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For many men, it’s enough to know that Viagra makes it possible to regain erectile function — albeit temporarily — that allows them to resume sexual activity previously impossible because they could not reliably get and keep an erection suitable for intercourse.
However, for those men who really want to know precisely how sildenafil citrate, the little blue pill’s active ingredient, accomplishes that goal, here is a brief overview of the physiological mechanisms that Viagra puts into motion.
Sets Off a Series of Chemical Reactions
Designed specifically to treat ED caused by insufficient blood flow to the penis, Viagra accomplishes this goal by triggering a cascade of chemical reactions that temporarily improve blood flow, making it easier to get and keep an erection.
Don’t pop a Viagra tablet and wait for an erection to magically appear; that process still needs to be initiated the old-fashioned way with physical stimulation to the male genitals or thoughts of sexual desire. Such mental or physical stimulation triggers the brain to send high levels of the neurotransmitter nitric oxide coursing toward the male genitals.
Blood Flow to Penis Increased
As it makes its way toward the pelvic region, nitric oxide sets off secondary and tertiary chemical reactions. One of those gives rise to a sharply increased synthesis of a substance called cyclic guanosine monophosphate, or cGMP. This substance paves the way for erection by signaling the smooth muscle tissue that lines the walls of arteries to relax, thus causing them to expand so that they are able to carry the increased volume of blood needed to achieve and sustain erection.
However, in men whose vascular function is already compromised, erectile function can be sabotaged by a pesky enzyme known as phosphodiesterase-5, or PDE5. One of the enzyme’s primary tasks is the chemical breakdown of cGMP.
In men with healthy vascular function, this presents no great problem because their bodies readily produce more cGMP to replace that broken down by PDE5.
But in males with impaired vascular function, the PDE5 enzyme breaks down cGMP faster than the body can replace it, thus making it difficult to get and/or keep an erection.
First of the PDE5 Inhibitors
Viagra was the first drug in a family of medications known as PDE5 inhibitors, so called because they temporarily sideline the PDE5 enzyme, thus allowing the erection process to proceed unimpeded. In the case of Viagra, a pill taken 30 to 60 minutes before the start of sexual activity continues to hold the PDE5 enzyme at bay for four to six hours, during which time getting an erection is much easier than it would be otherwise.
Neither Viagra nor any of the other PDE5 inhibitors offers a cure for ED. They do, however, as mentioned earlier, open up that window of time to optimize blood flow and thus support erectile function.
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