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What is sildenafil Sildenafil is a selective PDE5 inhibitor developed in the 1990s to improve blood flow through vasodilation. It was initially researched for cardiovascular conditions but soon became widely used for treating erectile dysfunction (ED) due to its strong effect on penile circulation. By blocking the enzyme PDE5, sildenafil increases the level of cyclic guanosine monophosphate (cGMP) — a molecule responsible for relaxing smooth muscle cells in the vascular walls. This process a..