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The GIP receptor activation appears to reduce nausea compared to pure GLP-1 agonists, which is why retatrutide shows a 28% nausea rate versus 44% for semaglutide despite being more potent

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This dysfunction is further exacerbated by the decreased expression and activity of both nNOS and eNOS, leading to impaired neurovascular regulation of penile erection [31,32,33]