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Moreover, hypertension and other comorbidities may further compound testosterone-driven impairments in erectile function [58]

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Using several hormones in low doses and incorporating lifestyle interventions might maximize the clinical effect while minimizing the side effects. Clearly, many patients would find daily injections of hormones preferable to undergoing bariatric surgery, even if these injections would need to be continued in the long-term to keep the weight off

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This might contribute to feelings of tiredness as your body experiences a caloric deficit