Cialis (tadalafil) is yet another medication that is both sinner and saint. We have
already presented many of Cialis' excellent properties and you can read my link
on The Long Term Benefits of Cialis for more
details. However, Cialis also has a darker side as well, one that your
doctor is unlikely to tell you about. It is important to examine the
potentially ugly side of any drug, but especially Cialis since most guys are so
glad to get rid of their erectile dysfunction that they think, "Side effects,
schmide effects - I'm in the saddle again!"
NOTE: Cialis has recently come out with a Cialis Daily lower
dose version that can keep a guy in the game 24/7. Eli Lilly's info page is
Below are some of the concerns that researchers and medical professionals have
noted with Cialis on a daily basis:
1) Brain. Headaches are extemely common with Cialis (tadalafil).
In one 4 week study, 7.2 percent of patients experienced headaches.  This is
almost one out of every 14 patients and shows that Cialis is affecting something
in the brain. Viagra, a fellow PDE5 Inhibitor like Cialis, has actually been studied more
extensively and found to effect the brain
on the neurotransmitter level. For example, researchers have found that
it 1) causes anxiety in rodents and 2) exhibits some antidepressant like
qualities.  The bottom line is that Cialis and the other PDE5 inhibitors
are clearly affecting the brain in a profound way and researchers have almost no
understanding as to how. So I will ask the question, "Is something that
causes headaches in one out of 14 men really going to be good for your long
term health after decades of use?"
2) Backache and Muscle Pain. These are quite common with Cialis and often
do not go away for 24-48 hours.  Again, what is disconcerting is that
researchers have no explanation. Just what is Cialis affecting?
3) Retina. Cialis also effects PDE6 to a significant extent. PDE6 is
another related phosphodiesterase enzyme and is present in the retina.
Here are the kind of all-too-common side effects reported with regular tadalafil
(Cialis) use: "Transient changes in vision, transient and mild impairment in
color discrimination, eye pain, eyelid swelling, electroretinographic
abnormalities, abnormal histopathologic findings,4 pupil-sparing third nerve
palsy, and central serous choroidopathy have been reported."  Again, after
decades of use, what is this going to do to your vision?
4) Cortisol. Cortisol is one of the biggest enemies of the middle-aged and
beyond male. If too high for too long of a time, it decreases
testosterone, increases visceral fat, increases insulin resistance and destroys
neurons just for starters.  Now Cialis has also been found to improve
the testosterone to estrogen ratio, but the truth is that we just do not
know if the increase in cortisol could cause long term issues. Could it
slightly increase the chances for visceral fat? metabolic syndrome?
We just don't know.
European Urology, Sep 2004, 46(3):362-369, "Efficacy and Treatment Satisfaction
with On-Demand Tadalafil (Cialis®) in Men with Erectile Dysfunction"
2) J Neural Transm, 2007 Sep 7, "Appearance of antidepressant-like effect by
sildenafil in rats after central muscarinic receptor blockade: evidence from
behavioural and neuro-receptor studies"
4) Archives of Ophthalmology, Jul 2006, 124(7), "Tadalafil-Induced Subretinal and
Choroidal Hemorrhage in a Patient With an Unsuspected Uveal (Choroidal and
Ciliary Body) Melanoma"
5) J Clin Endocrinol Metab, 2008 Sep, 93(9):3510-4, Epub 2008 Jun 17, "The type 5
phosphodiesterase inhibitor tadalafil influences salivary cortisol,
testosterone, and dehydroepiandrosterone sulphate responses to maximal exercise
in healthy men"