Viagra and the Battle Between PDE5 and cGMP

Viagra is designed to temporarily improve blood flow to the penis in men whose arteries have become clogged with fatty plaque or are otherwise constricted. Too much of a substance called PDE-5 can cause problems with blood flow – problems Viagra addresses directly.

The key to robust erectile function is strong blood flow to the penis. So it’s hardly surprising that the biggest obstacles to getting and keeping an erection suitable for intercourse are any physical factors that compromise penile blood flow.

Among such factors are the buildup of fatty gunk on the inner walls of arteries, dysfunction of the smooth muscle cells that allow normal relaxation and constriction of arteries, and nerve damage that disrupts normal nervous system communications.

Viagra Was First PDE5 Inhibitor

Viagra, Pfizer’s pioneering answer to blood flow-related erectile dysfunction, was the first of a family of drugs known as PDE5 inhibitors. They are so called because they temporarily disable an enzyme known as phosphodiesterase-5, which has among its primary tasks the breakdown of a substance known as cyclic guanosine monophosphate, or cGMP.

It’s cGMP, the good guy, that signals the smooth muscle cells lining the interior walls of arteries to relax. As they relax, the blood vessels expand and can then carry a greater volume of blood, a flow robust enough to support erectile function.

In men with no vascular problems, the breakdown of cGMP by PDE5 isn’t a significant problem, because the body quickly produces more cGMP to take the place of that broken down by the PDE5 enzyme. However, in men with blood flow problems, PDE5 breaks down the good guy faster than the body can replace it. By temporarily holding PDE5 at bay, Viagra and the other PDE5 inhibitors allow cGMP to keep arteries expanded to handle the increased blood flow need to achieve and sustain erection.

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