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Research indicates that this complex can influence gene expression related to collagen production, extracellular matrix remodeling, and angiogenesis-associated signaling

Other established ED treatments include: Vacuum erection devices Intracavernosal injections (alprostadil) Intraurethral alprostadil Testosterone replacement (for confirmed hypogonadism) Psychosexual therapy Penile prosthesis surgery (for refractory cases) All of these options have defined roles in ED management and are supported by clinical evidence

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Bloating affects 2-5% of users but typically normalizes within the first week