Anyone done any research on this… is Lee Hebel’s comment accurate?
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Unfortunately I have never awoken with an erection. I didn’t realize that was a thing.
However I never have a problem when duty calls. 
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I think you may be forgetting your teenage years…
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adssx
#16
I checked a bit and found:
Men without physiological erectile dysfunction or severe depression experience nocturnal penile tumescence, usually three to five times during a period of sleep, typically during rapid eye movement sleep.
On average, one has 3–5 episodes of NPT each night, and each episode lasts 30–60 minutes, although the duration is reduced with advanced age.
We’re giving it a lot of text here because it’s commonly discussed — but before we get into the specifics, we want to be clear: The NPT test is outdated and not really very accurate.
Morning wood is a good indicator of both erection health and general health. If you usually wake up with an erection, it’s a good sign that your body is physiologically capable of achieving an erection and that you likely aren’t affected by physical ED. It’s also perfectly normal to occasionally not wake up with an erection. Most men get an erection anywhere from one to five times during sleep. Sometimes, you’ll snap out of sleep at the wrong moment and wake up without an erection. As long as it’s occasional, it’s usually not a problem. However, if you frequently wake up without an erection, there’s a risk that it could be the sign of an underlying health issue such as physical ED. If you’re concerned that you’re not getting nocturnal erections you can try a simple postage stamp test. You take a length of connected postage stamps and secure them to your flaccid penis prior to going to sleep. If the perforated connections of the stamps are torn when you wake up it’s evidence that you’re experiencing nocturnal erections. It’s not a perfect test, but it’s something simple you can do by yourself.
The most common causes of infrequent or no morning wood are hormonal issues, such as low testosterone, as well as health conditions such as obesity, high blood pressure, diabetes and high cholesterol.
Another factor that affects the frequency of morning wood is age. Older men – particularly men in their 60s and 70s – are less likely to experience frequent morning wood than younger men.
If you stop experiencing NPT, this may be an early sign of an underlying medical problem. Pay attention to how often you experience morning wood. If it stops, speak with a doctor.
However, I struggled to find data. I found this but it is in patients “after nerve-sparing radical prostatectomy (nsRP)”:
Effect of Tadalafil Once Daily on Penile Length Loss and Morning Erections in Patients After Bilateral Nerve-sparing Radical Prostatectomy: Results From a Randomized Controlled Trial 2015
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tj_long
#18
Tadalafil seems to make my reflux worse, so I stop using it. “There are no solutions, only trade-offs”.
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tj_long
#20
I might trying 2.5mg 3 times a week.
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Agetron
#21
Definitely… that is a lifespan dose not an ED dose.
Once tadalafil (accidentally wrote finasteride) builds up… you don’t need as often. Every third day. The low does builds-up in your system to reach a steady-state plasma concentration within 5 days.
Link: How long does tadalafil last? - Dr Fox.
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Still effective?: 36–48 hours
Some men can get good erections for up to 48 hours. This is why tadalafil is sometimes known as ‘the weekend pill’ – you can take it on a Friday night and still make use of it on a Sunday morning!
I take at night before bed with finasteride another drug that builds up with time.
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Have you ever heard of someone getting this from Tadalafil? Especially at such a low dose?
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Dr.Bart
#24
A postmarketing safety surveillance study by Eli Lilly reported the risk of tadalafil-associated priapism as less than 1 in 10,000.1
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Not to be too much of a skeptic, there has to be some wiggle room in terms of what they report, or how they parse out things that “might” not be classified as full “priapism”, so they can remove it from the count. Could the real number be 3 to 5 times higher?
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Something to keep in mind here is that the single dose recommended for taking it once to last a “holiday weekend” type thing is 20mg - four 5mg pills. So I’m wondering how many dudes that experienced priapism were just taking a pill a day vs the four pill “weekender” dose. I’m hoping it’s mostly the latter as I take 5mg a day and really appreciate its affect on my BPH-affected urine flow.
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You did a long period (three years?) of continuous daily use, correct? Did you feel like it was losing effectiveness over time? And did taking two weeks off restore the receptors and make it work better when you restarted?
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Agetron
#28
Yes, I’ve been on the medication for 3 years.
With no lack of benefit, so I’ve never cycled it, nor has my doctor told me to cycle, because I’m on the low dose of 5 mg daily.
I considered taking a break after the above video. But have since thought no. Keep on the program… daily use.
There is no evidence to suggest that tadalafil directly down-regulates receptors, specifically in the context of its primary use for ED or BPH. Down-regulation typically refers to a decrease in the number of receptors or their sensitivity on the surface of cells, usually due to prolonged exposure to a stimulus or drug.
Tadalafil acts on the PDE5 enzyme rather than directly on receptors. Over time, the body may develop a certain level of tolerance to drugs that work on receptors, but this is different from receptor down-regulation. In the case of tadalafil, tolerance development appears to be minimal, and its long-term use has not been associated with significant down-regulation or desensitization of receptors.
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LukeMV
#29
I have this problem too and it sucks. I now take 2.5mg daily instead and it’s not nearly as bad, so try dropping the dose. I cut the 5mg tab in half and take it with breakfast
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Dr.Bart
#30
Keep in mind that this 1 in 10,000 are in people with ED…(the opposite of priapism). Would the number change if the drug is used in 10,000 people with normal erection ?
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KarlT
#31
Anecdotally, in 30 years in the ER, I’ve only seen 4 or 5 cases of priapism, none related to these medications.
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