{"id":6820,"date":"2026-09-10T14:19:57","date_gmt":"2026-09-10T14:19:57","guid":{"rendered":"https:\/\/silvybrand.com\/?p=6820"},"modified":"2026-09-10T14:19:57","modified_gmt":"2026-09-10T14:19:57","slug":"optimizer-cialis-tadalafil-mens-health","status":"publish","type":"post","link":"https:\/\/silvybrand.com\/?p=6820","title":{"rendered":"New standards for masculinity are stacked against men\u2019s health"},"content":{"rendered":"


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This is <\/em>Optimizer<\/a>, a weekly newsletter sent from <\/em>Verge senior reviewer<\/em> Victoria Song<\/em><\/a> that dissects and discusses the latest gizmos and potions that swear they\u2019re going to change your life. Opt in for <\/em>Optimizer here<\/a>.<\/em><\/p>\n<\/div>\n

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Whenever the algorithm serves up a steaming pile of looksmaxxing, I flash back to an old sketch<\/a> from That Mitchell and Webb Look<\/em>. An ordinary woman is told by a commercial narrator that she\u2019s \u201cleaking, hairy, aging, overweight, and everything hurts.\u201d Women, the smug narrator says, for god\u2019s sake, sort yourselves out <\/em>by buying roughly $300 of products. After a jump cut, an average man is told to shave and get drunk, guitars blaring in the background. The reason? Because he\u2019s already brilliant.<\/p>\n<\/div>\n

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Back when that sketch first aired in 2009, it was funny because it felt broadly true. But in the age of looksmaxxing, where men are increasingly obsessed with testosterone, smashing their bones in pursuit of a sharp jawline, and optimizing their penises, that sketch feels like a glimpse into antiquity.<\/p>\n<\/div>\n

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Today, you have men in subreddits<\/a> and Facebook groups posting before-and-after pics at the gym, arms flexed for maximum veiny bicep effect. In the comments, they ask for each other\u2019s stacks, protocols, and dosing advice, which include everything from T to unapproved gray-market peptides. Some say it\u2019s to score baddies. Others say it\u2019s to maximize their gains at the gym. A few seem to think turning themselves into science experiments is how they\u2019ll find the fountain of youth. To me, it feels similar to what women have done for ages: buying snake oil that preys on their insecurities.<\/p>\n<\/div>\n

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\u201cI take Cialis, but not for sex,\u201d begins one of biohacker and tech entrepreneur Bryan Johnson\u2019s X posts<\/a>. \u201cIt\u2019s actually a longevity medicine. Cialis (Tadalafil) is great for the same reason it gives you fantastic erections\u2026 it improves blood flow.\u201d<\/p>\n<\/div>\n

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Tadalafil does, in fact, improve blood flow. The medicine is a vasodilator, meaning it relaxes muscles and widens blood vessels. It\u2019s most widely known as a treatment for erectile dysfunction. (To be clear, it doesn\u2019t cause erections but helps them last when they occur.) It\u2019s also prescribed to alleviate urinary issues in people with enlarged prostates and high blood pressure in the pulmonary artery. Biohackers like Johnson tout a low dose of tadalafil daily as helping lower cardiovascular risk and cognitive decline. Gym rats often microdose tadalafil as a preworkout supplement because, well, the erections are supposedly better and<\/em> dilating blood vessels is thought to lead to better \u201cmuscle pumps.\u201d<\/p>\n<\/div>\n

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Enhanced, the company behind the pro-doping Enhanced Games<\/a>, sells low-dose tadalafil on its site. Clavicular, the most infamous looksmaxxer, has also stated that he\u2019s taken about 5mg of tadalafil in the past as part of an extensive stack<\/a>. This, despite the fact that he\u2019s 20 years old and far from the conventional profile of someone a doctor might prescribe tadalafil to. Popular podcaster Andrew Huberman has also recommended on his show<\/a> that every man over 40 should be taking a low dose of tadalafil as a preventative measure.<\/p>\n<\/div>\n

