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Disease-specific evidence shows that patients with SSc complicated by ED often exhibit abnormal penile hemodynamics, including decreased peak systolic velocity (PSV), weakened flow-mediated dilation (FMD), and a decline in the cavernous artery Doppler index (55, 56), indicating that ED can be one of the manifestations of systemic vascular diseases

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What the mechanism does NOT prove: A clean cortisol fingerprint in a rat model does not confirm that ipamorelin is safe or effective for any human indication