This is well researched and just like with semaglutide I believe a big part of the population should take daily tadalafil.
Better cardiovascular health, more erections and many positive downstream effects (lower E:T ratio, weight loss) that are beyond the scope of this comment.
One of many, looking at just one detail (sitting): https://www.health.harvard.edu/staying-healthy/sitting-may-i...
From a personal experience, so it's just a guess, a contributor may be fluid movement in the body. Fluid in blood vessels are pumped directly, but must fluid is not in blood vessels. The heart has a diminishing effect outside the vessels (capillaries have small holes to let water and small molecules through into extracellular space, and then to collect it back, rest goes through the lymphatic system which also drains back into the bloodstream). Muscle and body movement helps. From what I experienced and experimented, just walking did a lot more than running. I focus on this specifically due to personal health experiences that I don't want to go into that let me feel a clear difference, where intensive running did hardly anything but then just walking did, an experiment I performed during a period of my life when "getting stuff out from all over my body" mattered.
Personally, I choose to run only when my brain/body tell me to, when I feel like it. Definitely not when I would have to fight myself to get going. (If your body/brain tells you the opposite then it is what it is, personal feel over generic advice)
Every person has a limit of how much time and energy they can put into exercise. If they can go beyond that with a pill (with no other cost), why wouldn't you want everyone to take it?
The health benefits of exercise are most likely due to improved blood flow and related physiological effects. In principle, pills could theoretically achieve similar outcomes by enhancing circulation or other underlying mechanisms.
Not taking sides here, just reasoning out loud.
The best results are achieved when these are working together toward some health or fitness goal. It's far more effective to align your lifestyle, diet, exercise, and medications than to have these working against one another (I'll take this pill to compensate for my drinking / smoking / drug use / pollution exposure / stress, etc.). Of course, that's not always possible, and there are circumstances where it's difficult or impossible to attain some of these mechanisms (parapalegic, living in a highly polluted environment, inherently stressful living conditions, GI compromise limiting eating or diet, congenital or genetic conditions or predispositions). Even here, if the patient can make some progress in a specific modality, they'll probably see some benefit.
Some of the most impressive athletes I've seen, from a sheer grit perspective, are those who are working against some major limitation: the swimmer at a health club long ago paralyzed in both legs, the one-legged open-water swimmer, old farts with their pacemakers showing through their chests swimming in the San Francisco Bay, patients with diabetes, heart failure, Parkinsons, recovering from cancer, with various injuries or scars, still at it. Some are astonishingly good by any measure, many aren't, but damned if they're not trying and generally living far better than if they weren't.
This isn't "don't take your meds", it's "use all the available tools". Lifestyle, diet, an exercise are underrated and powerful tools.
"You don't look like your medical history" is a high compliment coming from a doctor, and I'd strongly recommend earning it.
Agreed - low dose daily cialis/tadalafil (e.g. 5mg/day) is very common among elite athletes, bodybuilders, etc. As are GLP-1's despite elite athletes rarely being overweight.
Tadalafil is taken for its endothelial benefits (erections are a convenient side effect), and GLP's for its nutrient partitioning and insulin sensitization effects.
Medications are very often most effective when paired with good lifestyle habits, rather than one of the other.
It also depends on what your goals are, obviously.
5mg daily tadalafil is fine for me though and that‘s also the normal daily dosage.
