What are the Benefits of Tadalafil? How Does Cialis Work?

Tadalafil.  Understanding its Uses, Benefits, and Side Effects

Tadalafil, often recognized under the brand name Cialis, is a medication primarily prescribed for the treatment of erectile dysfunction (ED) and symptoms of benign prostatic hyperplasia (BPH). However, its use extends beyond just these conditions, encompassing various off-label uses and potential benefits. In this article, we discuss the mechanism of action, therapeutic uses, potential benefits, side effects, and precautions associated with tadalafil.

What is Tadalafil?

Tadalafil belongs to a class of medications known as phosphodiesterase type 5 (PDE5) inhibitors. It works by inhibiting the enzyme PDE5, which regulates blood flow to certain areas of the body. By inhibiting PDE5, tadalafil promotes relaxation of the smooth muscles in the blood vessels, facilitating increased blood flow. This mechanism is pivotal in achieving and maintaining erections, making tadalafil a cornerstone in the treatment of ED.

Therapeutic Uses of Tadalafil

Erectile Dysfunction (ED) Tadalafil is primarily prescribed for individuals experiencing difficulties in achieving or sustaining erections, a condition known as erectile dysfunction. It is renowned for its efficacy in providing longer-lasting effects compared to other ED medications. Tadalafil can be taken as needed, with effects lasting up to 36 hours, earning it the moniker "the weekend pill." Known mostly under its brand name Cialis, Tadalafil is typically associated for its use in treating low libido and ED in men. It’s often used successfully to improve erectile functioning, improve sexual performance and libido in men especially when used alongside testosterone replacement therapy.

Benign Prostatic Hyperplasia (BPH) Tadalafil is also indicated for the management of symptoms associated with benign prostatic hyperplasia, a non-cancerous enlargement of the prostate gland. Benign prostatic hyperplasia (BPH) is a medical condition characterized by an enlarged prostate gland. This condition commonly occurs in men as they age, as the prostate undergoes two significant growth phases: initially during puberty, when it doubles in size, and later around the age of twenty-five, when it continues to gradually enlarge throughout life. BPH typically manifests during the latter phase of prostate growth. 

The enlargement of the prostate gland can exert pressure on the urethra and lead to thickening of the bladder wall, resulting in potential complications such as weakened bladder function and incomplete emptying. Symptoms of BPH may include urinary incontinence, a weakened urinary stream, nocturia (excessive nighttime urination), frequent urination, and a persistent urge to urinate. By relaxing the smooth muscles in the prostate and bladder, tadalafil helps alleviate symptoms such as urinary frequency, urgency, weak stream, and nocturia. BPH is different from prostate cancer. There is a misconception about testosterone therapy and prostate cancer however it has been proven that there is no link between Prostate cancer and TRT.

Pulmonary Arterial Hypertension (PAH) In addition to its primary indications, tadalafil is approved for the treatment of pulmonary arterial hypertension, a rare condition characterized by high blood pressure in the arteries of the lungs. Pulmonary arterial hypertension (PAH) is a distinct form of pulmonary hypertension characterized by the narrowing and thickening of the small arteries in the lungs. This constriction impedes blood flow through the lungs, leading to increased blood pressure within the pulmonary arteries. Consequently, the heart must exert greater effort to propel blood through these narrowed vessels. Over time, this strain on the heart diminishes its capacity to efficiently circulate blood throughout the body. Tadalafil's vasodilatory effects help reduce pulmonary arterial pressure and improve exercise capacity in individuals with PAH.

Off-Label Uses and Potential Benefits of Tadalafil

Beyond its approved indications, tadalafil is increasingly being explored for various off-label uses and potential benefits. Some of these include:

Raynaud's Phenomenon Tadalafil's vasodilatory properties have shown promise in improving blood circulation and alleviating symptoms associated with Raynaud's phenomenon, a condition characterized by cold-induced vasospasms in the extremities.

Altitude Sickness Studies suggest that tadalafil may help prevent high-altitude pulmonary edema (HAPE), a severe form of altitude sickness, by improving pulmonary vascular function and oxygenation.

Female Sexual Dysfunction While primarily studied in men, tadalafil has also been investigated for its potential efficacy in treating female sexual dysfunction, including arousal and orgasmic disorders. Research in this area is ongoing and warrants further exploration, however anecdotal evidence suggests that lower doses can improve blood flow to the clitoris and heighten sexual sensitivity and improve both pleasure and libido in women.

Exercise Performance Some athletes and bodybuilders have reported using tadalafil to enhance exercise performance and muscle pump during workouts. However, the use of tadalafil for this purpose is controversial in some circles and not supported by scientific evidence. There has been growing interest in using antioxidants as a potential strategy to prevent or alleviate exercise-induced oxidative stress, which could potentially enhance athletic performance. However, it is essential to assess the use and potential misuse of these substances, particularly in competitive sports where elite athletes are subject to rigorous physical demands. Currently, there is limited research on the effects of administering PDE5 inhibitors on oxidative balance in individuals with fitness levels comparable to elite athletes.

Dosage and Administration of Tadalafil

The recommended dosage of tadalafil varies for patients depending on the indication and individual response they have to the medication. For the treatment of erectile dysfunction, the typical starting dose is 10 mg, taken orally as needed, approximately 30 minutes before sexual activity. The dose may be adjusted based on efficacy and tolerability, with a maximum recommended dose of 20 mg once daily. For the management of benign prostatic hyperplasia and pulmonary arterial hypertension, tadalafil is usually taken at lower doses and on a daily basis, as prescribed by a healthcare provider. Tadalafil can be administered orally via a tablet, capsule or dissolvable troche underneath the tongue.

Side Effects and Precautions

While generally well-tolerated, tadalafil, like any medication, may cause side effects in some individuals. Common side effects include headache, flushing, indigestion, back pain, muscle aches, nasal congestion, and dizziness. These side effects are usually mild to moderate in nature and tend to diminish with continued use. However, if they persist or worsen, it is advisable to consult a healthcare professional.

In rare cases, tadalafil may cause more serious side effects, including:

Priapism An erection lasting longer than four hours, which requires immediate medical attention to prevent tissue damage and permanent impotence.

Sudden Hearing Loss In rare instances, tadalafil may cause sudden hearing loss or ringing in the ears (tinnitus). Patients experiencing these symptoms should discontinue tadalafil and seek medical evaluation promptly.

Vision Changes Tadalafil has been associated with vision changes, including blurred vision, changes in color perception, and sudden loss of vision in one or both eyes (non-arteritic anterior ischemic optic neuropathy). Patients experiencing vision changes should seek immediate medical attention.

It is important to exercise caution when taking tadalafil, especially in individuals with certain medical conditions or those taking medications that may interact with tadalafil. Patients with a history of cardiovascular disease, liver or kidney impairment, bleeding disorders, or anatomical deformation of the penis should inform their healthcare provider before initiating tadalafil therapy. Additionally, tadalafil may interact with nitrates, alpha-blockers, antihypertensive medications, antifungal agents, HIV protease inhibitors, and other drugs.

 Therefore, it is crucial to disclose all current medications to a healthcare professional to minimize the risk of potential drug interactions. Tadalafil should be used with caution and under the guidance of a healthcare professional, taking into account individual medical history, medication regimen, and potential side effects. With proper dosage and administration, tadalafil can provide significant improvement in quality of life for individuals experiencing erectile dysfunction and other related conditions.