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"Critically, when dysfunction is driven primarily by psychosocial factors, such as relationship distress, pharmacotherapy (medication) alone is unlikely to succeed." In his own practice, Balazs reported seeing "both ends," although most of his patients have improved sex lives

, which involved healthy test subjects aged 21-61 and followed a randomized, placebo-controlled, double-blind, ascending dose design [16]
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But people with severe liver disease, like decompensated cirrhosis, were excluded from trials

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