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Under adequate antioxidant defense, enzymes such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) neutralize these reactive oxygen species (ROS)

That hormone then reaches the liver and muscle and prompts them to produce IGF-1, the insulin-like growth factor that carries the message forward

Regular hormone panels, semen analyses, and symptom logs let clinicians adjust doses or swap agents to target true synergy rather than additive side effects

Furthermore, two studies from Benussi et al

[6] Caution is also needed when using them with alpha-blockers and in patients with recent stroke or myocardial infarction