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Sildenafil Citrate, the active ingredient in Cenforce 200 mg, works by inhibiting the PDE5 enzyme. PDE5 typically breaks down cyclic guanosine monophosphate (cGMP), a substance that helps relax the blood vessels in the penis. By blocking PDE5, Cenforce helps maintain higher levels of cGMP, promoting increased blood flow to the penis. This enhanced blood flow helps men with ED achieve and maintain an erection when sexually aroused.