hold a peak.

Look at what the coaches of good athletes are prescribing, not just at the latest fashions. The 80:20 "rule" of base work to hard interval work is much touted and will keep you safe though, in fairness, starting out on cardio vascular fitness, you can be more like 70:30 or more as you don't have the high volume. Whatever, no one should be without a long slow run once a week/ ten days. I have just got back form my ten miles. It was a bit cold this morning. You just won't get some adaptations if you are running with high lactate levels. Most of the time you want your red muscle to be saying "oh yum, yum lactate is my favourite fuel give me more blood supply to utilise what my white pals are turning out" not "Shit another lactate dump from those white bastards, these hydrogen ions are burning us all too much to cope" Also your endothelium is precious to your circulatory health. Don't constantly burn and scour it with too much intensity.

I can understand someone who has been working in the gym a lot being worried about getting too catabolic with a lot of cardio vascular work. I call it the "endurance athlete's paradox" -how can you achieve anything anabolic if you are always getting into deeply catabolic states. This is not an entirely groundless fear but it really only makes a significant difference to those at the very top of their game. I have a daughter who is a good middle distance athlete, XC runner and steeple chaser. Recently a gym bunny started to follow her on her social media. This girl was an ex pro bikini fitness competitor. We thought it a bit odd but - what is some roided up girl who takes slutty pictures of her abs doing messaging an athlete? But then this girl pops up at a local 5k race and introduces herself. It turns out that she decided she now wants to be fit more than to look fit and has become a very good runner. We have seen her a few times at local 5ks and my daughter does not wait too long to shake her hand on the finish line. She is running 5k in under 18.30 while carrying a lot of excess muscle and fake tits. She does 10 mile long runs. If women can have real cardiovascular fitness fitness and carry muscle, men certainly can.

When it comes to the number of times you can climax and the refractory period, consider Prolactin levels. I would not touch Cabergoline with a barge pole -the heart valve damage risk is way high. But consider working on prolactin's antagonist -dopamine. The dopamine feedback loop is no way as complex as the Test feedback loop. If you can nudge it in the right direction it can often stay there. Look at what aminos encourage dopamine -off the top of my head I would say tyrosine. Also consider making sure your life is full of small rewards and that you enjoy them.

I think Dopamine is a big part of erectile health. Consider how when you get a new woman you suddenly can do it lots more -because there is a bigger dopamine reward from the novelty. The same also applies to running two women at the same time. You rarely find you can't please both of them in the day. Getting on to something different is a real reward based turn on. Its probably all there is behind those couples who find they need to do more and more freaky shit just to get off -they need fresh rewards, so try to make this part of your life, as opposed to just your sex life. The stereotypes of the high dopamine guy having plenty of sex really are true. Trying to de-stress and get small joys from life is a real help.

Kegels, yeah I think they help but only to a point. If your pelvic floor is already good from your gym exercises, it may not make a huge difference but its a easy to find out by doing a few weeks of them.

cardio can really help.

same for general fitness. same for low bodyfat (but not too low, eg go for about 12%).

stress doesn't help

get your bloodwork tested, esp. T (obviously), HGH, a few things like that.

I'd get lab work and see what your testosterone, estrogen, and prolactin levels are. Cardio is always a good addition to a fitness routine (I need to do more of it myself). But I'd get lab work and see if any hormones are out of whack.

as i get older

when I was younger

How old are you?

i heard that cardio (both steady state and interval training) is where it's at for sexual health, because from what i gather erection quality depends on your cardiovascular system

Yes. You need cardio for overall health. Lifting is more important overall, but you still need cardio.

ED has many potential causes, most of which are treatable. But a bunch of strangers on a forum can't tell you which one(s) need treating. See your doctor. Get the lab work done.

Running on a treadmill isn't going to give you back the rock hard erections you enjoyed as a younger man, but you should be doing some cardio anyway, especially as you age. It's great for overall health as well as maintaining balance, and mobility.