This is important because plaque buildup in the arteries is largely due to an inflammatory process where leukocytes white blood cells adhere to and “attack” arterial walls. This is the time post-ejaculation that it takes for guys to recover before they can become erect. If you are taking tadalafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Tadalafil is also sometimes taken once a day every day without regard to timing of sexual activity. Do not take a double dose to make up for a missed one.Side Effects. Headache, stomach upset, back pain, muscle pain, stuffy nose, flushing, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. To. Tadalafil – STADA T20 – 20 Milligramm. Tadalafil, sold under the brand name Cialis among others, is a medication used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. [4] [5] [7] It is taken by mouth. [7] Onset is typically within half an hour and the duration is up to 36 hours. 4. Testeosterone and the T/E Ratio. Don’t forget that long term Cialis use has been shown to significantly improve the all-important testosterone to estrogen ratio by an average of 24%. A one year study of males with an average age of 54 showed an increase in testosterone of % and a decrease in estrogen of 15%.