Fascinating! I have non-hearing damage induced Tinnitus and Bipolar Disorder and have been interesting in my PDE genetics for sometime as a link to my issues. It seems I have a natural inhibition of many PDE genes (PDE4B specifically, but I have some less studied changes in my PDE5A genetics which suggests an inhibition there as well).

Sildenafil has been know to make BP people relapse in one case...

https://academic.oup.com/ijnp/article/7/4/525/707950?login=f...

And also investigated with some mood issues...

https://link.springer.com/article/10.1007/s00213-023-06361-3

Zinc and Magnesium are cofactors for all the PDE genes and those have helped me, specifically the zinc.

I have a feeling that low GTP is causing issues in ED since Cyclic GMP is made from GTP.