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An additional consideration is that the IGF-3/IGF-1 ratio may be an important factor determining the level of GH stimulation [3]

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Pearce EN, Farwell AP, Braverman LE

But bremelanotide might be insufficient alone for a man with complete neurogenic ED (e.g., after spinal injury) where no amount of brain signal can overcome nerve damage in such cases, alprostadil injection directly into the penile tissue is more effective

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