Just to clarify my position, I haven’t taken any PDE5i myself and have no interest in using it in the future, so I’m looking at this purely from an objective perspective.
There’s actually an interesting paradox here: hearing loss is linked to an increased risk of AD, yet some studies show that PDE5i might actually reduce AD risk. Looking at all the medical databases currently available, I believe hearing loss is a low-probability event that can be effectively managed and prevented with regular hearing tests.
Subjective tinnitus was not “nocebo”. It was so loud that I had trouble falling asleep towards the end (when I was at 0.4mg). Stopped completely about 48h after my last dose. Rechallenge - same thing.
Tinnitus or cochlear stress is not something a hearing test would pick up. Conventional hearing tests are not very sensitive.
It is a pity I do not tolerate PDE5is as they are amazing drugs. But subtle progressive hearing damage from these drugs is probably more common than most people think - that does not make it common but still something to pay attention to.
A friend who has been taking 2.5mg for 2 years has an audiogram that is 10 years his senior. Sure, could be many other things. Also Bryan Johnsons hearing got more shitty in the last 4 years. Sure, could be other things. Reddit anecdotes of people getting tinnitus from PDE5 inhibitors