Prescription medications such as Cialis and Viagra have changed the way erectile dysfunction is treated, but their growing popularity has also created a new problem: men are increasingly treating these medications like ordinary performance supplements rather than prescription drugs.
It is a trend that recently caught the attention of Playboy, which interviewed Dr. Judson Brandeis, a board-certified urologist and men’s sexual health specialist in San Ramon, California, for its article, “The Science of Bodybuilding and Boner Pills”.
The article explored the growing use of Cialis among younger men and bodybuilders, including men taking the medication for increased blood flow or a better “pump” in the gym rather than to treat erectile dysfunction.
Dr. Brandeis’s message was straightforward: medications that affect blood flow should be treated as medications.
That distinction matters whether you are considering Cialis, generic tadalafil, Viagra, generic sildenafil, or another treatment for erectile dysfunction.
Why Are Cialis and Viagra So Popular?
Cialis and Viagra belong to a group of medications known as PDE5 inhibitors.
They help improve the natural erectile response by supporting increased blood flow to the penis when a man is sexually stimulated.
For millions of men with erectile dysfunction, these medications can be an effective first-line treatment.
The American Urological Association recommends that men with erectile dysfunction be informed about FDA-approved oral PDE5 inhibitors as one of the available treatment options.
But Cialis and Viagra are not identical.
Viagra vs. Sildenafil
Viagra is the brand name for sildenafil.
Sildenafil is generally taken as needed before sexual activity. Depending on the individual, its effects typically last several hours.
Many patients now choose generic sildenafil because it contains the same active medication while generally costing significantly less than the brand-name version.
Cialis vs. Tadalafil
Cialis is the brand name for tadalafil.
Tadalafil has a substantially longer duration of action and may remain effective for up to approximately 36 hours.
It can also be prescribed in different ways. Some men take tadalafil as needed, while others may be prescribed a lower daily dose.
This longer window is one reason some patients prefer Cialis or generic tadalafil over sildenafil.
Cialis vs. Viagra: Which Is Better for Erectile Dysfunction?
There is no single ED medication that is best for every man.
For some patients, sildenafil (Viagra) provides exactly the flexibility and response they need.
Other patients prefer tadalafil (Cialis) because its longer duration reduces the need to plan sexual activity around a shorter medication window.
A urologist may consider factors such as:
- How frequently you have sexual activity
- How quickly you want the medication to take effect
- How long you would like the effects to remain available
- Other medications you take
- Cardiovascular health
- Blood pressure
- Previous response to ED medications
- Medication side effects
- The underlying cause of your erectile dysfunction
- Whether urinary symptoms or prostate conditions are also present
This is why searching for the cheapest Cialis or Viagra online is not necessarily the same as receiving appropriate treatment for erectile dysfunction.
Why Dr. Brandeis Warned Playboy About Buying Cialis Online
The Playboy article highlighted an increasingly common practice: younger men obtaining tadalafil through questionable online sources or products labeled for “research” use.
Dr. Brandeis cautioned readers about obtaining medications from unregulated sources.
The concern goes beyond whether a pill actually contains tadalafil.
A proper erectile dysfunction evaluation can help determine why erectile problems are occurring in the first place.
For some men, ED may be connected to:
- Cardiovascular disease
- High blood pressure
- Diabetes
- High cholesterol
- Obesity
- Hormonal abnormalities
- Low testosterone
- Medication side effects
- Smoking
- Psychological factors
- Pelvic or prostate conditions
In some cases, difficulty achieving or maintaining an erection can be one of the first noticeable signs that vascular health is changing.
Simply ordering sildenafil or tadalafil without an evaluation may temporarily address the erection while overlooking the reason the problem developed.
Cialis, Pre-Workout Supplements and the Bodybuilding Trend
One of the most interesting parts of the Playboy report was the growing use of Cialis among bodybuilders who do not necessarily have erectile dysfunction.
Why would someone take an erectile dysfunction medication at the gym?
Blood flow.
Tadalafil affects pathways involved in blood-vessel relaxation, which has led some athletes and bodybuilders to use it in an attempt to increase vascularity or muscle “pump.”
But prescription medication should not be confused with an ordinary sports supplement.
As Dr. Brandeis explained in the article, combining Cialis with certain pre-workout products may create additional concerns because several products can influence blood pressure or blood flow at the same time.
That is particularly relevant when supplements contain ingredients designed to affect nitric oxide pathways or when they are combined with stimulants.
Men taking tadalafil, sildenafil or other prescription medications should discuss supplements and pre-workout products with their physician rather than assuming combinations are automatically safe.
Cialis and Viagra Should Never Be Combined With Nitrates
One of the most important safety considerations with PDE5 medications involves nitrate medications.
Sildenafil and tadalafil can significantly lower blood pressure when combined with nitrates.
For that reason, men taking medications such as nitroglycerin should not simply start Cialis or Viagra without medical guidance.
Your physician should also know about your other prescriptions, supplements and relevant medical conditions before recommending an ED medication.
Seek immediate medical care for serious symptoms or an erection lasting longer than four hours.
What If Viagra or Cialis Does Not Work?
Another misconception is that erectile dysfunction treatment begins and ends with pills.
It does not.
Dr. Brandeis specializes in evaluating men for the underlying causes of erectile dysfunction and offers multiple treatment approaches at BrandeisMD in San Ramon.
