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I know that Viagra is called a PDE5 inhibitor, but I have no idea what that really means. How do drugs of that type work and, more importantly, will Viagra work for me?

Sildenafil citrate, the active ingredient in Cialis, belongs to a family of medications known collectively as PDE5 inhibitors. They are so called because they are able to temporarily sideline an enzyme known as phosphodiesterase-5, which can interfere with blood flow to the penis.

Erections originate in the brain when that organ detects feelings of sexual desire or physical stimuli to the male genitals or other erogenous zones. When the brain receives such signals, it releases a flood of nitric oxide coursing toward the pelvic region, setting off secondary chemical reactions as it goes. One of those reactions triggers the synthesis of a substance known as cyclic guanosine monophosphate or cGMP.

The cGMP, in turn, signals the smooth muscle tissue lining the arteries that supply the penis to relax, and as they do, blood flow through those vessels increases sharply. Once the spongy erectile tissue of the penis has been filled with blood, erection is achieved. To ensure that the erection lasts until sexual activity is complete, the cGMP signals the veins that carry blood away from the penis to constrict, trapping blood in the penis and sustaining the erection.

One of the primary tasks of the PDE5 enzyme is to break down cGMP, which isn’t a serious problem in men with robust vascular systems because more cGMP is created to take its place. However, in men whose vascular systems are already compromised, the PDE5 can overwhelm the cGMP and sabotage the erection. PDE5 inhibitors hold the PDE5 enzyme at bay for four to 36 hours, allowing a window of opportunity for an erection to occur and sexual activity to be completed.

As previously noted, Viagra and the other PDE5 inhibitors are designed primarily to help men suffering from erectile dysfunction caused by insufficient blood flow to the penis, the single largest cause of ED. If your symptoms of ED are psychological in origin or caused by traumatic or congenital damage to your genitals, Viagra might be of little help.

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