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\"Cialis,<\/a><\/div>\n<\/div>\n<\/div>\n

Cialis, or tadalafil, works by relaxing muscles and improving blood flow.<\/em><\/figcaption>Photo: Getty Images<\/cite><\/p>\n<\/div>\n<\/div>\n<\/div>\n
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Of course, tadalafil is just like any other medicine. While many may not experience adverse effects at low daily dosages, some will. And like any medication, there are some people who shouldn\u2019t take it and there are drug interactions to be wary of.<\/p>\n<\/div>\n

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It\u2019d be one thing if these influencers were just promoting tadalafil. But most are promoting multiple substances, seemingly all of which you need to be a man. Testosterone, for instance, is massively popular in the same cohort. Ninety-one percent of the athletes at the inaugural Enhanced Games dabbled with testosterone. Notably, Pete Hegseth recently announced mandatory testosterone screenings<\/a> for the troops. Some also hype up retatrutide, an unapproved peptide currently undergoing phase three clinical trials, along with TB-500 and BPC-157, two gray-market peptides colloquially known as the Wolverine stack for their supposed wound healing and muscle recovery benefits. And the more things you stack, the greater the risk that a combination has an unintended effect. In the case of lesser-studied experimental treatments, even doctors may not know what those effects are \u2014 and might not know for a long time.<\/p>\n<\/div>\n

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The stated reasons for taking these risks are myriad. But whether it\u2019s because it\u2019ll help someone get jacked, live longer, perform better in bed, or just \u201chave more energy,\u201d it boils down to a singular message: It\u2019ll make you more of a man.<\/p>\n<\/div>\n

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\u201cThis kind of masculinity is a little bit fantastical,\u201d says Dr. Arthur Burnett, the Patrick C. Walsh professor of urology at Johns Hopkins, referring to the current cultural obsession with \u201cmaxxing.\u201d Burnett should know. On top of over three decades as a men\u2019s health expert, his research into nitric oxide biochemical mechanisms in erectile tissue helped pave the way for drugs like Viagra.<\/p>\n<\/div>\n

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Regarding men taking on all of these additional requirements, he says that \u201cthere\u2019s not really a scientific basis.\u201d
\u201cI think it\u2019s unfortunate that we\u2019ve pushed the pendulum in a direction that may be harmful, frankly, psychologically at the very least but possibly even physically to the body. It could be problematic trying to adopt medical terms like \u2018prevention\u2019 and \u2018men\u2019s health\u2019.\u201d<\/p>\n<\/div>\n

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I\u2019m researching a story on peptide use, and I\u2019m looking to interview regular people who are using gray-market peptides. If you\u2019re interested in participating, email me at victoria.song@theverge.com or message me at Signal @vicmsong.14.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Burnett is essentially pointing to the divide between how clinicians and the biohacking \/ looksmaxxing communities view medicine. On the one side, you have medical professionals who largely view drugs as a way to treat deficiencies and bring people back to a \u201cnormal\u201d baseline. On the other, you have influencers and enthusiasts (which can include clinicians) who believe that drugs can and ought to be used to \u201cenhance\u201d people beyond their natural limits. It\u2019s a tension that\u2019s at the heart of so many debates in the wellness wild west.<\/p>\n<\/div>\n

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\u201cPreventative care should really be something that those who are at risk or have health adversities can make changes in a way that\u2019s going to correct a problem. What you have here is completely healthy people doing things that can be problematic,\u201d explains Burnett.<\/p>\n<\/div>\n

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Testosterone, he says, is a classic example. Otherwise healthy men who over-supplement the hormonal steroid often inadvertently make themselves infertile. For some men, too much testosterone can also trigger a genetic predisposition for hair thinning \u2014 which looksmaxxers often address by taking minoxidil. Add another supplement, drug, or product to combat the side effects of minoxidil \u2014 which include dizziness, headaches, and bloating \u2014 and that\u2019s how you end up with a stack.<\/p>\n<\/div>\n

