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Malegra FXT is a combination medication designed to treat two common sexual health concerns: erectile dysfunction (ED) and premature ejaculation (PE). Sildenafil: Sildenafil works by increasing blood flow to the penis when sexually aroused, allowing men with erectile dysfunction to achieve and maintain an erection. It works by inhibiting the PDE5 enzyme, which normally breaks down cGMP, a compound that helps relax the blood vessels in the penis.