In simplest terms, erectile dysfunction occurs when you are unable to achieve or maintain an erection. It has many causes, and while disinterest in sex may be one of them, there are usually other contributors.

If you can’t produce an erection, it may be possible that you’re suffering from physical conditions like heart disease or diabetes that affect blood flow. Mental afflictions, like anxiety or depression, can also keep you from getting hard.

Erectile dysfunction can be debilitating because it can affect your ability to be intimate. Not being able to perform can damage your self-esteem and lead to strain in your romantic relationships. Erectile dysfunction can also stir up feelings of anger, disappointment, and resentment – both in you and your partner.

While ED may sound dire, there is good news: In most cases, it’s treatable. Depending on the cause, things as simple as exercise and a better diet can help. Other times, you may require the help of a medication like Cialis.

It can sometimes be difficult to determine if you’re suffering from occasional “performance anxiety” or something more serious.

According to the Cleveland Clinic, it’s completely normal if you fail to produce an erection up to 20% of the time you try.

That means if you have difficulty performing once every five times, your problem can likely be attributed to minor or temporary issues. For example, you might be tired or stressed out, or you may have had too much to drink.

On the other hand, if you can’t produce an erection 50% of the time, you are likely suffering from clinical erectile dysfunction. This is a medical condition that afflicts mens of all ages and backgrounds.

That’s right: erectile dysfunction can strike men in their 30s just as it can men in their 80s, and in both cases, it’s not normal and can usually be treated.

For 12 weeks, Mount Sinai researchers monitored nearly 2,000 men with erectile dysfunction who had begun taking tadalafil (Cialis), a once-daily medication.

Beyond improved erections, they saw an 85% boost in the men’s sexual self-confidence—measured through psychological questionnaires given throughout the study.

According to Ashutosh Tewari, MBBS, MCh, Chair of Urology at the Icahn School of Medicine at Mount Sinai (who wasn’t involved in the study), managing ED involves a mix of physical, psychological, and functional factors.

Specialist urologists play a key role in evaluating and managing ED and BPH—not merely prescribing a pill. For instance, the urology department at the Mount Sinai indicates a robust program addressing men’s health, sexual dysfunction, benign prostate conditions, and complex urologic cases.
Their approach includes:

• Thorough evaluation for underlying causes of ED (cardiovascular risk, endocrine/hormone issues, urologic anatomy)
• Discussion of lifestyle factors (weight, exercise, smoking, alcohol) that impact sexual health
• Integration of medication options (including tadalafil) alongside other therapies (counseling, devices, surgery)
• Management of BPH and urinary tract symptoms with medications (including PDE5 inhibitors) and minimally invasive options.
  Thus while telehealth and online prescribing offer convenience for tadalafil, seeing a specialist urologist (particularly if you have complicating conditions) remains important. If you live locally (in New York or near a similar tertiary centre) you may benefit from specialist consultation.

While many men can safely use tadalafil under care of a general practitioner or via telehealth, there are situations when a specialist urologist should be involved:

• If ED is newly onset and you have cardiovascular disease, diabetes, or other significant comorbidities.
• If you have complex urologic history: prior prostate surgery, prostate cancer treatment, Peyronie’s disease, penile curvature, significant BPH with urinary retention, or other anatomical issues.
• If you experience recurring or severe side effects or the drug does not work despite correct usage.
• If you have BPH with symptoms of weak stream, frequent urination at night, hesitancy, or suspicion of prostate cancer or bladder issues—then evaluation by a urologist (like at Mount Sinai) is prudent.
  In these cases, the specialist can determine whether tadalafil alone suffices, or whether other interventions (surgery, other meds) are needed.

