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Over a billion dollars a year are spent in the U.S. on PDE5-inhibitors like tadalafil (Cialis) -- and not all of that is to remedy erectile dysfunction. Tadalafil also helps ease lower urinary tract symptoms (leaking, dribbling, trouble urinating) associated with benign prostatic hyperplasia, AKA enlarged prostate. PDE5 is an enzyme found in the walls of blood vessels, and when inhibited, it makes your blood vessels relax and blood flow increases, easing urinary woes.

However, a study in the British Journal of Ophthalmology recently found that tadalafil is also associated with an increased risk for glaucoma, ocular hypertension, and open-angle glaucoma. So how do you determine if you should take tadalafil or not?

Have your ophthalmologist assess your risk for these serious eye problems and talk with your ophthalmologist and prostate doctor about the risk-benefit ratio for you.

Thankfully, for most guys, this potentially increased risk of vision problems is not a concern, and they can reap the prostate benefits -- and more. Tadalafil is also associated with a decreased risk of dementia and all-cause mortality. That's why I say if you don't have elevated eye pressure (related to glaucoma), then tadalafil's benefits may greatly exceed the risks for you.

Also, ask your doctor about other remedies for prostate-related lower urinary tract symptoms. They include reducing or eliminating intake of alcohol, caffeine and spicy foods. Practice double voiding (pee twice when you go). Make sure other meds you take don't increase symptoms. There are also other options for meds, like alpha-blockers and 5-alpha reductase inhibitors (5-ARIs).

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. Check out his latest, "The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow," and find out more at www.4YOUngevity.com. Email your health and wellness questions to Dr. Mike at drmikerealage@gmail.com.

(c)2026 Michael Roizen, M.D.

Distributed by King Features Syndicate, Inc.

(c) 2026 Michael Roizen, M.D. Distributed by King Features Syndicate, Inc.