This document summarizes how erections occur through the nitric oxide pathway and how ginseng and Viagra can affect this pathway. Nitric oxide binds to guanylyl cyclase, which produces cGMP, activating PKG and lowering calcium levels to cause muscle relaxation and erection. Ginseng increases nitric oxide production to enhance the pathway. Viagra inhibits PDE5 from breaking down cGMP, also increasing its levels and further activating the pathway. If neither work, a problem with PKG itself may be disrupting the process.