MultiGen Wellness Health Article #31 -The Interaction of Tadalafil, Oxytocin, and TRT: A Comprehensive Report 

Overview: 

Combining Tadalafil (Cialis), Oxytocin, and Testosterone Replacement Therapy (TRT) creates a synergistic effect that enhances sexual performance, cardiovascular health, mood, and overall well-being. Each component plays a unique role, and together they can optimize both physical and emotional aspects of masculinity. 

At MultiGen Wellness Online we focus on perfection of the human body by first balancing the hormone system and then optimizing it. We use comprehensive blood panels to see inside the body and compare the blood panel to the patient’s life symptoms to determine treatments. Internal medicine IE; Hormone Therapy or HRT better known at TRT is as much as science as it is about the art of HOW the patient feels.

We know that most men feel their best at a testosterone range of 900 – 1,200. But some men prefer 700 and some 1,100. This is where the cookie cutter approach to Hormone Therapy just does not work. What we like to do is look for the imbalances in the hormones like low testosterone and high estrogen. Then, we balance those. Its pretty simple.

We have mastered a few combinations of powerful treatments that we will look at and review in this article. We like to prescribe me a cocktail of 3 custom compounded medications to begin treatment.

1. Tadalafil And/or Variants
2. Oxytocin And/or Variants
3. Testosterone And/or Variants

Along with a few other foundational medications:

1. Anti-Estrogen (Anastrozole.) 
2. Therapeutic Blood Donations if needed 
3. Testicular Support (Gonadorelin or Clomiphene.)

You can read our other articles to learn more about these other treatments. For now, let’s focus on the core 3 medications and how they can benefit the male or female body given different dosages for both.

1. Effects on Sexual Function & Performance

• Testosterone (TRT): Increases libido, enhances erection quality by boosting nitric oxide, supports stamina, and improves sexual confidence.
• Tadalafil (Cialis): Increases blood flow for harder, longer-lasting erections, works up to 36 hours, improves heart health, and reduces BPH symptoms.
• Oxytocin: Enhances orgasm intensity, increases emotional connection and affection, and counteracts TRT-induced emotional blunting.
• Synergistic Effect: TRT boosts libido and confidence, tadalafil ensures strong erections, and oxytocin enhances pleasure and emotional bonding.

2. Effects on Mood, Confidence, and Well-Being

• Testosterone (TRT): Increases motivation, confidence, and assertiveness, enhances dopamine, and reduces stress.
• Tadalafil: Improves blood flow to the brain, enhances mood, and reduces performance anxiety.
• Oxytocin: Reduces anxiety and stress, promotes emotional warmth and bonding, and improves social interactions.
• Synergistic Effect: TRT increases dominance and drive, oxytocin balances it with emotional warmth, and tadalafil supports cognitive function and relaxation.

3. Cardiovascular and Overall Health Benefits

• Testosterone (TRT): Supports lean muscle mass, reduces body fat, and requires hematocrit monitoring.
• Tadalafil: Lowers blood pressure, improves arterial flexibility, and supports heart health.
• Oxytocin: Lowers cortisol, reduces stress impact on the heart, and has mild anti-inflammatory benefits.
• Synergistic Effect: TRT improves metabolism and body composition, tadalafil enhances vascular health, and oxytocin reduces stress-related cardiovascular risks.

4. Potential Side Effects and Considerations

• Testosterone (TRT): Increased hematocrit (requires monitoring), possible mood swings, and potential DHT-related hair loss.
• Tadalafil: Can cause headaches, nasal congestion, or lower blood pressure. Should be used cautiously in men with cardiovascular conditions.
• Oxytocin: Too much may reduce aggression, lower motivation, or cause temporary nausea.
• Risk Management: Regular hematocrit and estradiol monitoring on TRT, moderate dosing of oxytocin to avoid emotional overstimulation, and Tadalafil used as needed or at a low daily dose (5 mg) for long-term benefits.

5. Ideal Candidates for This Stack

✔️ Men on TRT who want to maximize libido, erection quality, and overall health 

✔️ Those experiencing emotional flatness on TRT and want to improve bonding & connection 

✔️ Individuals with mild erectile dysfunction but high libido 

✔️ Men looking for a confidence boost in both sexual and social settings 

Suggested Dosing Strategy for a Male in His 40s (Approx. 190 lbs) on TRT, Tadalafil, and Oxytocin 

This dosing protocol is designed to optimize sexual function, mood, cardiovascular health, and overall well-being while minimizing side effects. 

1. Testosterone (TRT) Dosage & Strategy

• Testosterone Cypionate or Enanthate: 150–200 mg per week, split into two doses (e.g., Monday & Thursday, 75–100 mg each)
• Aromatase Inhibitor (if needed): Only if estradiol rises too high (consider microdosing Anastrozole 0.125–0.25 mg once or twice per week, but only if symptoms arise)
• Hematocrit Management: Monitor levels every 8–12 weeks and donate blood if necessary

✔ Goal: Maintain high-normal testosterone levels while controlling estradiol and hematocrit. 

2. Tadalafil (Cialis) Dosage & Strategy

Two Options: 

1. Daily Microdosing: 5 mg daily for continuous blood flow benefits, prostate health, and mild sexual enhancement.
2. On-Demand: 10–20 mg taken 30–60 minutes before sexual activity for maximum erection strength.

✔ Goal: Improve erection quality, lower blood pressure, and enhance vascular function. 

3. Oxytocin Dosage & Strategy

• Sublingual Oxytocin: 5–10 IU taken 15–30 minutes before intimacy or social interaction
• Intranasal Oxytocin: 10–20 IU, 15–30 minutes before desired effect (better absorption but shorter duration)
• Max Daily Dose: No more than 20 IU per day to prevent excessive emotional sensitivity

✔ Goal: Enhance orgasm intensity, increase emotional bonding, and reduce stress while avoiding lethargy or emotional blunting. 

4. Stacking & Timing Strategy

Morning: 

• Testosterone: Optional (if using split doses)
• Tadalafil: 5 mg (if using daily dosing)
• Oxytocin: None
• Notes: Boosts vascular health and mood stability

Evening (Before Sex): 

• Testosterone: None
• Tadalafil: 10–20 mg (if using on-demand dosing)
• Oxytocin: 5–10 IU (sublingual) OR 10–20 IU (intranasal)
• Notes: Enhances erection, pleasure, and bonding

TRT Injection Days (2x per week, e.g., Monday & Thursday): 

• Testosterone: 75–100 mg
• Tadalafil: Same as above (daily or on-demand)
• Oxytocin: Same as above (before intimacy)
• Notes: Keep TRT injections consistent

5. Additional Considerations

• Monitor Blood Pressure (especially if using daily Tadalafil)
• Check Estradiol & Prolactin (if using TRT & Oxytocin)
• Limit Alcohol & Dehydration (as Tadalafil lowers blood pressure)

This regimen balances testosterone-driven confidence and libido, tadalafil’s erection-enhancing effects, and oxytocin’s emotional and pleasure-boosting properties.