From the Guidelines
Tadalafil is not recommended for promoting endometrial growth due to the lack of clinical evidence supporting its effectiveness for this purpose. The primary mechanism of action of tadalafil, a phosphodiesterase type 5 inhibitor, involves increasing blood flow by relaxing smooth muscles in blood vessels, which does not directly address the hormonal stimulation required for endometrial growth 1. Established treatments for promoting endometrial growth include estrogen supplementation, such as oral estradiol 2-6mg daily or estradiol valerate injections, which directly stimulate endometrial proliferation.
Some key points to consider in the management of endometrial growth include:
- Estrogen supplementation is the primary treatment for promoting endometrial growth
- In cases of thin endometrium resistant to estrogen therapy, other approaches like low-dose aspirin, vitamin E, pentoxifylline, or vaginal sildenafil have shown some promise in small studies
- The mechanism behind endometrial growth primarily involves estrogen stimulation of endometrial cells and increased uterine blood flow
- Patients concerned about endometrial thickness should consult with their reproductive endocrinologist or gynecologist for evidence-based treatment options tailored to their specific situation
It is essential to prioritize treatments with established clinical evidence for promoting endometrial growth, focusing on morbidity, mortality, and quality of life outcomes. Given the current evidence, tadalafil is not a recommended treatment for endometrial growth, and patients should explore other evidence-based options under the guidance of a healthcare professional 1.
From the Research
Endometrial Growth and Tadalafil
- The effectiveness of tadalafil, a phosphodiesterase type 5 inhibitor, in promoting endometrial growth has been investigated in several studies 2, 3, 4.
- A study from 2004 found that neither sildenafil nor vaginal estradiol improved endometrial thickness in women with thin endometria after taking oral estradiol in graduating dosages 2.
- In contrast, a 2015 pilot study found that tadalafil improved endometrial growth in patients under clomiphene ovarian stimulation, with a significant increase in endometrial thickness compared to the control group 3.
- However, a 2022 double-blind, placebo-controlled RCT found no significant difference in endometrial thickness and pregnancy rates between patients treated with oral or vaginal tadalafil and a control group 4.
- Other studies have investigated the role of hormones in treating endometrial hyperplasia and cancer, highlighting the potential benefits of progestins, gonadotropin-releasing hormone analogs, and aromatase inhibitors 5, 6.
- The use of tadalafil for promoting endometrial growth may be beneficial in specific subgroups of patients, but more research is needed to confirm its effectiveness 3, 4.