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Cialis is an effective, reversible, selective inhibitor of phosphodiesterase type 5 (PDE 5) specific to cyclic guanosine monophosphate (cGMP). When sexual stimulation causes local release of nitric oxide, inhibition of PDE 5 by Cialis leads to increase of cGMP levels in the cavernous body of penis. It results in relaxation of arterial smooth muscles and blood flow to the tissues of the penis that causes erections. Cialis has no effect when sexual stimulation is absent. Cialis improves erection and lets achieve a successful sexual intercourse. The drug acts during 36 hours. If sexual arousal is present the effect appears even after 16 minutes after the medication was taken.Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. tentex royal vs viagra The study was conducted by Laura Berman, director of the Berman Center and a professor of OB-GYN and psychiatry at Northwestern University in Chicago, and Dr. Jennifer Berman, director of the Female Sexual Medicine Center at UCLA Medical Center in Los Angeles. The researchers say that the results are preliminary. voice changessore throat and discomfort when swallowing

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