Erectile Dysfunction Frustrations

Patient : I am a 59 year old male taking high blood pressure medication, insulin dependent diabetic, 6'0" 295 lbs. When in bed with my wife I have a very difficult time getting an erection, however, when we get in the shower or stand up erections come easily. Why is that and what can I do to turn things around? I still get erections during the night, when dreaming, but they don't last. The doctor has given me samples of Cialis and I have taken over the counter remedies without any effect. Cialis and Viagra are so cost prohibitive! My wife and I have only been married two months. It's a little frustrating.
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