Before starting any new medication, especially one that affects vascular and sexual function, it’s important to ask your healthcare provider the right questions. This ensures safety, sets realistic expectations, and gives you a clear understanding of what to expect. Here are smart questions to bring up:

1. Am I healthy enough for sexual activity?
   Tadalafil doesn’t cause sexual arousal – it supports physiological function during sexual activity. But if you have serious heart issues, sexual exertion may pose risks. Your doctor should evaluate your cardiovascular health.
2. Are there any medications I take that interact with tadalafil?
   Be upfront about every drug or supplement you take. Especially nitrates (like nitroglycerin), alpha-blockers (for prostate/BPH), antifungals, antibiotics, or HIV meds. These can cause serious interactions.
3. Should I take tadalafil as needed or daily?
   If you have sex infrequently, as-needed might work best. But if you want spontaneity or have BPH too, a low-dose daily version may be better. Your doctor can recommend the right plan based on your lifestyle and symptoms.
4. What dose should I start with?
   Typical starting dose for ED is 10 mg as needed. For daily use, it’s 2.5 mg or 5 mg. But this depends on your age, kidney/liver function, and how you’ve responded to other meds.
5. What side effects should I watch for – and when should I call you?
   Your doctor should walk you through both common (headache, flushing, back pain) and rare (vision or hearing loss, prolonged erection) side effects. Know when something is serious enough to stop and call.
6. Can I drink alcohol while on tadalafil?
   Small amounts are usually fine, but too much can worsen dizziness or drop your blood pressure. Ask about your specific risk.
7. Will insurance cover it – and is there a generic option?
   Most people prefer generic tadalafil for cost reasons. But coverage varies widely. Your doctor or pharmacist may help find discounts or patient assistance programs.
8. How long should I try it before deciding if it works or not?
   Some men need several tries to judge effectiveness – especially if anxiety or stress is a factor. Be clear on what timeframe you should give it before tweaking the dose or trying alternatives.
9. What if it doesn’t work – what’s next?
   Your doctor should outline a Plan B: options include other medications, hormone testing, lifestyle changes, therapy, or a referral to a urologist.
10. Do I need any tests before starting?
    Depending on your age and health, your provider may order blood tests (for testosterone, glucose, lipids), a stress test, or a prostate exam.

Coming prepared with these questions not only helps you get the most out of your doctor visit – it makes sure you’re taking tadalafil safely and with confidence.

Cialis is a brand name for the medication tadalafil. While Cialis is a medication that’s primarily used to treat erectile dysfunction (ED), it’s also prescribed to treat symptoms of benign prostatic hyperplasia (BPH) in men and pulmonary arterial hypertension (PAH) in both men and women.

Along with drugs like Viagra and Levitra, Cialis is a phosphodiesterase type 5 (PDE5) inhibitor. PDE5 is an enzyme that breaks down another molecule called cyclic guanosine monophosphate (cGMP).

When cGMP is broken down, it prevents the smoothing of muscles in the penis that are required to achieve an erection.

When prescribed for erectile dysfunction, Cialis works by relaxing the blood vessels in the body. This allows for increased blood flow to the penis, helping you to achieve and maintain an erection.

Generic Cialis contains the same active ingredient as the brand-name version — tadalafil. It works by increasing blood flow to the penis, helping men with erectile dysfunction (ED) achieve and maintain an erection.

Because it’s chemically identical to brand-name Cialis, generic tadalafil offers the same effectiveness, duration (up to 36 hours), and safety profile.

The key difference is price. Without the brand label, generic Cialis is significantly cheaper, making it a more accessible option for many men.

Whether prescribed as a daily low-dose or taken as needed, generic tadalafil provides a reliable, cost-effective solution for ED without sacrificing quality or performance.

Generic versions (tadalafil) are often available at a lower cost with the same active ingredient and results.

There’s often confusion: the brand name is Cialis, the generic form is simply tadalafil.  They are the same active compound.
Key considerations:

• Brand name (Cialis) may cost more; generic (tadalafil) is typically less expensive when available.
• Legally, generic must have same active ingredient, dosage form, safety/efficacy as the brand. Thus your doctor may feel comfortable prescribing generic Cialis.
• In some cases physicians might prefer brand name for specific patients (e.g., insurance coverage issues) but many patients shift to generic once available.

Cialis comes in two formulations:

Determining which is right for you depends on your lifestyle.

Cialis Daily is taken once a day and is available in two doses: 2.5mg and 5mg.

The lower dose of 2.5mg is generally prescribed to men who may have other health conditions that could be worsened by the medicine or who are taking other medications that could interact with higher doses of Cialis.

The primary advantage of Cialis Daily is that it allows you to have more spontaneous sexual activity, without the need to plan around the timing of the medication.

