I disagree with this completely. When certain patterns are strong and results speak for themselves then to me that is the best study one can have/hope for. Finding confounders is like making excuses to deny reality. There are no coincidences and/or confounders when results are overwhelming. A
s an example you say having a partner =emotional support, it is the opposite for a lot of people, you get better emotional support from an animal/pet. For me and I know for many of my friends’ long-term relationships tend to add a bit of stress and not the opposite. We are not made well to deal with the BS that woman go through and throw at us LOL, so IMO that confounder is null at best, or the opposite at worst.
I’d also read a study (as an example) that people in high altitudes had much lower incidences of CVD and then toward the end of the study the mentioned that it may be the case that people are more active, to me that is total BS to undermine something that is very real and obvious.
The data is pretty clear for men that marriage is a huge longevity intervention. Has been known for 50+ years.
So what you or your friends might interpret as stress maybe is good stress.
The data is pretty close to irrefutable despite lots of confounders. Certainly mental illness is bad for longevity and the more severe tend to be single.
There is a huge healthy user bias and probably a marriage bias in PDE5 studies. Doesn’t completely negate it in my opinion but I don’t deny the bias is there.
But that’s the whole point: the evidence in favor of sildenafil/tadalafil is NOT strong. Many papers found nothing and Mendelian randomization is negative. The few studies that found benefits often do not find a dose-response relationship and are poorly controlled for confounders.
Well, I thought our friend @LukeMV posted few studies showing pretty convincing benefits. So, I don’t know maybe now it’s become mine is better than yours (studies) lol. To be fair, I do get somewhat of a less clear vision when using either (Cialis a bit more so) and that definitely is a turn off, but the benefits are also HUGE (as in performing better than in your 20’s) if nothing else the EGO man, holly molly big boost LOL. Maybe I’ll use them more sparingly or as needed but there are definitely benefits to be had knowing that you’ll be more of a man than you’ve ever been. Nothing more depressing for a man than a limp limb😂
You didn’t get my point: There are papers that found benefits. There are papers that found no benefits. And there are papers that found risks. And when you look at papers that found benefits they’re often low-ish quality (especially poor control for confounders + no dose-response). So overall the case for those drugs is not strong. It does not mean those drugs are bad. But it’s not like statins, SGLT2i or GLP-1RAs for instance.
BTW, GLP-1RAs are evil. I’ve cursed the person that invented them for seven generations LOL
I might just do a microdose of 1mg weekly for a bit of appetite suppression but NEVER again at doses suggested to lose weight. Using them made me experience what it is like to be 110 years old at only 55 LOL.
I think the argument for both sides are valid. While the drug classes you list are much better, I still think it’s a net positive and will continue to take Tadalafil because I think the nitric oxide boosting effects are unique to PDE5s and probably part of the reason they would reduce mortality. That being said, I reserve the right to change my mind as more data comes out.
So true. Really, from a quality-of-life aspect these drugs are absolutely amazing.
But I do agree with @adssx that the purported benefits are not as exciting as I think we’d initially hoped. I think he’s correct that any sort of observational study has a huge amount of confounders at play, and that’s definitely made me re-evaluate whether to keep using these medications.
Yes, my criticism is that I feel they’re overhyped vs the current evidence. It would be better to say “if you’re a man, those are great drugs for your quality of life, and, cherry on the cake, they might have some long-term health benefits”.
No, I wasn’t depressed, but it was weakness to the point of not wanting to get out of bed. P{lus had big GI issues especially heartburn and indigestion. Might have also affected sleep negatively though my poor sleep I think was mainly due from Cialis.
My verdict, if I had to guess, is that {Viagra or Cialis} is good for cardiovascular health quite broadly and mildly, and if you’re at high risk of bad cardiovascular outcomes, then it will probably help you to live longer and to live healthier. Moreover, it’s good to take anyway for the treatment and prevention of ED if you’re a man.
Study title: Risk of glaucoma among patients using tadalafil for lower urinary tract symptoms: a multinational cohort study.
Risk with long term use of Cialis. Just wanted to put this here because this thread seems to be popular. Any info adds something to the convo. Did not have full access to the study.
" Abstract
Aim: To evaluate the association between tadalafil use for lower urinary tract symptoms (LUTS) and the risk of developing glaucoma.
Methods: This multinational, retrospective cohort study was conducted using the TriNetX database. Men aged ≥40 years with a history of LUTS were enrolled between 2012 and 2022. Individuals with a history of glaucoma prior to cohort entry were excluded. Participants were categorised into the tadalafil group and the non-phosphodiesterase type 5 inhibitor (non-PDE5i) group. Propensity score matching (1:1) was conducted to balance age, race, comorbidities, renal function and concomitant medications. Hazard ratios (HRs) were estimated for incident glaucoma of different subtypes and initiation of glaucoma treatment.
Results: The cohort included 36 927 tadalafil users and 36 927 matched non-PDE5i users. Up to 5 years, tadalafil use was associated with an increased risk of glaucoma compared with non-PDE5i use (HR 1.22; 95% CI 1.12 to 1.33). Elevated risks were observed for ocular hypertension (HR 1.32; 95% CI 1.06 to 1.65), primary open-angle glaucoma (HR 1.33; 95% CI 1.05 to 1.67) and initiation of glaucoma treatment (HR 1.33; 95% CI 1.20 to 1.47). No significant associations were found for low-tension or primary angle-closure glaucoma. Tadalafil users had a higher 5-year cumulative incidence than non-users (3.93% vs 3.16%; p<0.001), with consistent risk in men >50 years, white population and across comorbidities, remaining robust to 1-, 3- and 6-month lag times.
Conclusions: Tadalafil was associated with increased risk of glaucoma compared with non-PDE5i in males with LUTS. Ophthalmic evaluation and follow-up may be considered, particularly in patients with risk factors for glaucoma."