So my daily supplements reg?
You are more than likely crashing your E2 too low. Zinc (ZMA) functions as a weak AI, Cialis is also known to reduce E2 when taken daily, so you are probably ramping your E2 balance off due to this.
The answer is simple, side effects. Drugs take the body outside of as natural state and that’s why there are side effects with medications, you either live with them or you stop the medicine.
As another poster mentions, Cialis can change T->E2 ratios and have an anti estrogen effect which could then affect your joints. I’ve seen some men who have such horrible side effects on Cialis that they have to live an asexual life,. that is until another medicine comes out this is better tolerated.