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During sexual arousal, nitric oxide is released in the genital area, leading to the activation of guanylate cyclase and the production of cGMP. This, in turn, causes relaxation of the smooth muscle cells and dilation of the blood vessels, allowing more blood to flow into the erectile tissues of the clitoris. By inhibiting PDE5, sildenafil citrate helps to maintain higher levels of cGMP, prolonging the vasodilation and enhancing blood flow to the clitoris, which can result in increased sexual arousal and satisfaction.

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