As usual, without double blind studies, this is playing with fire… maybe the people taking it have better health because of the extra exercise that goes with an active sex life.

I would imagine the sex itself isn’t super relevant in terms of exercise. But people who seek out medical treatment (or enhancement) likely take better care of themselves in general.

But I would be surprised if there were not a measurable increase in health markers for men who take Cialis. Pretty much any drug that reduces blood pressure is going to have a positive effect on longevity for the average male population (but not the sub-population who have low blood pressure).