Can you take testosterone and Cialis together? No interaction is listed: the Cialis leaflet does not name testosterone, and a testosterone leaflet names no erectile dysfunction medicine. Whether the pair helps is another matter. In the largest placebo-controlled trial, adding testosterone to an ED tablet did not improve erections further, and testosterone is prescribed only to men whose bodies do not make enough of it.
Does testosterone interact with Cialis?
No interaction is listed in either direction. The Australian Cialis leaflet's list of interacting medicines does not include testosterone or any other hormone (Cialis CMI), and nor does the European product information for tadalafil (EMA — Cialis). The leaflet for Testavan, a testosterone gel sold in Australia, lists warfarin, corticosteroids, insulin, bupropion, ciclosporin and some herbal products as medicines that may interfere with it; no ED medicine is among them (Testavan CMI). "Not listed" is not the same as "tested", but in the trial below, men took testosterone gel with sildenafil for 14 weeks and adverse events were about as frequent as with a placebo gel.
Does adding testosterone make Cialis or Viagra work better?
Not in the best trial. Erectile dysfunction and low testosterone often occur together, so a trial took 140 men aged 40 to 70 with both, found each man's best sildenafil dose, then added testosterone gel or a placebo gel for 14 weeks. Sildenafil alone improved erection scores substantially; adding testosterone made no significant difference — including in men with lower testosterone levels or a poor first response to sildenafil (Spitzer et al., 2012). A 2014 analysis of 41 trials found that testosterone improves erections in men with a genuine deficiency (while flagging possible publication bias), but the apparent boost to ED tablets "was not confirmed in placebo-controlled studies" (Corona et al., 2014). An earlier review suggested it might help men with testosterone below 10.4 nmol/L whose ED tablets had failed, while calling the studies heterogeneous, with "several methodological drawbacks" (Alhathal et al., 2012). A tadalafil study gave testosterone injections to all 60 men and compared daily with on-demand tadalafil, so it cannot show what testosterone added (Park et al., 2015).
Can low testosterone cause erection problems?
It can. Low testosterone can cause reduced sex drive and problems getting or keeping an erection, along with low mood, low energy and poor sleep (Healthy Male — Testosterone). But a lower-than-normal level does not necessarily mean androgen deficiency: it can come from illnesses such as an infection or diabetes (Healthy Male — Low testosterone), and lower levels with age often go with obesity or diabetes, where "more research is required to know whether testosterone treatment is appropriate" (Healthy Male — Testosterone). Whether too much testosterone causes erection problems is answered in can high testosterone cause erectile dysfunction?, and whether Viagra itself changes testosterone in can Viagra increase testosterone levels?
Who is testosterone prescribed for in Australia?
Men with a confirmed deficiency, and only on prescription (Testavan CMI). Low testosterone is diagnosed with blood tests: levels vary, so a low result needs a second test, best taken early in the morning while fasting (healthdirect — Testosterone). Your doctor will refer you to an endocrinologist or urologist to confirm the diagnosis (Healthy Male — Low testosterone). On the PBS, testosterone cream is Authority Required: for men with a pituitary or testicular disorder, or for men aged 40 or over in whom the deficiency "must not be due to age, obesity, cardiovascular diseases, infertility or drugs", confirmed by at least two morning blood samples (PBS — Testosterone 10378F). It is not prescribed to men with prostate or breast cancer, or to men trying to have a child (healthdirect — Testosterone).
What are the risks of combining them?
Each brings its own. Testosterone treatment can cause acne, male pattern hair loss, higher red blood cell counts and PSA levels, and reduced fertility, so your doctor checks your blood regularly (healthdirect — Testosterone); the Testavan leaflet adds a possible higher risk of prostate enlargement and prostate cancer, and asks you to check with your doctor first if you have high blood pressure, heart problems or a history of blood clots (Testavan CMI). Cialis is ruled out with some heart problems, a heart attack in the last 3 months or a stroke in the last 6, because sex "puts extra strain on the heart" (Cialis CMI). The doctor who prescribes one needs to know about the other.
What must never be taken with Cialis?
Nitrates for angina, amyl nitrite ("poppers") and riociguat (Cialis CMI) — see can nitrates be taken with Viagra? The full list is in Cialis interactions with other medicines and supplements; steroid medicines such as prednisone have their own page: can you take Viagra while on steroids?
The short answer
No leaflet lists an interaction between testosterone and Cialis, and men in trials have taken testosterone with an ED tablet. But adding testosterone did not improve erections in the largest placebo-controlled trial, and it is prescribed only for a confirmed deficiency. If you have erection problems and low energy or low sex drive, a GP can check both. Every other combination is covered in our guide to taking Viagra or Cialis with other medicines.
