Here's the deal: I have no trouble getting it up and climaxing with a provider, and can do it on my own as well..but with the wife it has become hit or miss since I hit 60. Not that she is unattractive, but about half the time I lose wood when the occasion presents itself.
So the question is: Is this dysfunction that is treated, or would a doctor (presumably if I were able to tell the whole story) just say I need the right stimulation? Don't necessarily want to get into pills but it's good to have a life with the spouse too.

then it's a software issue, not hardware.

Perhaps some kind of sexual counselling between you and the wife is in order.

Have you two ever tried to spice up things by doing something really kinky

threesome!

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Even if it's a software issue, the extra boost of confidence you get knowing you have this pharmaceutical enhancement will allow you to relax and maintain an erection throughout the activities, whether it's with your wife or someone else.  Software? Hardware? Who cares!  It has really helped me and many millions of other guys

make the arteries of the penis more sensitive to stimulation. (This is why you get an erection quicker, long lasting, and with a shorter refractory period [the time between erections is the refractory period.])  

Sex with a new person is generally more stimulating than sex with the lady you have been taking out the garbage with for the last 30 years.  The use of the meds allow the weaker stimulation to dilate the arteries that increase flow into the penis and produce an erection.

I am more likely to use cialis with my still attractive wife than with anyone else

I've had a similar problem for awhile. But I know why.

Providers LFK/DFK me like there's no tomorrow.  Wife doesn't kiss me at all, except pecks on the cheek--anything more makes her uncomfortable (not her fault--long story).  
Providers make love to me--touching, caressing, teasing, sliding, rubbing, licking, sucking all over my body. Wife lays on her back and lets me make love to her, but even when I give her hints and encourage her to touch me she just isn't into it (same long story).
Providers I see have fit, healthy bodies (of various shapes and sizes)--a real turn on visually and tactile-ly. Wife let herself go about 15 years ago, never exercises, and is about 60 pounds overweight with most of it around her middle.  (In case you're wondering if I'm being a hypocrite, I'm extremely fit for my age.)

So I usually have to use chemical assistance with my wife.  Which isn't very often, only the 3-4 times a year that she feels up to it.

The things we do for love...

-- Modified on 11/4/2016 6:29:15 PM

As has been stated, providers are often more exciting than one's own wife.  Most women (speaking from personal experience here) after menopause begin to see having sex as something to put up with.  They don't do it to enjoy it, but as an obligation.   Thus it is easier and more fun to have sex with a provider who provides a sexual fantasy that is second to none.  Hearing someone say "Are you almost done" during sexual intercourse is enough to cause an erection to fade and with it interest as well.