We are talking about tadalafil, better known by the brand name “Cialis.” This medication for treating erectile dysfunction belongs to the group of phosphodiesterase-5, or PDE5, inhibitors. Sildenafil, better known as “Viagra,” also belongs to this group, writes “Verywell Health.”
These drugs were initially studied as a potential treatment for high blood pressure and cardiovascular diseases. Later, after noticing their effect on erections, the main use became the treatment of erectile dysfunction.
However, scientists continue to investigate whether PDE5 inhibitors could be beneficial in other cases. Interest was especially sparked by an observational study published in 2025. In it, tadalafil use was associated with:
- 34% lower risk of early death;
- 27% lower risk of heart attack;
- 34% lower risk of stroke;
- 32% lower risk of dementia.
These results were discussed on social networks by entrepreneur Bryan Johnson, famous for longevity experiments. He stated that he takes 5 milligrams of tadalafil daily.
In other studies, drugs from this group were associated with a 44–55% lower risk of overall or heart disease-related death. The numbers look impressive, but specialists emphasize an important circumstance – these were observational, not randomized clinical trials.
Scientists only analyzed already collected patient health data. Study participants were not randomly assigned to tadalafil and placebo groups, so the results do not prove that the drug itself reduced the risk of heart attack, stroke, dementia, or early death.
“Cialis” works longer than “Viagra”
The 2025 study found a positive association with the use of both tadalafil (“Cialis”) and sildenafil (“Viagra”), but the results for the first drug were more pronounced. One possible reason is the different duration of action of the drugs.
“Cialis” can work up to 36 hours, while “Viagra” lasts about four or five hours.
The study author, Dietrich Jehle, head of the Emergency Medicine Department at the University of Texas Medical Branch, explained that tadalafil relaxes blood vessels longer, which can improve circulation throughout the body – in the heart, brain, and smallest blood vessels.
It is also considered that it may inhibit platelet tendency to form clots and reduce oxidative stress – cell damage caused by reactive oxygen species. Theoretically, these processes could be beneficial for the heart and other organs, but this does not yet mean that the drug prolongs life.
Men taking the drug are healthier
When evaluating study results, it is important to consider the so-called healthy user effect. A person taking tadalafil may differ in many ways from someone who does not take this drug.
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Nelson E. Bennett Jr., professor of urology at Northwestern University’s Feinberg School of Medicine, noted that such a man is more often sexually active, maintains close relationships, visits doctors, and generally takes better care of his health. All these factors are individually associated with longer life expectancy.
Therefore, the benefits observed in studies may not be related solely to tadalafil. Regular doctor visits help detect and start treating diseases earlier, which might otherwise remain unnoticed for a long time.
Erectile dysfunction – an early warning
Erectile dysfunction is sometimes one of the first signs of cardiovascular disease. The blood vessels in the penis are smaller, so circulation problems there may appear earlier than in the vessels supplying the heart or other organs.
According to N.E. Bennett, a 40-year-old man who develops erectile dysfunction without a clear cause should not only receive a prescription for medication. He should have his blood pressure, cholesterol, and blood glucose levels, as well as other cardiovascular and metabolic disease risk factors, evaluated.
It is precisely the early detection of possible health problems, not just the drug for erectile dysfunction, that may be the most important part of this story related to longevity.
Self-experimentation is dangerous
Although reliable randomized clinical trials are lacking, some online wellness platforms offer tadalafil (“Cialis”) for longevity purposes even to women.
Martin Gross, associate professor of urology at Yale School of Medicine, emphasized that women did not participate in the mentioned studies. Therefore, there is no data confirming the safety of using this drug off-label for women.
Tadalafil can also dangerously interact with other medications. It is especially risky to combine it with nitrates – drugs used to treat angina and some other heart diseases. Such a combination can cause a sudden and dangerous drop in blood pressure.
M. Gross advises discussing possible tadalafil use with a doctor who knows the patient’s health and all medications, rather than relying on online questionnaires designed to sell subscription drugs.
Even for those people for whom tadalafil is reasonably prescribed to treat erectile dysfunction, the most important longevity measures remain the same:
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- physical activity,
- adequate sleep,
- not smoking,
- normal blood pressure
- cholesterol level control.
