I am a professional urologist and to make things clear I would like to explain the mechanism of male erection. Erection takes place when blood flows into the penis, provided the penis valves prevent the blood from flowing back during the erection. The blood flow into the penis starts as soon as the brain pulses a signal, which is delivered by nerves to penis blood vessels. Therefore, any obstacle on the way from the brain to the penis valves may result in erection failure. This occurs pretty often and is known as erectile dysfunction. The causes of erectile dysfunction are numerous; among them is diabetes, hypertension, valve defects, low testosterone level, atherosclerosis, psychiatric disorders and many others. Every case is individual of course, but treatment of any kind of erectile dysfunction starts with oral medications. Contemporary medical market swarms with various pills and as a urologist, I have witnessed many of them in action. And I must say that Cialis Super Active+ astonished me, so effective it was. This is the only medicine I warrant to be working.