Depending on the patient, options may include:
- Viagra and Cialis
- Generic sildenafil and tadalafil
- Erectile dysfunction evaluation and treatment
- Low-intensity shockwave therapy
- Vacuum erection devices
- TriMix injections
- Platelet-rich plasma treatments
- Hormonal evaluation
- Testosterone treatment when medically appropriate
- Pelvic floor treatment
- Penile implants for selected patients
- Lifestyle and cardiovascular risk-factor management
The appropriate approach depends on what is causing the erectile dysfunction and how a patient responds to treatment.
For some men, medication works extremely well.
For others, medication becomes less effective over time or produces unwanted side effects.
And some patients come to BrandeisMD specifically because Viagra or Cialis is no longer providing the results it once did.
Why See a Urologist for Erectile Dysfunction?
Online ED services have made sildenafil and tadalafil easier to obtain.
Convenience can be useful, but erectile dysfunction is still a medical condition.
A urologist specializing in men’s sexual medicine can evaluate more than whether you qualify for a prescription.
An evaluation may include discussion of erectile quality, cardiovascular risk factors, sexual function, medications, hormone levels, urinary symptoms, lifestyle, previous treatments and other aspects of men’s health.
That becomes particularly valuable for men who:
- Have persistent erectile dysfunction
- Have tried Viagra or sildenafil without satisfactory results
- Have tried Cialis or tadalafil without satisfactory results
- Experience side effects from ED medications
- Have diabetes or cardiovascular risk factors
- Have low testosterone symptoms
- Developed ED unexpectedly
- Have erectile dysfunction following prostate treatment
- Want to understand options beyond pills
Board-Certified Urologist in San Ramon, California
Dr. Judson Brandeis is a board-certified urologist specializing in men’s health and sexual medicine in San Ramon, California.
He has served men throughout the San Francisco Bay Area for more than two decades and has extensive experience evaluating and treating erectile dysfunction.
Dr. Brandeis completed his medical education at Vanderbilt University School of Medicine, conducted research at Harvard Medical School, and completed his surgical and urology training at UCLA.
He has also served in urologic leadership positions and has led clinical research focused on men’s sexual health and erectile function.
His work and commentary on men’s sexual health have appeared across national media, including his recent contribution to Playboy’s discussion of Cialis use among bodybuilders.
For patients, however, the objective remains much more practical:
Find out why your erections have changed and determine which treatment makes the most sense for your body.
Looking for Cialis, Tadalafil, Viagra or Sildenafil in San Ramon?
If you are searching for Cialis in San Ramon, tadalafil in San Ramon, Viagra in San Ramon or sildenafil in San Ramon, consider starting with an erectile dysfunction evaluation rather than choosing a medication based solely on price or convenience.
At BrandeisMD, Dr. Brandeis can evaluate your sexual and overall health, discuss the differences between available ED medications, and determine whether medication alone or a broader erectile dysfunction treatment plan may be appropriate.
BrandeisMD also provides generic sildenafil and tadalafil for established patients, offering a local option for men who prefer receiving ED treatment through a board-certified urologist rather than an anonymous online medication service.
Schedule an Erectile Dysfunction Consultation in San Ramon
BrandeisMD
Dr. Judson Brandeis, Board-Certified Urologist
100 Park Place, Suite 140
San Ramon, CA 94583
Phone: 925-255-7867
Request a consultation with Dr. Judson Brandeis
Frequently Asked Questions About Cialis, Viagra, Tadalafil and Sildenafil
Is tadalafil the same as Cialis?
Tadalafil is the active medication in Cialis. Generic tadalafil contains the same active drug used in brand-name Cialis.
Is sildenafil the same as Viagra?
Sildenafil is the active medication in Viagra. Generic sildenafil contains the same active drug used in brand-name Viagra.
How long does Cialis last?
Tadalafil can remain effective for up to approximately 36 hours in some patients, although individual response varies.
How long does Viagra last?
Sildenafil generally has a shorter duration of action than tadalafil, with effects commonly lasting several hours.
Can I take Cialis every day?
Tadalafil can be prescribed as a lower-dose daily medication for certain patients. Whether daily tadalafil is appropriate should be determined by your physician based on your health, medications and treatment goals.
Can I take Viagra and Cialis together?
Do not combine erectile dysfunction medications unless specifically directed by a qualified physician. Taking multiple medications that affect the same vascular pathways can increase the risk of adverse effects.
Can I buy generic Cialis or Viagra in San Ramon?
BrandeisMD offers generic tadalafil and sildenafil to its patients at its San Ramon men’s health practice. An evaluation can also help determine which medication and dosing strategy may be appropriate.
Should I see a urologist if Viagra or Cialis stops working?
Yes. Reduced response to sildenafil or tadalafil can have several explanations, including progression of vascular disease, medication issues, hormonal changes or other underlying causes of erectile dysfunction. A urologic evaluation can help determine the next step.
Who treats erectile dysfunction in San Ramon, CA?
Dr. Judson Brandeis is a board-certified urologist and men’s sexual medicine specialist in San Ramon, California, providing evaluation and treatment for erectile dysfunction, including oral medications and advanced ED treatment options.
Medical Disclaimer: This article is for general educational purposes and is not a substitute for individualized medical advice, diagnosis or treatment. Prescription medications such as sildenafil and tadalafil should be used only under appropriate medical supervision. Individual results and treatment recommendations vary.