Because it provides a continuous level of the drug in your bloodstream, Cialis Daily might be the better option for you if you are relatively healthy and experience ED frequently.

The primary drawback of taking Cialis on a daily basis is that you are more likely to experience side effects because you always have the drug in your system.

Common side effects include back pain, flushing of the face, headache, indigestion, and muscle aches. More serious side effects are rare, but they can include sudden hearing loss and vision changes.

The usual recommended dose of on-demand Cialis is 10mg, but this can be adjusted based on your needs and tolerability. The maximum recommended dose is 20mg, and it’s important to not exceed this amount.

Taking more Cialis than necessary doesn’t provide better results, and it could result in worse side effects.

The primary advantage of taking Cialis as needed is that you don’t have to worry about constant side effects. While you may still experience symptoms like blurred vision or flushing, they generally go away once the medication is out of your system.

The primary drawback of on-demand Cialis is that you need to plan sexual activity around taking the pill.

While the medicine can take effect in as little as 30 minutes, it can also take an hour or longer, which prevents spontaneity.

The good news is that once Cialis kicks in, its effects can last up to 36 hours – this is how it got the name “the weekend pill”.

Now that you know more about Cialis and may be interested in trying it, let’s talk about how to get it.

The traditional way to obtain prescription medication is to visit your doctor. After an exam and discussion of your concerns, your doctor can write a prescription. The benefits of obtaining a prescription from your doctor include:

While seeing your doctor has lots of important advantages, there are also some disadvantages:

Telehealth offers the expert care of a doctor, without the need to leave your home. If you have access to the internet, you can have access to a telehealth doctor. Here are the biggest pros of seeing a virtual doctor:

For all its bonuses, there are some drawbacks to telemedicine:

To legally obtain Cialis, you need a prescription from a licensed healthcare provider. The good news is, getting that prescription is now easier than ever—thanks to online platforms and telemedicine services.

Traditionally, a Cialis prescription required an in-person visit to a doctor or urologist. During the appointment, a provider would assess your medical history, ask about ED symptoms, and determine whether tadalafil is safe and appropriate for you.

Today, telemedicine has changed the game. You can now consult with a licensed clinician from the comfort of your home. Many online healthcare providers offer secure, discreet evaluations where a doctor reviews your responses and, if appropriate, issues a prescription—sometimes within minutes.

Once prescribed, Cialis can be picked up at a local pharmacy or delivered to your door through online services.

Cialis Together is a branded program available in some countries (such as: UK) that offers men guidance and support alongside their treatment. It often includes access to a pharmacist or clinician, lifestyle tips, and information to help users get the best results from their medication. While the program doesn’t replace professional medical advice, it provides helpful tools for managing ED holistically.
Telemedicine platforms have made it easier to access Cialis prescriptions with privacy and convenience.

These services typically require you to complete a medical questionnaire, which is reviewed by a licensed provider. If approved, your prescription is sent directly to a partner pharmacy or mailed to your home. This process eliminates the awkwardness or delay often associated with ED treatment.

n short, getting a Cialis prescription today is simple, safe, and discreet. Whether through a traditional doctor’s visit or an online platform, men have more control and flexibility than ever before. Programs like Cialis Together and the rise of telemedicine make managing ED easier, more affordable, and more accessible for millions of men.

Buying medicine from an online pharmacy can be a convenient and cost-effective way to obtain medication – the same exact medication you’d find at your local drug store. Here are some reasons to considering buying Cialis online:

Advantages:

Disadvantages:

Cialis is one of several PDE5 inhibitors used to treat ED. Each has its own profile in terms of how fast it works, how long it lasts, and how it fits into your life. Here’s how tadalafil stacks up against other major options.

Cost for Cialis or Tadalafil can vary widely according to dose, quantity, whether branded vs generic, insurance coverage, region, pharmacy. Some things to know:

• The brand version (Cialis) typically costs more than the generic (tadalafil).
• Some insurance plans may cover ED medications, others may not (especially if considered “lifestyle” rather than strictly medical).
• Generic availability often drives price down; when patent expires for brand, generic competition typically reduces cost.
• Online pharmacies/tele pharmacy may offer better pricing, but you must ensure legitimacy (avoiding counterfeit meds).
• If you’re in a country outside the U.S., price and insurance rules may differ; always check local regulation and pharmacy licensing.
• Ask your provider and pharmacist whether there are coupons, discount programs, or generic options to reduce cost.

