Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 2/11/2021
So you might have erectile dysfunction, you’re looking over your treatment options, and you’ve heard that some are better than others.
Do you want something that you swallow like Popeye downing spinach, or should you covertly add another pill to your morning pill cocktail and be done with it?
Tadalafil (which is the active ingredient in brand name Cialis®) gets a lot of attention for being a better option for a more variable sexual schedule. It also has two effective treatment options—an as-needed dose and a smaller daily option.
If you’re suffering from ED, one of these options may be just the right thing for you. To understand how Tadalafil works, and why there’s more than one way to take it, let’s start with the basics… of boners.
If you’re reading this, you may be less than impressed with your unit’s recent performance. There’s no reason to be embarrassed. ED is a fairly common condition, affecting an estimated 30 million to 50 million men nationwide.
The National Institutes of Health (NIH) defines erectile dysfunction pretty clearly: “A condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse.” There are a couple of things to know about what is or isn’t going on down there.
Erections are the result of two primary processes: increased bloodflow to the penis’s blood vessels, and the trapping of that blood in the penis in two long champers called the corpora cavernosa.
When you become aroused, your brain sends chemical signals to your body to dilate the blood vessels in the penis, allowing blood to flow in. The blood becomes trapped in the corpora cavernosa, keeping you erect. That’s how it’s supposed to work, if you don’t have erectile dysfunction.
There are many factors that can cause erectile dysfunction. They include: heart disease, diabetes, high cholesterol, high blood pressure, obesity, depression, anxiety, illicit drug use, excessive alcohol use, and performance anxiety to name a few. What is Tadalafil?
Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor that works by blocking the breakdown of certain substances in your body, leading to prolonged dilation of your blood vessels and subsequent increase of blood flow to the soft tissue of your penis.
Because PDE5 inhibitors cause dilation of blood vessels, they can also be used to treat certain types of hypertension. That’s why it’s important to talk to your healthcare provider before using Cialis if you have a heart condition, or if you use medication for high blood pressure.
Tadalafil is also the first ED medication ever approved for daily use; unlike its competitors, it can be taken daily (at lower doses).
Tadalafil differs from other PDE5 inhibitors in that it has a significantly larger time frame of efficacy. Unlike Viagra, for instance, which can work for a few hours after the medication is taken, Tadalafil can be effective for up to 36 hours from just a single dose, according to the National Library of Medicine.
This is probably a good time to mention that there’s a difference between tadalafil’s effective time frame and an actual erection.
Most guys are skeptical that there’s such a thing as a “too long” erection, but one of the reasons you may be wondering how long Tadalafil (the active ingredient in the popular drug Cialis) lasts is that warning about erections lasting more than four hours—a condition called Priapism.
Priapism is a rare side effect of ED drugs that results in prolonged erections, which can damage blood vessels and potentially permanently damage your member. Erections lasting more than four hours sound kind of painful, and if you have one, you should seek emergency treatment.
Cialis and Viagra are two of the most popular erectile dysfunction medications on the market.
Both Cialis and Viagra are PDE5 inhibitors, but the key difference that separates tadalafil from Viagra is that Viagra is a shorter term medication, typically resulting in four to six hours of effects, while Cialis can work from a day to a day and a half.
This means that, in general, Viagra has been prescribed as a sort of in-the-moment solution; date night is going well, you’re heading back to her place, so you take a pill to coincide with your best laid (pun intended) plans.
Tadalafil, on the other hand, is more of a carpet bomb medication with regards to your down-and-dirty schedule. Its wider window of efficacy means that a morning dose has the capacity to prepare you for some afternoon delight and/or late night activities.
And that’s why tadalafil is also an exceptionally better option when your sex life isn’t so neatly designed as to fit into your iCal at regular intervals; if your partner can be game whenever, tadalafil as a daily medication is designed to help you meet the challenge.
Of course, different applications of the drug mean different dosages. But they won’t necessarily affect the duration of your boner green light.
Tadalafil is typically prescribed in two fashions: either as a once-daily regimen, or as needed. According to the FDA, daily doses of tadalafil are typically prescribed much smaller than as-needed.
As-needed medication will typically be prescribed either as a 10 or 20 mg dosage, whereas a daily dose will be a fraction of that—typically between 2.5 mg and 5 mg. This is because taking the drug daily will allow it to build up in your system—you don’t need to drop it all into the mixture at the same time.
One of the questions associated with Tadalafil usage is whether a larger dose significantly changes the efficacy of the drug. That’s not the case—in fact, larger doses of certain PDE5 drugs could cause the side effects to double even while you’re no better off in the bedroom.
We probably don’t need to tell you this, but this drug does not just give you erections. In fact, tadalafil probably couldn’t get you up on its own unless it came wrapped in pictorials from old Playboys.
Tadalafil and other PDE5 inhibitors are merely getting the system operating optimally—you still have to get stimulated, aroused, or otherwise activated by something.
And taking more than the recommended amount of any of these drugs is neither going to make it harder or bigger. That would be like filling your car’s gas tank with premium instead of regular and expecting it to suddenly sprout two extra cylinders.
When used properly, these drugs can help you thwart physical effects of ED, and stride confidently into the bedroom.
But if your source of ED is coming from elsewhere—intimacy issues, self confidence problems, or something else—then there may be more to treatment than getting the mechanics working efficiently again. Talk to a therapist or other mental health professional if this sounds like it may apply to you.
Still, tadalafil offers great options for a lot of ED issues, so if you’re suffering from unreliable, incomplete, or otherwise finicky erections, talk to a healthcare provider about a tadalafil prescription.