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10.1016/S0955-2863(99)00033-9 31 MorettiP.PetersS

Furthermore, it regulated the expression of purinergic receptors (including A2A, A3, P2X4, P2X7, and P2Y1), which are recognized for their significant roles in the inflammatory response associated with DED [77]

L-carnitine also enhances blood flow and oxygen delivery to muscles, further reducing fatigue and boosting performance

The drug's mechanismworking centrally rather than peripherallyhas been suggested to potentially offer advantages for men whose ED has a psychological component, but this remains speculative without further research