The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
Malleable implants are a pair of bendable rods placed inside the penis. You manually move your penis, and therefore rods, into a position suitable for sex. Such implants do not affect penis size.

Other medicines are usually taken on demand, 30 to 60 minutes before sexual activity.
severe shortness of breath, cough with foamy mucus;ringing in your ears, or sudden hearing loss;irregular heartbeat;swelling in your hands, ankles, or feet;a seizure; or (convulsions); ora light-headed feeling, like you might pass out.