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Erectile dysfunction, or ED, is a condition where a person is not able to attain or keep an erection firm enough to have sexual intercourse. While occasional troubles with erection aren’t uncommon and aren’t necessarily a cause for concern, frequent ED can be a sign of health issues that need attention and treatment. Erectile dysfunction can cause stress, contribute to relationship problems, and affect your self-confidence. 

One of the most common medications used to treat Erectile Dysfunction is Tadalafil (brand name Cialis). It has long been known to treat ED in men. According to a study published in therapeutics and Clinical risk Management, Cialis is an effective and safe option for both general ED as well as difficult-to-treat erectile dysfunction.[1] However, with usage, sometimes men find that Cialis is not working as well as it has worked in the past. There might be plenty of reasons for Cialis not working and there are other options available. If you are wondering what to do when Cialis stops working and how to take Cialis, make sure you read this till the very end.

What Is Cialis? How Does It Work?

what is cialis how does it work

Cialis is the brand name for tadalafil, a medication used to treat ED or Erectile Dysfunction. It is also used to treat signs and symptoms of Benign Prostatic Hyperplasia or BPH. Tadalafil belongs to the class of drugs called phosphodiesterase-5 (PDE-5) inhibitors.

As a PDE-5 inhibitor, tadalafil works by blocking an enzyme known as phosphodiesterase type 5 and increasing the amount of chemical cGMP in the penis of the person. This leads to relaxation of the blood vessels, causing more blood flow into the penis. 

During arousal, the increased blood flow to the penis allows one to get and maintain an erection. It is important to note that Cialis and other PDE-5 inhibitors do not cure ED or increase the libido. It will not give a person an erection without physical and psychological stimulation and arousal.

How to take Cialis?

how to take cialis

Cialis can be taken as an oral tablet. It can either be taken as a low-dose daily medication regardless of sexual activity or as a higher-dose on-demand medication consumed before indulging into sexual intercourse. It should not be taken more than once a day.

Cialis can take up to 2 hours to take effect and works for up to 36 hours after taking the medicine. When taking an on-demand dose, a person needs to take it at least 30 minutes before sexual activity. For those who take daily doses, one should take it at about the same time every day. 

According to studies, both these options are the same in terms of safety and efficacy.[2] To get the most out of Cialis, one should additionally focus and work on managing stress and maintaining healthy communication with their partner.

Does Cialis Work For Everyone?

does cialis work for everyone

While Cialis is one of the more popular medications for Erectile Dysfunction, it may not work for 20-30% of men who try it for treating ED.

It is vital to understand that Cialis may not work after just the first dose. A person should take at least 8-10 doses before getting concerned about the effectiveness of the medicine for them.

It is also crucial that a correct starting dose is chosen based on the severity of erectile dysfunction, the patient’s risk factors for peripheral vascular disease, Cialis tolerance, and other health and lifestyle factors. This makes it very important to take Cialis only under the prescription and guidance of a doctor.

Reasons For Cialis Not Working

reason for cialis not working

Does Cialis lose effectiveness over time? This is a common question asked by patients.

Sometimes, men feel that Cialis doesn’t work for them anymore or is not working as well as it has in the past. While Cialis does not lose potency over time, its effectiveness in obtaining erections may decrease based on other problems in the body.

The reasons for Cialis not working well for some men or not working well any longer may include:

  1. Cialis works for most men but not all men: As mentioned earlier, Cialis may not work for 20-30% of men who try it for the treatment of ED. The most common reason for the medication not working for some people is an inadequate trial or incorrect use of Cialis. Cialis works best when it is taken daily. When taking Cialis on an on-demand basis, one needs to make sure they are taking it 30 minutes to about 2 hours before attempted sexual intercourse. It is also crucial to take the correct dose of the medicine depending upon the severity of the erectile dysfunction, and other health and lifestyle factors of the patient. Sometimes, men who initially thought that Cialis does not work for them, may overcome Cialis resistance and find that the medication works well when taken in adequate doses and as instructed.
  1. Hormonal Problems: Another common reason why medications such as tadalafil, or Cialis, may not work well for some men is hormonal problems in men. This may include problems like low testosterone, low thyroid hormone, high prolactin, high estradiol, etc. Seeking treatment and correcting these hormonal abnormalities often results in improved effectiveness of Cialis. 
  1. Signs of Worsening Vascular Disease: If you find a decrease in the effectiveness of Cialis or if Cialis stopped working for you, it may be a sign of worsening of the underlying causes of erectile dysfunction. Vascular insufficiency or worsening of vascular disease caused by underlying medical problems may decrease the effectiveness of Cialis in obtaining erections. Some of the common causes include high cholesterol, poor control of high blood pressure, poor control of diabetes, and weight gain. It is important to address these underlying problems not only for the sexual health of a person but also for their heart health.
  1. Reasons not related to blood flow: Another reason why Cialis doesn’t work for a person is if their ED is caused by an issue that is not related to blood flow. This may include factors like sexual performance anxiety or damage to the nerves. It is important to talk to your doctor and resolve these underlying issues for improved sexual health.

