I have to admit these past couple of months I've been really struggling with my campaigns.
I feel like bid prices are way up, and conversion/CTR percentages are down.
Even running volume, I don't see how a small paybump (what's usually given these days) can put you in the green.
I don't mind running smaller geos, but it seems like these offers tend to die pretty quick. Larger geos like US are just way too expensive and the payouts are crap.
Am I missing something here? lol
You're not missing anything
You simply need to find the right offer and GEO. It took me a couple months too, then I found 1 offer in 1 GEO (about 10-15 million people) and that started it all.
You need an offer where you can get significant bumps, then work on the quality and scale from there. I also had to change a couple affiliate networks, to land with some that performed better than the others.
It's all about being persistent and testing like a made mad ... that's all it is about.
Thanks Matuloo I appreciate the insight.
In your opinion, is running Tier 1 on major sites (ie Pornhub, Youporn, Redtube etc) for the most part a losing battle?
I feel like I've advanced a lot as a media buyer to profit in smaller geos, so I wanted to move on to Tier 1 to give it a crack. However I feel like I'm just chasing "Fool's Gold" sometimes, where given the nature of the landscape it's almost impossible to compete.
Just curious to your opinion.
Matuloo always gives solid advice - the best thing about targeting smaller GEOs is that you don't have to compete against the big guys with huge spend, teams working under them etc. We can help you with optimizing through smartlinks while you get more comfortable with scaling. I hit you up in PM if you want to try a test.
Or you can do that on your own and pick the best out of 14000 offers
You can do that through HybridLink® by BitterStrawberry which is a private "SmartLink" which you can create from the bottom up with the offers and rules of your choice. So instead of relying on our in-house SmartLink settings/rules, our system gives you the options to configure it the way you want it.
It's definitely a game changer! Test it & let us know how it went for you 
Mainstream offers running on adult traffic is big, especially apps.
The best way - make tests and tests and you will find the best offers for you.
Of course as we make adult games I can recommend you to try our offers)
Anyway, adult desktop is stiil blowing, just need to find your offers.
Matuloo is right!
But besides, honestly the Smartlink (SL) works really well with Adult (if you are not working with tier-1 countries though). It's quite easy to adapt to the changing trends on a market (specifically segments), you just need to be following them carefully, communicating with your AM and trust him. As soon as you see there's a potential segment popping out - you create a campaign for it and push your SL. It's not true that those can be used only for remnant traffic monetization - we saw cases of people making all their money with Smartlinks.
And you really never know which country will be profitable tomorrow. If your AM is good at stats analysis, or if your network provides you detailed information about the market, you can find the profitable segment even before your competitors will know about it. It happened to one of our affiliates, his AM saw it on time and the guy earned really well in a GEO that would come THE LAST to your mind, when you are thinking about monetization. It was similar to Matuloo's case - about 10 million people.
Think about it 
And don't give up. We all see your work and effort here, and I am sure you are very very close to the goal!