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Would prefer to see a few studies on other patient populations that take these drugs around the clock.

1. Pulmonary hypertension

2. Cialis (tadalafil) is like a longer acting viagra, and being prescribed for daily use to treat benign prostate hyperplasia.

Of course, these and the linked study would be associations. Could be the conditions themselves being treated are protective. Or other pesky confounders.

PDE5 inhibitors like Viagra and Cialis have been demonstrated to improve endothelial and nerve function by improving blood supply, leading to local release of growth factors - in humans, some of the erectile function improvement is permanent, and moise models of diabetic neuropathy demonstrate lasting nerve function improvements.

They improve cerebrovascular bloodflow as well, iirc.

The odd thing is that PDE5 inhibitors have also been shown to be associated with increased risk of sensorineural hearing loss (both short term and long-term).
I believe that they have the potential to cause optic nerve compression, though severe side effects are extremely rare here. Not sure what their effect on the ear might be, but it wouldn't be the first time the same protein had wildly different effects in different parts of the body.
>that take these drugs around the clock.

I see what you did there.

That is a hard pill to swallow
Viagra was invented to manage cardiovascular problems, and cardiovascular problems have been linked to Alzheimer's.

The theory all fits. Healthier blood flow logically should mean a healthier brain.

The real question, should you add it to your stack and at what dosage.

The question I always have with studies around the positive effects of viagra, cialis, and the like is… what about women.

I know nothing, but I always see that women shouldn’t take these drugs (for some reason). Could we apply the same learnings to find a drug that benefits both sexes?

Viagra is also used to treat hypertension in men and women. It relaxes blood vessels. No reason it would be harmful to women.
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As I understand it, Viagra works by making your blood vessels more sensitive to nitric oxide, which relaxes the blood vessels. You can also eat a diet high in nitrates like spinach and beets, to boost nitric oxide levels.
Spinach is also high in oxalates, which is considered to be an anti-nutrient. It binds to other minerals like calcium and magnesium and prevent them from being absorbed[1].

So while most people can get away with eating more spinach than they are currently (because they probably don't eat very much of it at all), it might not be a good idea to go too heavy on eating spinach (or if you do, you should boil it first before eating them, as boiling vegetables significantly reduces oxalates).

[1]: https://medium.com/@jj_virgin/the-dark-side-of-spinach-what-...

Pretty sure if your choice comes down to weighing the secondary effects of spinach vs viagra, you'd still want to choose the spinach.

The identified and unidentified side effects of most pharmaceuticals, and viagra in particular, are far more concerning than whatever may shake out of a plausibly realistic increase in dietary oxalates.

That's not to say one can't or shouldn't make a reasonable choice to take viagra, but the oxalates in spinach shouldn't be a very relevant factor in one's decision-making.

I'm only arguing against going hard into eating Spinach without being aware of the possible risks. A lot of times people make an assumption that because something is a natural it can't really hurt them and they don't have to be careful how much of it they consume (like the Grapefruit diet or whatever) and go overboard with it.

Personally I eat a decent amount of spinach myself, although I don't go super crazy with it, but someone with a history of kidney stones or low calcium or magnesium might not want to, or might want to at least take some steps to reduce the oxalates before eating it.

> You can also eat a diet high in nitrates like spinach and beets, to boost nitric oxide levels.

The sibling comment explained why it's not a good idea.

If you want to restore your nitric oxide levels (boost doesn't mean anything in a vacuum), quit eating tons of sugar, especially fructose. Its obesogenic effect on the liver is direct cause for the reduction of nitric oxide synthesis seen in metabolic syndrome, which presents as hypertension.

In other words, go low carb and/or fix your diet-related hypertension, which is most likely caused by low nitric oxide levels.

Eating a ton of spinach will probably just result in the formation of kidney stones and mineral deficiencies.

--

First result on Kagi on fructose/NOS for further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947541/

> go low carb

No, eat a healthy and balanced diet while avoiding processed foods, especially those containing large amounts of sweeteners.

That is what I said.
Ideally your balanced diet should include a large amount of whole grains and fruit, not low carb.
L-Citruline works well for nitric oxide boost
The title should probably be “Viagra use associated with lower incidence of Alzheimer’s disease.” There is an association in the large correlational study[0] on which TFA is based but causality isn’t established. There are other experimental data out there in mouse models that suggest a therapeutic benefit though.

[0]: https://pubmed.ncbi.nlm.nih.gov/37203519/

Maybe it’s the subsequent sex acts following Viagra ingestion which provided the real protection. Or was that controlled for?
There's no mention of it in the abstract. It's probable men who are sexually active also have higher T-levels and are generally in better health. There aren't many other reasons to prescribe PDE5 inhibitors.
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It's a real shame that drugs like cialis / tadalafil have negative social/cultural stereotype due to the meaning we attach to unaided sexual prowess and shame to sexual difficulties, as it really does feel like a drug that just makes sex better for people with sexual difficulties but also make sex amazing for people with normal sexual function. And likely has other unknown long-term benefits as well.
Do they have negative stereotypes? Does one consider stereotypes when deciding whether to take a drug? I've never thought about the social aspect of any prescription I've gotten.
Yes. PDE5's are stereotyped as "enabling dirty old men".
The only people that seem to actually care or consider that negative are…. Younger men? Maybe?
Definitely.

The idea that you'd "need" to take Viagra or Cialis is an assault on many men's sense of masculinity and virility.

No one cares about this that is old enough to have to take either. These are the thoughts of a young man who can't contemplate what it must be like being old.

When you are old and have to actually use these medications all you will be thinking about is how much it must have sucked before they were invented.

I don't really agree. Many men experience weaker erections or fewer spontaneous erections even in late 20s or early 30s, and that is definitely culturally a time where you are expected to be at your 'peak masculinity'.

In a world absent stigma, perhaps these drugs would simply be seen as performance enhancing to the extent 21 year olds with perfectly functional circulatory systems would take them so they could go for a round 2 and round 3 more quickly.