Cialis: Complete Guide to Uses, Safety, and What to Do

Disclaimer: This information is educational and is not a substitute for a doctor’s consultation, diagnosis, or treatment. Always speak with a qualified healthcare professional about your symptoms and before starting or changing any medication.

Cialis: what it is and what to do

Cialis is a brand name for tadalafil, a prescription medication most commonly used to treat erectile dysfunction (ED) and certain urinary symptoms caused by benign prostatic hyperplasia (BPH). It belongs to a group of drugs called PDE5 inhibitors, which improve blood flow in specific areas of the body.

Quick summary in 30 seconds

  • Cialis (tadalafil) helps improve erections and may relieve urinary symptoms of an enlarged prostate.
  • It works by increasing blood flow but requires sexual stimulation to be effective for ED.
  • Common side effects include headache, flushing, and indigestion.
  • Seek urgent care for chest pain, sudden vision loss, or an erection lasting more than 4 hours.

What is Cialis

Cialis is a medication approved for:

  • Erectile dysfunction (ED) – difficulty achieving or maintaining an erection sufficient for sexual activity.
  • Benign prostatic hyperplasia (BPH) – non-cancerous enlargement of the prostate that can cause urinary symptoms.
  • In some cases, both ED and BPH together.

The active ingredient, tadalafil, works by blocking an enzyme called phosphodiesterase type 5 (PDE5). This leads to relaxation of blood vessel walls and improved blood flow, particularly in the penis. Unlike some other ED medications, tadalafil has a longer duration of action, sometimes up to 36 hours. However, this does not mean a constant erection—it only works in response to sexual stimulation.

For a broader understanding of men’s sexual health, see our section on erectile dysfunction basics.

Causes and risk factors

Cialis itself does not cause erectile dysfunction; rather, it is used to treat it. Understanding the underlying causes of ED or BPH is essential.

Common causes of erectile dysfunction

  • Cardiovascular disease (atherosclerosis, hypertension)
  • Diabetes
  • Obesity and metabolic syndrome
  • Smoking
  • Hormonal imbalances (e.g., low testosterone)
  • Psychological factors (stress, anxiety, depression)
  • Certain medications

Risk factors for BPH

  • Aging (more common after age 50)
  • Family history of prostate enlargement
  • Hormonal changes
  • Obesity and sedentary lifestyle

Because ED can be an early warning sign of heart disease, men with persistent symptoms should consider cardiovascular evaluation. You may find helpful background in our men’s health prevention guide.

Symptoms and how to distinguish from similar conditions

Erectile dysfunction symptoms

  • Difficulty getting an erection
  • Difficulty maintaining an erection
  • Reduced sexual desire (sometimes)

BPH symptoms

  • Frequent urination, especially at night
  • Weak urine stream
  • Difficulty starting urination
  • Feeling that the bladder is not completely empty

Distinguishing from similar conditions

SymptomWhat it may meanWhat to do
Sudden inability to get an erectionPossible psychological stress or acute medical issueConsult a doctor if persistent or associated with other symptoms
Gradual worsening of erectionsPossible vascular disease or diabetesMedical evaluation and blood tests
Burning urination with feverUrinary tract infection, not BPHSeek prompt medical care
Pelvic pain and difficulty urinatingPossible prostatitisDoctor evaluation required

Cialis does not treat infections, low testosterone, or psychological disorders directly. Identifying the correct cause is key to effective treatment.

Diagnosis

Before prescribing tadalafil, a healthcare provider typically performs:

  • Medical history review – including cardiovascular risk and medication use.
  • Physical examination.
  • Blood tests – glucose, cholesterol, sometimes testosterone levels.
  • Urinalysis – to rule out infection (for urinary symptoms).
  • Prostate evaluation – digital rectal exam or PSA test if BPH is suspected.

In some cases, additional testing such as penile Doppler ultrasound may be considered. Diagnosis focuses on identifying underlying conditions and ensuring that PDE5 inhibitors are safe for the patient.

Treatment and approaches

Treatment depends on the underlying condition. Cialis is one option among several.

For erectile dysfunction

  • PDE5 inhibitors (such as tadalafil)
  • Lifestyle modifications (weight loss, smoking cessation)
  • Psychological counseling if stress or anxiety is involved
  • Vacuum erection devices or other medical interventions

For BPH

  • Alpha-blockers
  • 5-alpha-reductase inhibitors
  • Tadalafil (in selected patients)
  • Surgical procedures in severe cases

Important: Cialis should only be taken as prescribed. It must not be combined with nitrate medications (often used for chest pain), as this can cause a dangerous drop in blood pressure. Always follow the instructions and your doctor’s guidance.

For more information on medication safety, visit our safe medication use overview.

Possible complications and when to see a doctor urgently

Common side effects

  • Headache
  • Flushing
  • Indigestion
  • Back pain
  • Nasal congestion

These are usually mild and temporary. However, serious adverse effects are rare but require immediate medical attention.

Red flags (seek urgent care)

  • Chest pain during sexual activity
  • Sudden vision or hearing loss
  • An erection lasting more than 4 hours (priapism)
  • Severe dizziness or fainting

If you experience any severe or unusual symptoms, stop taking the medication and seek emergency care.

Prevention and lifestyle

While Cialis can improve symptoms, long-term health outcomes depend heavily on lifestyle.

Healthy habits that support sexual and prostate health

  • Regular physical activity
  • Balanced diet rich in fruits, vegetables, and whole grains
  • Weight management
  • Limiting alcohol
  • Quitting smoking
  • Managing stress

Addressing underlying conditions such as diabetes and hypertension can significantly improve erectile function. Explore more strategies in our chronic disease prevention section.

FAQ

1. How long does Cialis last?

The effects of tadalafil may last up to 36 hours in some individuals, but this varies. It does not cause a continuous erection.

2. Can I take Cialis every day?

There are daily and as-needed regimens, but only a healthcare provider can determine which is appropriate. Do not adjust frequency without medical advice.

3. Is Cialis safe for people with heart disease?

It depends on the individual’s condition and medications. It must not be used with nitrates. A cardiology evaluation may be necessary.

4. Does Cialis increase sexual desire?

No. It improves blood flow but does not directly increase libido.

5. Can women take Cialis?

Tadalafil is not generally approved for treating sexual dysfunction in women, except in specific medical contexts determined by specialists.

6. Can alcohol be consumed while taking Cialis?

Small amounts may be tolerated, but excessive alcohol can increase side effects such as dizziness and low blood pressure.

7. Is Cialis available over the counter?

In most countries, it requires a prescription.

8. What if Cialis does not work?

A doctor may reassess dosage, timing, underlying causes, or consider alternative treatments.

Sources

  • U.S. Food and Drug Administration (FDA): https://www.fda.gov/
  • MedlinePlus – Tadalafil: https://medlineplus.gov/
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): https://www.niddk.nih.gov/
  • American Urological Association (AUA): https://www.auanet.org/
  • Mayo Clinic – Erectile Dysfunction: https://www.mayoclinic.org/