WOULD YOU RATHER lose your sight or your sex life? The 50 million men taking the erectile dysfunction drug tadalafil (Cialis) may soon ask themselves this very question.
There’s a study making the rounds that found a link between people using the PDE5 inhibitor and a higher risk of glaucoma, an eye condition that causes damage to the optic nerve. The optic nerve receives visual information from the brain. If left untreated, continued damage to the nerve can result in blindness.
When it comes to fixing erectile dysfunction, the last thing you want is to swap one health issue for another. But before you get into a mental wrestling match on what to prioritize, know there’s a lot of caveats. Doctors not involved in the study also had some interesting takes. More on that below.
What Did the Study Find Exactly?
THE STUDY PUBLISHED in the British Journal of Ophthalmology tracked 36,927 men over the age of 40 for five years with prescriptions for tadalafil and compared their health stats to another 36,927 guys not using PDE5 inhibitors. Between the two groups, the men taking an ED pill had significantly higher rates of being diagnosed with glaucoma, ocular hypertension, and open-angle glaucoma. They also were more likely to start treatment for glaucoma compared to men who didn’t use PDE5 inhibitors.
“Ophthalmic evaluation and follow-up may be considered [for tadalafil users], particularly in patients with risk factors for glaucoma,” the researchers wrote in the study’s conclusion.
But we can clearly see there’s not a blindness epidemic happening. So what’s going on? Well, one important note is that the study looked at men taking a PDE5 inhibitor because of a history with urinary tract infections, not ED. So could it be something to do more with the bladder? Maybe.
Now let’s look at the mechanism of PDE5 inhibitors. Aaron Zimmerman, OD, clinical professor of optometry at The Ohio State University, says this class of medication works by relaxing smooth muscle and expanding blood vessels. In the eyes, all of these actions have the unintended consequence of increasing fluid in the eye. This can add more pressure in the eye area and potentially damage your optic nerve.
Another potential explanation for the link between tadalafil and glaucoma is because the medication does run the risk of insufficient blood flow to areas like the optic nerve. Dr. Zimmerman says it’s possible that the blood supply to the optic nerve isn’t controlled as well in older adults and tadalafil may impact this even more, he says. “This combination may be damaging the optic nerve.”
Still, this is all speculation. The study only showed something might be happening. “The study shows an association between tadalafil and glaucoma, but it does not prove that tadalafil causes glaucoma,” says Bavand Youssefzadeh, DO, ophthalmologist with Cedars-Sinai and co-founder at Global LASIK & Cataract Institute. “I would view this as an important signal that deserves further study, not a definitive cause-and-effect finding.”
“Glaucoma becomes more prevalent with age, so that may be somewhat contributing to this, though it should be noted that the subjects were age-matched—so something else is likely occurring,” adds Dr. Zimmerman.
What Are the Chances Your ED Meds Will Make You Blind?
NOT MUCH. OVERALL, the risk of glaucoma was small. Tadalafil users had about a 0.8 percent higher risk of being diagnosed with glaucoma over the five-year study period compared with nonusers.
David Kaufman, MD, director of Central Park Urology, a division of Maiden Lane Medical, says that the findings are interesting but not strong enough to warrant guys to dump their ED pills. There is one caveat.
If you have a family history of glaucoma or already have the condition, Dr. Kaufman says it’s fair to be cautious about using tadalafil for ED. Just be aware that the overall risk of developing blindness from it is low and that there are other alternatives beyond tadalafil if you so choose.
Korin Miller is a seasoned freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Everyday Health, Food & Wine, and more. She has a master’s degree from American University and lives by the beach.
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