Like all medications, tadalafil comes with potential side effects and interactions. Key points:
Common/mild side effects may include headache, flushing, stuffy nose, back pain, muscle aches, indigestion, dizziness.
Serious side effects (though less common) may include:

• Prolonged erection (priapism) lasting more than 4 hours – time to seek immediate medical help.
• Sudden loss of vision in one or both eyes (possible non arteritic anterior ischemic optic neuropathy, NAION) – rare but serious.
• Sudden hearing decrease or loss.
• Significant drop in blood pressure (especially if used with nitrates or certain blood pressure drugs). For example, you should not use tadalafil with nitrates (nitroglycerin) because of risk of dangerous hypotension.
  Interactions:
• Nitrates (for chest pain) – contraindicated.
• Some antihypertensive or alpha blocker medications (for prostate/BPH) – risk of lowering blood pressure too much.
• Strong CYP3A4 inhibitors (some antifungals, HIV protease inhibitors, certain antibiotics) may raise tadalafil levels; dose adjustment may be required.
  Precautions:
• If you have cardiovascular disease, heart rhythm issues, low blood pressure, severe liver/kidney problems, you should discuss these in depth with your provider.
• Alcohol and tadalafil together can increase risk of dizziness, drop in blood pressure, fainting.
  What you should do: Use exactly as prescribed, don’t exceed the recommended dose, inform your provider of all medications (including over the counter), and monitor for any worrying symptom (vision/hearing loss, erection lasting >4 hours).

Using tadalafil is not a “magic bullet.” Success and satisfaction increase when combined with healthy lifestyle and realistic expectations. Some key points:

• Ensure modifiable risk factors for ED are addressed: cardiovascular health (blood pressure, cholesterol, smoking, exercise), glucose control if diabetic, weight management, reducing alcohol intake, good sleep.
• Understand that psychological factors (stress, anxiety, relationship issues) often contribute to ED; medication alone may not resolve all underlying issues.
• Be realistic: drug improves ability to get/keep erection when stimulated, but does not guarantee it in all situations (e.g., if underlying nerve damage or severe vascular disease).
• For BPH, using tadalafil may improve urinary symptoms – but it may not reverse prostate enlargement; surgical or other interventions may still be needed if symptoms are severe.
• Monitor your response: Talk to your doctor about how long it takes for you to respond, whether 10 mg is sufficient or you need adjustment, whether you’re comfortable with side effects or need a change.
• Understand timing: if you are using tadalafil for “as needed” ED use, plan accordingly (e.g., take it ahead of anticipated activity, but remember it remains in system for many hours).
• Keep open communication with your partner about expectations, timing, any side effects, and overall sexual health – it’s a shared issue not just individual.

It can be hard to talk about sensitive medical conditions like erectile dysfunction. Many men won’t even admit that they suffer from it, let alone seek treatment.

But the truth is, this isn’t an ailment that you have to suffer from. If you have trouble gaining or keeping an erection, you can talk to your doctor, set up a telemedicine appointment, or treat the issue yourself by buying a medicine like Cialis from an online pharmacy.

• Cialis (tadalafil) is an effective prescription medication used for ED, BPH, or both.
• It works by inhibiting PDE5 and increasing blood flow (and relaxing bladder/prostate muscles).
• The “generic vs brand” question is largely one of cost and availability; generic tadalafil is equivalent in active ingredient.
• Telehealth has improved access to prescriptions, but you still need a legitimate evaluation and monitoring.
• Cost varies, so ask about generic options, discounts, insurance issues.
• Safety is paramount: know your health status, avoid contraindicated medications (e.g., nitrates), heed side effects.
• Lifestyle factors matter – a healthy heart, good sleep, low stress, moderate alcohol, active lifestyle all support sexual health and make medication more effective.
• If you have complex health issues, or poor response to treatment, a specialist urologist (for instance at Mount Sinai) may offer advanced evaluation and options.
• Expect that medication helps with function when stimulated, but doesn’t automatically resolve all sexual or urinary problems on its own; a comprehensive approach is best.