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However, higher doses were used in most of the studies discussed in this article

doi: 10.1371/journal.pone.0203823

Based on these previous reports and the results in this study, we consider that the decrease in MMP dissipation at high doses of PQQ might be related to decreased cellular ATP levels and the enhanced regulation of ROS relating to apoptosis 44

The prevalence of ED increases with age and is more common in older men

Indeed, the clinical literature exhibits heterogeneity in design, dosing, duration, and outcome measures, frequent reliance on parent reported scales without uniform blinding, and underpowered samples that hinder strong inference and guideline development ( in vivo studies explicitly exclude female animals to avoid potential confounding effects related to hormonal fluctuations