I am taking daily tadalafil (Cialis) with an extra 10 mg dose and two 30 mg sildenafil (Viagra) tablets on the same night, and now experience partial erections that are firm at the base, bent, shortened, with a soft glans, especially when cuddling with a relative. What is causing these abnormal erections?

You Are Experiencing Drug-Induced Partial Erections from Excessive PDE5 Inhibitor Use

You need to immediately stop combining tadalafil and sildenafil together, as you are taking a dangerous overdose that is causing abnormal, incomplete erections. The FDA explicitly warns against using multiple erectile dysfunction medications simultaneously 1.

What's Happening to Your Erections

Your description—firm at the base, bent, shortened, with a soft glans—represents partial or incomplete tumescence caused by:

Medication Overdose Effects

• You're taking daily tadalafil PLUS an additional 10 mg tadalafil PLUS 60 mg sildenafil (two 30 mg tablets) on the same night
• This creates unpredictable blood flow patterns in penile tissue
• The result is uneven engorgement: proximal (base) rigidity without distal (glans) filling
• This mimics what happens with vascular insufficiency or venous leak, but is drug-induced

Why This Pattern Occurs

• PDE5 inhibitors work by enhancing blood flow, but require sexual stimulation to function properly 1
• When you're cuddling (non-sexual context), you're getting spontaneous partial erections from the massive drug load in your system
• The medications are forcing blood into the corpora cavernosa without the normal neurogenic coordination needed for complete, uniform rigidity
• Research shows sildenafil can cause erections independent of normal pathways at high tissue concentrations 2

Immediate Dangers You Face

Risk of Priapism

While you haven't described a fully rigid erection lasting >4 hours, your medication regimen puts you at significant risk. If you develop a rigid erection lasting >4 hours, this is a medical emergency requiring immediate treatment with intracavernosal phenylephrine 3. Untreated priapism causes:

• Permanent erectile dysfunction
• Corporal fibrosis
• Penile shortening
• Smooth muscle damage beginning as early as 6 hours 3

Cardiovascular Risks

Your drug combination can cause:

• Dangerous blood pressure drops
• Dizziness and fainting
• Increased heart rate 1

What You Must Do Now

Stop the Dangerous Combination

1. Never combine tadalafil and sildenafil—the FDA explicitly prohibits this 1
2. Choose ONE medication only
3. Use the lowest effective dose

Proper Dosing Guidelines

If using tadalafil:

• For daily use: 2.5-5 mg once daily 1
• For as-needed use: 10-20 mg, taken 30 minutes before sexual activity, maximum once per 24 hours 1

If using sildenafil:

• 25-100 mg as needed, maximum once per 24 hours
• Never exceed 100 mg in 24 hours

Why Your Current Approach Fails

• Sexual stimulation is required for these medications to work properly 1
• Taking excessive doses doesn't improve function—it causes dysfunction
• Cuddling with a relative is not an appropriate context for sexual arousal or medication testing

The Abnormal Erection Pattern Explained

Your bent, shortened appearance with soft glans indicates:

• Incomplete corporal filling: The medication forces blood into proximal chambers but fails to achieve uniform distribution
• Lack of proper neurogenic input: Without appropriate sexual stimulation, the normal cascade of smooth muscle relaxation and arterial dilation is disrupted
• Possible venous leak pattern: Excessive medication may paradoxically worsen venous occlusion mechanisms

Critical Warning Signs

Seek emergency care immediately if you experience:

• Any erection lasting >4 hours (even if partially rigid) 3
• Severe penile pain
• Chest pain, severe dizziness, or fainting during these episodes 1
• Vision or hearing changes 1

Moving Forward

1. Discontinue all PDE5 inhibitors immediately until you can see a urologist
2. Schedule urgent evaluation with a urologist or sexual medicine specialist
3. Be completely honest about your medication use—they need accurate information to help you
4. Expect evaluation for underlying erectile dysfunction causes
5. If medications are appropriate, use only ONE agent at the proper dose, and only in the context of intended sexual activity

The partial erections you're experiencing during non-sexual situations (cuddling) are a direct result of medication overdose creating uncoordinated vascular responses. This is not normal erectile function and indicates you're causing harm to your penile tissue.