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The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.PHOTOS: S&M movie scenes

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A man needs to be sexually aroused for the medication to work. It does not provide an instant erection without stimulation.

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