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Cialis May Beef Up AAS Effects?
By William Llewellyn
Can a “boner pill” really help make bigger and stronger steroid users?
A study of interest comes from researchers at the University of Rome. In a paper published in the Journal of Endocrinological Investigation, they presented data that could suggest Cialis, generic name tadalafil, might make an effective supportive agent during the use of anabolic-androgenic steroids (AAS).1 And we’re not talking about treating sexual problems like “Deca dick” here, as it is commonly called. We are talking about tadalafil potentially having a direct effect on the anabolic productivity of a cycle. Is this possible? Can a “boner pill” really help make bigger and stronger steroid users? It is too early to judge based on this data alone, but I do think this is still a topic worthy of discussion. Let’s review and see what this research is all about.
First, let’s go over some background. Tadalafil is a phosphodiesterase-5 (PDE-5) inhibitor. It sits in the same class of drugs as Viagra. PDE-5 inhibitors are widely prescribed to older men for the treatment of erectile dysfunction, and have already been associated with an increased testosterone level in some patients.2 The researchers in Rome sought to take this research one step further by examining the effects of tadalafil on two specific activities of testosterone. The first is the ability of the androgen to be converted to estrogen by aromatase. Next, they wanted to see if the drug would influence androgen receptor expression. Blood hormone levels are, of course, only one side of the equation. An effect on androgen receptors could substantially increase or decrease testosterone’s activity, depending on the direction.
What the researchers found was quite interesting. Using in vitro cell models, they demonstrated that tadalafil acted partly as an aromatase inhibitor. It decreased the estrogen-synthesizing capacity of the incubated cells. This may explain why PDE-5 inhibitors have been associated with increased testosterone/estrogen ratio. They could simply be increasing testosterone by lowering estrogen, which serves as a feedback mechanism for testosterone biosynthesis. More interestingly, perhaps, they also found tadalafil to increase the expression of cellular androgen receptors. This could, in turn, sensitize cells to the actions of testosterone, making a given blood level more productive. Since there are plenty of drugs that effectively (much more so) counter aromatase and lower estrogen, it is the androgen receptor finding that I’m really interested in.
This isn’t the first time we’ve heard of the potential for PDE-5 inhibitors to enhance bodybuilding performance. These drugs have been the subjects of quiet but regular such discussion for years now. This mainly stems from how they work. PDE-5 inhibitors increase nitric oxide synthesis, and in turn blood flow to the penis. The nitric oxide effect is not so localized, however. The same mechanism may trigger vasodilation of blood vessels leading to the muscles. As the logic follows, more blood flow to the area could increase nutrient and hormone delivery, supporting growth. The nitric oxide pathway is still under much investigation and debate, however. Noting a direct effect on androgen receptors would put the PDE-5 issue under a whole new light.
This study is very interesting, but not compelling, given the methods used. For one, they were in vitro. Directly treating cells with a drug allows near-complete control over your environment. It is an excellent investigatory tool. Unfortunately, the data produced by such experiments is generally just a starting point for future research. Very often, effects noted here are not repeated in human studies. For another, the researchers used osteoblasts (developing bone cells). Similar results would need to be demonstrated on skeletal muscle cells extracted from adult men (before and after using the drug) before we could draw any serious conclusions. For now, I don’t recommend anyone start popping PDE-5 inhibitors before hitting the weights. Frankly, think of the horror of a crowded gym if this practice actually became popular! I am certainly going to keep a close eye on this topic to see what develops, though.
William Llewellyn is widely regarded as one of the world’s foremost authorities on the use of performance-enhancing substances. He is the author of the bestselling anabolic steroid reference guide ANABOLICS and CEO of Molecular Nutrition. William is an accomplished researcher/developer in the field of anabolic substances, and is also a longtime advocate for harm reduction and legislative change. He built the website anabolic.org, an extensive online database of information on anabolic steroids and other performance-enhancing drugs.
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References:
1. Aversa A, Fittipaldi S, et al. Tadalafil modulates aromatase activity and androgen receptor expression in a human osteoblastic cell in vitro model. J Endocrinol Invest 2015;Jul 2.
2. Spitzer M, Bhasin S, et al. Sildenafil increases serum testosterone levels by a direct action on the testes. Andrology 2013;Nov;1(6):913-8. doi: 10.1111/j.2047-2927.2013.00131.x. Epub, 2013 Sep 18. PMID: 24106072
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