Cialis is a great first step with mild BPH, ED and LUTS. Ton's of studies on it. I've attached two but there are many. At what point is it considered? To me it would be based on blood work and conversations with your doctor. That said, I personally recommend Cialis for any older adult due to it's many health benefits as noted above along with it's originally intended purpose.
When it comes to the combination of Cialis and Doxazosin. Doxy is an Alpha-Blocker, meaning it's a smooth muscle relaxer. The prostate is smooth muscle as is the penis. So, the combination of the two drugs works synergistically for enhanced benefits. Unfortunately, not many doctors other than Uro's (or so it seems) are up on this tactic.
I've been on both for years at 5 mg Cialis x 2 and Doxy at 1 mg x 2 per day.
I'm curious where your DHT level normally is when on TRT and what your TRT protocol is?
https://www.ncbi.nlm.nih.gov/pubmed/25083163
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826864/
https://onlinelibrary.wiley.com/doi/...rol.111.013185