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March 27, 2014

Can Viagra and Cialis Pump You Up – Your Muscles That Is?

We Are Here to Pump You Up

Pumping iron may be one way to get bigger muscles. But, there might be another way – something that pumps up the penis. Yes, erectile dysfunction drugs – also known as PDE5 inhibitors (phosphodiesterase-5 inhibitors). PDE5 inhibitors appear to pump up muscles, too. So you get a two-for with these drugs. These drugs are popular among bodybuilders and professional athletes as athletic performance enhancing drugs.

A while back three young men ages 22 to 26 came to my practice for a complete physical examination (three separate patient visits). They reported being healthy, but at the end of their office visits they each said something like this, “Oh, by the way doc, can I have some Viagra or Cialis?” None of them were on any medications that might cause ED or low libido. They all reported being a little “stressed” at the time, though, and on occasions had experienced some erectile dysfunction.

Now at that age seeing a pretty girl should still get something in the pants of a male to dance a little – even if it’s just a little (stress or no stress). So I was a bit suspicious of them.

Around the same time another one of my patients who is a personal trainer and well chiseled and in his mid 30s also asked for Cialis. He reported no difficulty with erectile dysfunction but stated that such drugs help strength training workouts because of the increased blood flow the drugs produce, and that PDE5 inhibitors raise testosterone levels. That was the first I’ve heard of that, and it certainly makes sense that anything that improves blood flow might be advantageous when it comes to exercise . One thing I’ve learned – the cutting edge when it comes to exerise and nutrition occurs in the gym – not academic laboratories.

I now suspect the other 3 young men that came in probably wanted Viagra or Cialis for reasons outside treatment of ED – perhaps to see if it might improve their workouts, or to enhance the effects of recreational drugs, which PDE5 inhibitors can also do. I’m guessing they wanted it for the later – just a guess.

Do Viagra and Cialis Improve Exercise Workouts?

So do drugs like Viagra, Levitra, and Cialis (a fourth PDE5 inhibitor, Stendra, just hit the market, too) actually help exercise workouts and increase testosterone?

PDE5 inhibitors improve blood flow, but indirectly by increasing nitric oxide levels. We’ve written several articles in the past about nitric oxide; What is Nitric Oxide?, Nitric Oxide Foods, and Boosting Nitric Oxide with Exercise And, nitric oxide has been shown to activate muscle satellite cells.  Muscle satellite cells facilitate muscle repair and adapation. Muscle satellite cells are activated in response to muscle injury including the purposeful injury that occurs with weight training.

Improved blood flow to muscle can boost the so-called pump that bodybuilders and weight lifters strive for in their workouts – the engourging of muscle with blood. Along with that increased blood flow is delivery of oxygen and essential nutrients that lead to muscle hypertrophy or enlargement.

PDE5 inhibitors do more than improve blood flow to the penis – they improve blood flow throughout the body. So it certainly makes sense that PDE5 inhibitors might improve athletic perfomance by improving blood flow and there is some discussion about banning these drugs in some sports as there is evidence that PDE5 inhibitors do improve athletic performance in endurance athletes training at altitude. But, published studies on improving strength training are lacking – but I believe that is just a matter of time based on all I’ve researched thus far.

Do Viagra and Cialis Raise Testosterone Levels?

There are studies that also show these drugs to increase testosterone levels and lower estrogen levels. PDE5 inhibitors improve testosterone levels through at least two mechanisms. One is the lowering of estrogen and the other is the “encouragment or allowance” of more sexual activity.

Some testosterone gets converted into estrogen. If that conversion is blocked then the testosterone levels will naturally become higher. It’s also known that more sexual activity increases testosterone levels. So in men who have become less sexually active due to ED using PDE5 inhibitors may increase testosterone levels by allowing them to be more sexual activity. Higher testosterone levels improve the repair of muscle following strength training.

They say your patients will teach you if you listen. And, I have found that to be true.  I guess that’s one reason we call it the practice of medicine.

 

 

 

 

 

 

 

 

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Dr. Joe Jacko


Dr. Joe is board certified in internal medicine and sports medicine with additional training in hormone replacement therapy and regenerative medicine. He has trained or practiced at leading institutions including the Hughston Clinic, Cooper Clinic, Steadman-Hawkins Clinic of the Carolinas, and Cenegenics. He currently practices in Columbus, Ohio. Read more about Dr. Joe Jacko

  1. In the past few years, researchers at the University of Miami tried to replicate the results of the Stanford study with a pair of trials that included more participants, this time both men and women, and a wider range of altitudes. In the first trial, a field of 20 male and 15 female athletes did cycling time trials at the same simulated altitude as the cyclists in the Stanford study. Only a single male demonstrated a meaningful improvement in his time-trial time after taking a dose of sildenafil.

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