Can tadalafil 5mg increase testosterone levels?

Did you know that some research suggests that once-daily tadalafil 5mg, can increase testosterone levels? In this blog we will explore the relationship between tadalafil and testosterone: how this medication might influence hormone levels, its effects on men with erectile dysfunction and metabolic syndrome, and what the latest research says

Key takeaways

• Tadalafil 5mg may have a positive effect on testosterone levels, especially in men with low testosterone or metabolic syndrome [1], [2], [3], [4] .
• Research shows mixed but promising results on how PDE5 inhibitors like tadalafil influence hormone production.
• Tadalafil’s benefits go beyond erectile function, potentially improving quality of life and hormonal balance.
• More studies are needed to confirm the extent of testosterone changes from tadalafil use.
• Understanding tadalafil’s role can help men and healthcare professionals make informed decisions about treatment options.

Testosterone, erectile dysfunction, metabolic syndrome and tadalafil

Testosterone is a key hormone in male health, influencing muscle mass, libido, mood, and energy levels [5].

For many men, especially those with erectile dysfunction (ED) or metabolic syndrome, testosterone levels can be lower than ideal, impacting quality of life [6].

Tadalafil, commonly known for treating erectile dysfunction is a phosphodiesterase type 5 (PDE5) inhibitor that relaxes muscles and improves blood flow [7].

But can tadalafil 5mg increase testosterone levels? This blog explores the science, research, and practical insights to answer this important question.

What is tadalafil and how does it work?

Tadalafil is a medication primarily prescribed for erectile dysfunction and benign prostatic hyperplasia (BPH) [7], [8].

It works by inhibiting the PDE5 enzyme, which leads to increased levels of cyclic guanosine monophosphate (cGMP). This causes smooth muscle relaxation and improved blood flow to the penis and other tissues [9].

Tadalafil is known for its long duration of action, often lasting up to 36 hours, earning it the nickname “the weekend pill” [10].

While its main function is to aid erectile function, tadalafil’s muscle-relaxing effects extend to other areas, including the prostate and bladder, helping relieve symptoms of BPH [8].

Its role in potentially influencing testosterone levels is an area of ongoing research.

How might tadalafil influence testosterone levels?

Testosterone production occurs primarily in the Leydig cells of the testes, regulated by complex hormonal signals involving luteinising hormone (LH) and follicle-stimulating hormone (FSH) [11].

Some studies suggest that PDE5 inhibitors liketadalafil may enhance Leydig cell function, possibly via improved blood flow or direct cellular effects through cAMP/cGMP signalling pathways [1], [2], [3], [4] .

Research indicates that increased blood flow to the testes could enhance steroidogenesis, the process by which testosterone is produced.

Additionally, tadalafil’s positive effects on erectile function and sexual activity might indirectly boost testosterone levels by improving overall reproductive health.

What does the research say?

Several clinical studies have investigated the relationship between tadalafil and testosterone levels, with varying results:

• Hellstrom et al. conducted a placebo-controlled study with men taking tadalafil 20mg daily for three months. They observed significant increases in total testosterone compared to placebo, without adverse effects on sperm parameters [1].
• Ozcan et al. treated men with metabolic syndrome using tadalafil 5mg daily for three months. They reported an increase in testosterone from 11.45 nmol/L to 16.5 nmol/L, along with improved erectile function scores [2].
• Spitzer et al. found that sildenafil, another PDE5 inhibitor, increased testosterone levels alongside a reduction in LH, suggesting a possible direct testicular effect rather than just increased sexual activity [3].
• Other studies have shown mixed results, with some finding no significant changes in testosterone levels in eugonadal men after PDE5 inhibitor use [4].

Overall, the evidence suggests tadalafil may help increase testosterone levels, especially in men with low baseline levels or metabolic syndrome, but further research is needed.

Who might benefit from tadalafil’s potential testosterone effects?

Men with erectile dysfunction and low testosterone, particularly those with metabolic syndrome or type 2 diabetes, may experience the most benefit. Low testosterone is common in these groups and is linked to symptoms such as reduced libido, fatigue, and mood changes [6].

Tadalafil’s dual action on erectile function and possible testosterone increase could improve both sexual health and overall wellbeing. However, it’s important to consult a healthcare professional before starting treatment, especially if considering testosterone therapy.

Practical tips for men considering tadalafil

• Discuss your symptoms and hormone levels with your doctor before starting tadalafil.
• Use tadalafil as prescribed, typically 5mg once daily for BPH or ED.
• Monitor your response, including sexual function and any changes in energy or mood.
• Maintain a healthy lifestyle with regular exercise, balanced diet, and stress management to support hormone health.
• Report any side effects or concerns to your healthcare provider promptly.