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What gets lost in all these stacks and protocols is that health isn\u2019t about optimization. For many young men, \u201coptimizing\u201d seems to be less of a goal than a vaguely defined baseline they\u2019re expected to maintain forever. Anything less is a failure, a weakness \u2014 unhealthy.<\/p>\n<\/div>\n

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A depressing way to spend an afternoon is rifling through looksmaxxing and gear forums. (I don\u2019t recommend staying too long \u2014 unless you feel like torturing yourself reading 4chan-esque insults and slurs about penis size and \u201cweekly slays.\u201d)<\/p>\n<\/div>\n

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In one post<\/a>, a supposed 18-year-old asks for advice dosing Cialis to have better erections and \u201cget more flaccid hang.\u201d In a biohacking subreddit<\/a>, a 30-year-old essentially crowdsources whether he\u2019s developing a \u201cdependency\u201d on tadalafil. At no point, despite all the posturing, do any of the men in the posts I read seem to be genuinely happy. They\u2019re often boastful about how good they feel or how many conquests they\u2019ve had. But mostly, there seems to be an undercurrent of angry self-loathing. A desperate urge to \u201cfix\u201d oneself for\u2026 what or whom exactly? I never find a coherent answer.<\/p>\n<\/div>\n

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I can\u2019t believe I\u2019m writing about Cialismaxxing.<\/em><\/figcaption>Photo: Bloomberg via Getty Images<\/cite><\/p>\n<\/div>\n<\/div>\n<\/div>\n
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Admittedly, I\u2019m not a man. I will never know what it means to be a man or experience the societal pressures that men face. But there\u2019s something strange about how the internet is amplifying a subsect of men turning themselves into science experiments. There\u2019s a veritable pipeline from relatively benign trends like boy kibble protein-washing<\/a> and news stories about RFK Jr. working out shirtless with Kid Rock to whatever it is the Enhanced Games<\/a> and Bryan Johnson are doing<\/a>. It\u2019s easy to write off, until Whoop\u2019s AI recommends your boss up his testosterone levels<\/a> \u2014 not because he\u2019s deficient, but because he\u2019s not optimized<\/em> for performance.<\/p>\n<\/div>\n

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\u201cIt happens in my clinic periodically \u2014 guys thinking they need enhancements, or they\u2019re unhappy with certain interventions, or they feel they\u2019re not performing at a certain level,\u201d says Burnett. \u201cIt\u2019s counterproductive as it actually promotes stigma [around men\u2019s health] because they can\u2019t live up to what they think is the notion of the ideal man.\u201d That, he says, creates more anxiety, stress, embarrassment, and shame. On top of that, it makes it hard for men to speak more openly about genuine health issues or seek a professional\u2019s help. Anything \u201cabnormal\u201d becomes something to be suffered in silence or supplemented away.<\/p>\n<\/div>\n

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For now, it\u2019s probably contained to a chronically online niche. (Burnett says these behaviors aren\u2019t heavily prevalent in his practice just yet, but then again \u2014 how likely are the most susceptible men to trust the medical establishment when that\u2019s the first thing wellness grifters seek to discredit?) But this niche is loud and it loves to post. Eventually, those messages embed themselves in the broader culture \u2014 even if everyone knows better.<\/p>\n<\/div>\n

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The only thing I can conclude is that the looksmaxxers are not okay. I hope that one day they will be, that this is a passing fad that one day we\u2019ll look back and laugh at. But in the meantime, I\u2019ll leave this with some advice from Burnett.<\/p>\n<\/div>\n

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\u201cAs long as we\u2019re living healthy, we\u2019re doing the right thing. Please accept that you are a good man for who you are, and don\u2019t be swayed by the influencers.\u201d<\/p>\n<\/div>\n

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