Young Brazilians Misuse Erectile Dysfunction Drug “Tadala”: Risks & Warnings
The medication tadalafil, originally developed to treat erectile dysfunction and pulmonary hypertension, is increasingly being used recreationally, particularly among young men in Brazil. Dubbed “tadala” on social media, it’s falsely promoted as a performance enhancer – both sexually and in the gym – despite a lack of scientific evidence supporting these claims. This trend raises significant health concerns, as the drug carries risks even for those with legitimate medical needs, and those risks are amplified when used without medical supervision.
A Growing Trend Fueled by Misinformation
A review published in 2024 in Diversitas Journal analyzed over 20 Brazilian and international studies spanning two decades, revealing a consistent pattern: acquisition of tadalafil without a medical prescription. The study found that motivations for use often stem from behavioral and psychosocial factors, including curiosity, a desire for increased self-confidence, pressure to perform sexually, and attempts to reduce anxiety. Gustavo Alves Andrade dos Santos, a pharmaceutical biochemist and co-author of the publication from USP-RP (University of São Paulo in Ribeirão Preto), emphasizes that these issues are not solved by medication alone.
Sales figures corroborate this trend. According to data from Brazil’s National Health Surveillance Agency (Anvisa), sales of tadalafil jumped from 21.4 million boxes in 2020 to 47.2 million boxes in 2023. Preliminary data from the first half of 2024 indicates that 31.1 million boxes were sold, suggesting a continued upward trajectory. The BBC reported on this surge, noting the drug’s increasing presence in music and social media.
How Tadalafil Works – and Doesn’t
Tadalafil, along with vardenafil and sildenafil (commonly known as Viagra), belongs to a class of drugs called phosphodiesterase type 5 (iF5) inhibitors. These medications work by relaxing the tissues in the penis and increasing blood flow, facilitating erections. They are indicated for treating organic erectile dysfunction. However, in individuals without underlying physiological issues, these drugs offer no real benefit. They don’t prolong erections, increase intercourse time, or alter penis size.
The Brazilian Society of Urology (SBU) clarifies that the reported “pump” or temporary muscle swelling experienced by some users is likely due to transient peripheral vasodilation – a temporary widening of blood vessels – and represents a placebo effect. The SBU issued a statement cautioning against non-medical use.
Daniel Suslik Zylbersztejn, a urologist at Einstein Hospital Israelita, explains that the perceived benefits are often psychological. Believing the drug will enhance performance can boost confidence and reduce anxiety, acting as a “psychological crutch.” He stresses that sex is more than just penetration and that focusing solely on physical aspects can hinder genuine connection and enjoyment.
Serious Health Risks Associated with Recreational Use
The primary side effects of iF5 inhibitors stem from their vasodilatory action, causing flushing and nasal congestion. However, misuse can lead to more serious consequences, including tachycardia (rapid heartbeat), blood pressure fluctuations, fainting, temporary vision or hearing loss, and, in severe cases, heart attack, stroke, and sudden death.
A particularly dangerous complication is priapism – a prolonged, painful erection not associated with sexual desire. This condition is more common in individuals with liver problems, who metabolize the drug slowly, leading to prolonged exposure.
Combining tadalafil with alcohol can likewise be problematic. While alcohol also has vasodilatory effects, it’s a central nervous system depressant, reducing dopamine activity. This can counteract the drug’s intended effect and impair erectile function.
Beyond Physical Risks: Psychological Dependence
While tadalafil doesn’t cause physiological dependence or withdrawal symptoms, psychological dependence is a concern. Santos notes that young people increasingly struggle with social interactions, relying on digital communication and being exposed to idealized portrayals of sex through pornography. This can lead to insecurities and frustrations, with the drug being seen as a quick fix.
Zylbersztejn adds that individuals may mistakenly believe the pills will resolve underlying anxiety, body image issues, or relationship problems. He emphasizes that focusing on penis size or erection rigidity can prevent individuals from fully enjoying sexual experiences and building meaningful connections.
The Problem of Unregulated Access
A 2020 study published in the International Journal of Clinical Practice found that over half of the more than 25,000 young men surveyed who had taken erectile dysfunction medication did so without professional advice. This is exacerbated by the availability of unregulated formulations online, including gummies and supplements lacking Anvisa authorization and potentially containing harmful contaminants.
The packaging of these products, often designed to appeal to a younger audience, contributes to the normalization of misuse. Zylbersztejn stresses the importance of education and awareness to combat this trend. Pharmacists also have a crucial role to play by reinforcing the requirement for a prescription and providing information about the risks.
As Santos points out, a single instance of erectile dysfunction doesn’t warrant systematic medication use. Seeking professional evaluation is essential to identify the underlying cause and determine the appropriate treatment.
addressing the recreational use of tadalafil requires a multi-faceted approach, including public health campaigns, stricter regulation of online sales, and increased awareness among healthcare professionals and the public. It’s a conversation about more than just a pill; it’s about healthy relationships, realistic expectations, and prioritizing overall well-being.