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When PDE5 is blocked, cGMP levels increase, leading to the relaxation of smooth muscle cells in blood vessels. This increases blood flow, which can help treat conditions like erectile dysfunction and pulmonary hypertension. PDE5 inhibitors improve symptoms of erectile dysfunction (ED) by preventing the breakdown of a substance called cyclic GMP (cGMP). CGMP acts as a vasodilator, which means it relaxes smooth muscle and widens blood vessels allowing more blood flow into tissue. This also increases blood flow into the corpus cavernosum