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Intracellular cGMP is hydrolyzed by PDEs, terminating their action. PDEs are a diverse family of enzymes with different tissue distributions and functions, but all exert their effect by lowering intracellular cyclic nucleotide levels. "In some cases producing counterfeit medicine can be ten times as profitable per kilogram as heroin, yet in the UK someone can face greater legal sanctions if they produce a counterfeit T-shirt. If the veins in the penis cannot prevent blood from leaving the penis during an erection, an erection cannot be maintained. This condition is known as a venous leak. Venous leakage may occur with vascular disease, but it also can occur as a result of poor muscle relaxation of the penis. Difficulty with smooth muscle relaxation of the penis can occur with diabetes or with Peyronie's disease, a condition that results in the buildup of scar tissue of the sheath (tunica albuginea) surrounding the erection tissue (corpora cavernosa). Venous leak also can occur when neurological diseases or high levels of anxiety are present because these conditions can prevent adequate smooth muscle relaxation. Orgasm Exposure to high levels of a controversial chemical found in thousands of everyday plastic products appears to cause erectile dysfunction and other sexual problems in men, according to a new study published Wednesday. Treatment Oral therapy The end result: The couple can stop communicating altogether -- not only in the bedroom, but in all aspects of their relationship. And that, say experts, can only make problems worse for both partners. Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed. "Before I would put my money in a vaccine, I would want to think about some of the dietary things people can do," Mason added. Precautions A. Patients typically achieve an erection within 20 minutes. The erection can last between 30 and 90 minutes, becoming more rigid with sexual stimulation. However, the erection does not always disappear immediately after ejaculation. If too much of the drug has been administered, priapism - an unwanted, prolonged erection that lasts for longer than three or four hours - can develop. This painful and dangerous medical condition is named for Priapus, the Greek god of procreation. It can lead to the destruction of erectile tissue if left untreated. Thankfully, this serious condition can be reversed by injecting an adrenaline-like drug into the penis. Androgens The largest published trial of sildenafil evaluated efficacy based on the previously validated International Index of Erectile Function.21 In 312 men receiving sildenafil, mean scores for the frequency of penetration and maintenance of erections after penetration increased significantly.17 A clinically significant dose-response relationship was also demonstrated: erection appropriate for intercourse was attained in 72 percent of the men receiving 25 mg, 80 percent of those receiving 50 mg, and 85 percent of men those given 100 mg of sildenafil.17 The head (glans), located at the end of the shaft. Within the past years many medical practitioners have instigated recommending it over the artificial drugs because of its higher safety and the dearth of unpleasant effects. Things to Consider  Continuing research viagra no prescription Given the relatively high rate of prolonged erection or priapism with this form of alprostadil, prescribing physicians should be aware of appropriate management of these conditions. This includes aspiration of the corpora, followed by intracavernous injection with an alpha-adrenergic agonist such as phenylephrine (Neo-Synephrine). Surgery is occasionally necessary. Sildenafil (Viagra), whose labeling was approved by the U.S. Food and Drug Administration (FDA) in March 1998, is the first oral medication to be marketed for the treatment of erectile dysfunction. Sildenafil inhibits the conversion of cGMP to guanosine monophosphate in the corpus cavernosum, thereby increasing the available concentration of cGMP. This reaction is largely catalyzed by the enzyme phosphodiesterase type 5. Sildenafil inhibits this enzyme, resulting in relaxation of the cavernosal smooth muscle.17 Sildenafil is absorbed rapidly, with peak plasma levels achieved within an hour. It undergoes hepatic metabolism and has a half-life of about four hours.