Cialis Increases Testosterone

"All my athletes took it. It is bigger than creatine."

-Victor Conte

Victor Conte is of course referring to Viagra. Like Viagra, Cialis also is used to
treat erectile dysfunction. What’s the difference between the two? Although
Viagra and Cialis both work by inhibiting an enzyme called
phosphodiesterases, which increases vasodilatation, there are pharmacologic
distinctions between Viagra and Cialis, being that Cialis has a longer half-life
(17.50 hours) compared to Viagra (4.0–5.0 hours) and Levitra (4.0–5.0 hours),
resulting in longer duration of action14 which is partly responsible for Cialis
being dubbed "The Weekend Pill." Cialis’ molecular structure differs
significantly from Viagra; one of the benefits of Cialis is there are no visual
side effects like Viagra and an absence of effect of food on absorption. Nitric
oxide is a hot topic of debate in bodybuilding, as NO-producing supplements
are always one of the top-selling products. Being in touch with many
bodybuilders and powerlifters, many swear that by taking Cialis, they get
better pumps in the gym and can recuperate from exercise faster.

Many suspect its enhanced nutrient delivery or some other mechanism. Cialis
demonstrates similar vasodilator (blood pressure-lowering) effects in healthy
subjects when compared with Viagra in studies of 10mg or 20mg doses (mean
systolic blood pressure reduction, of ~4.3mg).12 Many of the experts in sports
will attest that nitric oxide only increases performance in environments with
low oxygen availability, such as high-altitude training or areas with high air
pollution. Brazilian Eduardo de Rose, president of the medical commission of
the Pan-American Sports Organization, stated in a recent interview:
"Scientifically, the only proof that Viagra improves sports performance
happened at high altitude. That is why it was decided not to include it in the
banned substance list. You will hardly get to play a football match on Mount
Everest." If there are no performace-enhacing effects, then why were Olympic
athltetes using it? There have only been a handful of studies on the
performance-enhancing effects of Cialis and sports performance, and none
yielded beneficial effects:

Ø In one study, 14 healthy young males were given a 20mg dose of Cialis or
a placebo and performed a maximal exercise test on a treadmill. The study
found that a single dose of Cialis had no effect on exercise performance,
exercise tolerance or cardiopulmonary responses.5

Ø The second study involved three “all-out” sprints to determine if Cialis

could increase anaerobic threshold. The study found no significant differences
in peak power, average power or fatigue index compared to a placebo. One
positive finding noted was that Cialis decreased the time to reach peak power.
The author concluded, “Cialis did not have an effect on peak power, but
time to peak power output was reduced. Only to sports that need to
reach maximum power output in a few seconds could Cialis
administration be beneficial.”13
Bodybuilders are known for bringing cutting-edge pharmacology to the
forefront of science. If NO (nitric oxide) products really don’t work, then why
do so many people use them? Given that the second study reported that the
author claimed that Cialis may increase peak force, the powerlifters who
swear by Cialis increasing performance may be onto something that research
has not discovered yet.

Nitric Oxide Supplements Increase Satellite Cells

You may have read in the Nutrition Performance section that aging results in a
blunted anabolic gene response to exercise. It has been previously reported
that aging results in a blunted satellite cell response to exercise. A decrease in
NO production with aging may be a contributing role of the decrease in
muscle mass with aging. Previous research has shown that blunting
production of NO decreases muscle hypertrophy during muscle overload. 9,
10
Others have reported that NO is a primary signal for satellite cell
activation.11 NO is an important regulator of hepatocyte growth factor (HGF),
which is a cytokine with various cellular functions on muscle. 2 Specific to
skeletal muscle hypertrophy, HGF activates satellite cells and may be
responsible for causing satellite cells to migrate to the injured area.1 A
previous research study that stretched muscle-induced hypertrophy via
release of HGF found that the release of HGF was dependent on NO
concentrations.3 Interestingly, researchers measured HGF levels in serum
after an intense bout of eccentric exercise. They found that liver-derived HGF
rose 19 percent approximately 4 hours after exercise, which resulted in an
activation of satellite cells! It is possible that the observed rise in serum HGF
showed that HGF may be carried to the site of injury by immune cells rushing
to the site of injury, which are increased in number during the inflammatory
response to muscle damage… or that muscle itself produces HGF, so they
were not sure which one it really was.

NO Increases Satellite Cells!

Researchers from the Center for Exercise Science in Gainesville, Florida

reported that increasing nitric oxide increased satellite cell
activity! They took old and young mice and induced muscle damage in both
groups. They found that the older mice had an impaired satellite cell
response. More importantly, they found that L-arginine and nitric oxide
precursors effectively increased satellite cell activation and that nitric oxide
precursors “rescued” satellite cell activation in older mice. 4 This study
suggests that taking a NO precursor supplement may increase satellite cell
and lead to greater muscle growth! Another interesting study reported in
the Journal of Muscle and Nerve was that NO was able to reverse the
damaging effects of cortisol-induced satellite cell depletion. They found that
NO had a dose-dependent effect on increasing satellite cell levels. 20

Cialis Increases Testosterone!

