Sildenafil citrate works by increasing blood flow to the penis during sexual stimulation, helping men achieve and maintain an erection. It does this by inhibiting the enzyme phosphodiesterase type 5 (PDE5), which is responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the penis. This leads to relaxation of the smooth muscle and dilation of the blood vessels, allowing for increased blood flow into the penis and the subsequent erection.
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