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Erectile dysfunction (ED) is a medical condition where men have difficulty getting or maintaining an erection.
What exactly causes the issue?
The issue is caused by inadequate blood flow to the penis, which thereby prevents an erection.
Inside the shaft of the penis, there are three columns of erectile tissue: the corpus spongiosum and the two corpora cavernosa.
These columns are rich in blood vessels.
When you’re sexually stimulated, the sacral and thoracolumbar erection system centers in your central nervous system (CNS) and sends nerve and chemical impulses to the blood vessels present in corpus spongiosum and corpora cavernosa. In response, the blood vessels start secreting nitric oxide. The released nitric oxide binds to guanylate cyclase receptors (found in the walls of the blood vessels) which in turn triggers an increased production of cGMP in the local area. The cGMP molecules cause blood vessels to dilate, thus increasing blood flow to the penis. Once blood is in the penis, pressure traps it within the corpora cavernosa which subsequently causes an erection.
If any of the above systems — neuronal, hormonal or vascular — are not functioning properly, blood flow to the penis is compromised.
Sildenafil or Viagra is a common FDA-approved drug used for the treatment of erectile dysfunction. In particular, sildenafil can only treat conditions where the vascular system is not functioning properly. In other words, where the blood vessels of corpus spongiosum and corpora cavernosa may become too narrow.
How sildenafil works…
Sildenafil inhibits the activity of PDE5 enzyme which acts to breakdown cGMP molecules, thereby increasing the levels of cGMP in blood and promoting vasodilation of the blood vessels of corpus spongiosum and corpora cavernosa.
The drug does not influence or reinforce the neuronal or hormonal system in any way.
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