Based on the research, acute dosages of Cialis do not have performance-
enhancing effects, but new research suggests that Cialis increases
testosterone! Researchers had participants perform three 30-second “all-
out” sprints to exhaustion and measured testosterone and cortisol responses
to exercise. They found that only after Cialis and exercise did testosterone
increase, however Cialis also increased cortisol levels. Cialis also lowered the
DHEA to cortisol response. The study demonstrates that Cialis increases the
“stress” response to the body, but also has some testosterone-enhancing
effects as well. It’s interesting that a large dosage of caffeine, which is a weak,
non-specific PDE inhibitor, also caused an increase in testosterone and also an
increase in cortisol.21 So it seems that Cialis has both positive and negative
effects on muscle. Cialis does not directly stimulate testosterone secretion per
se, meaning it does not stimulate LH release or SHBG release directly. This is
not the first study to find that Cialis raises testosterone:

Ø In a study of 74 patients with erectile dysfunction treated on demand

with 50mg of Viagra or 20mg of Cialis for three months, basal levels of total
testosterone and free testosterone were at the bottom of the normal range
that was reversed after treatment in both groups. Testosterone increase in
Viagra-treated cases was significantly lower than in those treated with Cialis,
suggested to be due to the higher frequency of full sexual intercourse in the
Cialis-treated group.15

Ø Another study reported that the increase in testosterone from taking

Cialis is mediated by a reduction in estrogen demonstration that Cialis may
have anti-estrogen actions. It was pointed out that the T/estradiol ratio was
associated with long-term Cialis treatment. There was no increase in LH levels
from Cialis, demonstrating that Cialis did not directly increase testosterone,
but indirectly increased testosterone by lowering estrogen.16

Ø One of the primary reasons that many older men have problems “rising
to the occasion” is that they have excess estrogen levels. Furthermore, in men
with hypogonadism, a low dose of clomiphene citrate (Clomid) is effective in
improving testosterone:estrogen ratio, thus giving more long-term benefit for
the management of erectile dysfunction in hypogonadal patients. 18 It seems
that based on the current study, Cialis has similar actions to Clomid by
improving T:E ratio.

Natural Phosphodiesterase Inhibitors: Horny Goat Weed and

Quercetin

In 1960, the first mechanism discovered for caffeine was PDE inhibition,
although this drug has effects on other non-PDE proteins that cause some of
its symptoms. Thus, caffeine was the first known PDE inhibitor. It was later
shown that at least 11 PDE families exist, and that caffeine inhibits most of
them. Moreover, caffeine is not a very potent inhibitor of these PDEs.17 Thus,
caffeine has often been referred to as the “poor man’s Viagra.” Cialis, on the
other hand, is a select PDE inhibitor. There are several natural alternatives to
Cialis and Viagra that have demonstrated similar biochemistry.
For example, it was recently demonstrated that Horny Goat Weed was
found to have similar effects to Cialis and Viagra on PDE
enzymes. Horny Goat Weed was able to inhibit PDE by 80 percent;
interestingly, other sexual-enhancement supplements such as cinnamon and
Tribulus terrestris had small effects on PDE activity (15-23 percent). The other
benefit of Horny Goat Weed is its low toxicity. Horny Goat Weed has been used
to treat erectile dysfunction in China for more than 1,000 years.7, 8 Quercetin is
the other natural ingredient that is a natural PDE inhibitor. Quercetin is a
photochemical that is part of the coloring found in the skins of apples and red
onions. It has been isolated and is sold as a dietary supplement. A recent
study showed that purified quercetin has similar effects as Viagra and acted
as a strong PDE inhibitory activity not likely related to its antioxidant
effects.6 Many studies have shown that quercetin has been able to lower blood
pressure through increasing vasodilatation.19

NO is clearly necessary for muscle growth in animals and test cultures, but
unfortunately no real long-term studies on subjects taking NO-enhancing
drugs have been investigated. We do know that Cialis has no effect on
maximal performance, but the recent study showing that Cialis increases
testosterone makes one wonder…what about long term use? Are the gym rats
using Cialis onto something new, not yet validated by long-term studies?
Based on the research, NO-enhancing products should contribute to muscle
hypertrophy; it just has not yet be validated.

References:

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molecular biology. Journal of Applied Physiology, 91: 534-551, 2001.
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Release of hepatocyte growth factor from mechanically stretched
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Cell, 13(8), 2909-2918.
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