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This CNS-mediated pro-sexual mechanism is mechanistically upstream of, and independent from, the nitric oxide/cGMP/PDE5 pathway targeted by sildenafil (Viagra), tadalafil (Cialis), and other PDE5 inhibitors which act at the vascular/penile smooth muscle level as downstream effectors of a pre-existing arousal signal

References Ho, C

Central amplification and fibromyalgia: Disorder of pain processing

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