A doppler ultrasound is the gold standard for diagnosis of venous leakage and I feel it should be interpreted by a vascular specialist or competent urologist not a GP. You seem too young to have the other venous conditions the previous poster describes. Usually those things creep along slowly which is why they manifest in 60s-70s. As others have posted elsewhere from time to time, TRT decreases erection quality and libido. I'm one of them and have experienced it being on and off TRT multiple times. Currently, off and libido has returned to satisfactory point whereas on, it was about non-existent. About the porn/mast, every other day is too much. I know it's very, very (you can do it!) difficult but you should try total abstinence for two weeks and no sex for two weeks, nothing. Then, give it the slow affectionate approach with gf/wife. See if it's different. If not, I'd repeat the Doppler and discuss with a good uro.
