In mid-2023, the tech mogul and self-proclaimed biohacker, the anti-age crusader Bryan Johnson began a new chapter in his longevity journey. He is already known his extreme anti-aging regimen - Project Blueprint. He has turned his attention to something unconventional. However, it is a telling health metric: nighttime erections. He has now started a daily dose of 2.5mg of tadalafil (Cialis). He has set out to track and enhance what he calls a crucial "vital sign". His goal is not performance, but optimization. He tells his followers on X, the results were "titanic". By early 2024, Johnson had added focused shockwave therapy and Botox injections to the mix. Within three months, he says, his nighttime erections improved by 34%. It has clocked in at quite an impressive three hours, with biological equivalent of an 18-year-old.It Is Not Just About SexWhile the idea of three-hour erections may sound like a punchline, Johnson is pretty serious about it. "Nighttime erections," he explains, "are a strong biomarker of cardiovascular, psychological, and sexual health." These spontaneous erections during sleep can reflect a man’s overall physical and vascular health.What is interesting to see is that he also maintains that Cialis itself is unlikely to be the sole driver of his sexual function improvements. While the drug is FDA-approved to treat erectile dysfunction, Johnson says it mainly supports long-term health. His claims are that it helps with improved heart function, cognitive health, and reduced urinary symptoms in men. The Therapy ProtocolIn order to push his results further, Johnson also turned to shockwave therapy. This is a treatment that involves acoustic pulses delivered via a wand to the penis. The shocks cause micro-injuries that stimulate blood flow and tissue repair - not unlike how muscles grow after a workout. However, it is not a spa day. Johnson rated that the pain is 7 on a scale of 10. When it is "at the tip", the pain goes up to 9 on a scale of 10. Alongside the shockwaves, Johnson began Botox injections, which might sound bizarre but are backed by emerging science. Botox, typically used to reduce facial wrinkles, is thought to relax the smooth muscle in blood vessel walls, allowing more blood flow and potentially firmer erections.ALSO READ: The Longevity Diet: Bryan Johnson Eats 3 Meals In 6 Hours—With Extra Virgin Olive OilWhat Are The Results Like?After three months on this combined protocol, Johnson says his nighttime erections rose from 2 hours and 15 minutes to 3 hours. Despite the gains, he reportedly sleeps alone, keeps an 8:30 p.m. bedtime, and schedules sex, if at all.His larger aim? To maintain all his organs — brain, liver, teeth, even his rectum — at peak teenage condition through strict diet, 111 daily supplements, and intensive routines.While Johnson’s methods are extreme, he hopes they help reduce stigma. “Men, if you’re not performing how you’d like, there are many paths to improvement,” he said. “There’s no shame in this — in fact, it will make you more of a man to address it head-on.”