Frequently asked questions (FAQs)

Can tadalafil 5mg increase testosterone levels naturally?

Research suggests tadalafil may help increase testosterone levels, particularly in men with low baseline levels or metabolic syndrome. The effect is likely due to improved testicular blood flow and Leydig cell function rather than direct hormone replacement [2], [1].

Is tadalafil a substitute for testosterone therapy?

No, tadalafil is not a substitute for testosterone replacement therapy. While it may boost testosterone production in some men, it does not replace the need for hormone therapy in those with significant deficiency [3].

How long does it take for tadalafil to affect testosterone levels?

Studies have observed changes in testosterone levels after several weeks to months of daily tadalafil use, typically around three months [1], [2].

Are there any risks of using tadalafil for testosterone increase?

Tadalafil is generally safe when used as prescribed, but side effects can occur. It’s important to use it under medical supervision, especially if you have cardiovascular conditions or take nitrates [5].

Can tadalafil improve fertility?

Current research shows tadalafil does not significantly affect sperm quality or fertility, though it may improve sexual function which can indirectly support fertility [6].

Conclusion

Tadalafil 5mg shows promise in potentially increasing testosterone levels, especially in men with low baseline levels or metabolic syndrome. While it is primarily prescribed for erectile dysfunction and BPH, its effects on hormone production may offer additional benefits. However, more research is needed to fully understand the mechanisms and long-term impact.

Men considering tadalafil for testosterone-related concerns should consult healthcare professionals for personalised advice and appropriate monitoring.

If you would like to find out more about how tadalafil can boost your testosterone levels, or even if you are interested in starting TRT, please contact us.

Concerned about your testosterone levels?

If you’re worried your testosterone might be on the low side, don’t hesitate to contact us. We’re here to help—and keep an eye out for the launch of the Courier Pharmacy TRT (Testosterone Replacement Therapy) clinic, coming soon!

Disclaimer: This article is for informational purposes only and does not replace professional medical advice.

References

1. Hellstrom W. et al. (2008). An evaluation of semen characteristics in men 45 years or older after daily dosing with tadalafil 20mg. European Urology, 53(5), 1058-65.
2. Ozcan L. et al. (2017). Effects of taking tadalafil 5 mg once daily on erectile function and total testosterone levels in patients with metabolic syndrome. Andrologia, 49(1), e12751.
3. Spitzer M. et al. (2012). Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction. Annals of Internal Medicine, 157(10), 681-91.
4. Kandel A.H. et al. (2016). Evaluation of the effect of sildenafil and tadalafil on testosterone blood level. Human Andrology, 6(3), 92-95.https://journals.lww.com/humanandrology/fulltext/2016/09000/evaluation_of_the_effect_of_sildenafil_and.3.aspx
5. Medical Mojo. (n.d.) Obesity and low testosterone. Available at: https://medicalmojo.co.uk/obesity-and-low-testosterone/ (Accessed: 14 October 2025).
6. British Society for Sexual Medicine. A Practical Guide on the Assessment and Management of Testosterone Deficiency in Adult Men [PDF]. (2023). Available at: https://bssm.org.uk/wp-content/uploads/2023/02/BSSM-Practical-Guide-High-Res-single-pp-view-final.pdf (Accessed: 15 October 2025).

7. Courier Pharmacy. (n.d.) The journey to once-daily dosing of tadalafil 5mg tablets. Available at: https://courierpharmacy.co.uk/the-journey-to-once-daily-dosing-of-tadalafil-5mg-tablets/ (Accessed: 14 October 2025).
8. Courier Pharmacy. (n.d.) Can tadalafil 5mg be used for an enlarged prostate? Available at: https://courierpharmacy.co.uk/can-tadalafil-5mg-be-used-for-an-enlarged-prostate/ (Accessed: 14 October 2025).
9. Courier Pharmacy. (n.d.) How to take tadalafil. Available at: https://courierpharmacy.co.uk/how-to-take-tadalafil/ (Accessed: 14 October 2025).
10. Courier Pharmacy. (n.d.) How long does tadalafil 20mg last after taking it? Available at: https://courierpharmacy.co.uk/how-long-does-tadalafil-20mg-last-after-taking-it/ (Accessed: 14 October 2025).
11. Midzak, A.S., Chen, H., Papadopoulos, V. and Zirkin, B.R., 2009. Leydig cell aging and the mechanisms of reduced testosterone synthesis. Molecular and cellular endocrinology, 299(1), pp.23-31.