While some men feel that Cialis no longer works for them, in reality, it is not a matter of reduction in Cialis efficacy. It is essentially a progression or worsening of ED. A worsening of the blood vessel disease may cause less blood flow to the penis. This means less blood flow is available for the medications to work.

What to do if Cialis does not work anymore?

what to do if cialis doesnt work anymore

Your healthcare provider can tell you what to do when Viagra and Cialis don’t work. The problem can be effectively resolved under proper medical guidance. It is recommended to talk to your doctor or healthcare provider about any changes in the effectiveness of Cialis and share all the information about any other medication you may be taking as well since some drugs can affect how tadalafil works.

The adequate dosage of tadalafil for a person may vary depending upon the individual dosing pattern and the effectiveness of the medication. In some cases, a change in the dosing schedule may be all that is needed for Cialis to become effective again. However, make sure you consult your healthcare provider and do so under their guidance. 

If Cialis as well as other PDE-5 inhibitors are no longer working for you, there are various other treatment options that your doctor may suggest. These may include:

  1. Shockwave therapy for ED: This therapy may help men with ED in recovering the ability to respond to Cialis.
  1. Testosterone Therapy: This may help in case of blood reports showing low testosterone levels.
  1. Penile Injection Therapy: Trimix injections, prostaglandin injections, Alprostadil, and other medications offer a reliable and effective option for the treatment of ED in many men.
  1. Vacuum Restriction Devices: They can help in sustaining the erection for up to 30 minutes.
  1. Intraurethral Therapy: Insertion of the Alprostadil pill into the opening of the penis may help in achieving and sustaining an erection.
  1. Penile Prosthesis or Implants: Surgically placed implants are an effective treatment option for ED that allows a person to obtain an erection.
  1. Penile Vascular Surgery: They are usually recommended for younger men with a medical history of trauma to the penis.
  1. Lifestyle changes: Several lifestyle changes such as eating a healthy diet, exercising regularly, quitting smoking, avoiding drugs and alcohol, decreasing and managing stress, etc. can have significant effects of improvement in erectile function.
  1. Addressing underlying medical conditions Addressing and resolving underlying medical conditions like heart disease, diabetes, high blood pressure, etc. may help in significantly improving the erectile function.
  1. Addressing underlying emotional issues: According to research conducted in 2017, addressing emotional issues like relationship conflicts, depression, stress, or anxiety from past difficulties with Erectile Dysfunction with therapy such as cognitive behavioural therapy can have positive effects on erectile function.[3]

To Conclude

If Cialis is not working anymore for you, there is no need to panic. Your healthcare provider can help you understand the underlying cause behind it and help you in resolving it. There are various other treatments available that may improve your erectile function and support you in having to enjoy satisfying and fulfilling sex life and maintain a healthier body. 

References

  1. Sharon A. Huang and Janette D. Lie, PharmD, BCACP. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P T. 2013 Jul; 38(7): 407, 414-419. PMCID: PMC3776492 PMID: 24049429

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776492/

  1. Zhufeng Peng , Lu Yang, Qiang Dong, Qiang Wei, Liangren Liu, Bo Yang. Efficacy and Safety of Tadalafil Once-a-Day versus Tadalafil On-Demand in Patients with Erectile Dysfunction: A Systematic Review and Meta-Analyses. Urol Int. 2017;99(3):343-352. doi: 10.1159/000477496. Epub 2017 Jun 21. PMID: 28628914

https://pubmed.ncbi.nlm.nih.gov/28628914/

  1. S Khan, A Amjad, D Rowland. Cognitive behavioral therapy as an adjunct treatment for Pakistani men with ED. Int J Impot Res. 2017 Sep;29(5):202-206. doi: 10.1038/ijir.2017.23. Epub 2017 Jul 13. PMID: 28701798

https://pubmed.ncbi.nlm.nih.gov/28701798/

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