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Nitric oxide radical is one of the local factors involved in ovarian follicullogeneis and steroidogenesis

This is risky for several reasons: Wrong patient selection, such as people with pancreatitis, gallstones, or severe kidney disease using them without screening Rapid, unsupervised dose escalation No monitoring of kidney, liver, pancreatic, or eye status Complications seen with unsupervised use include pancreatitis, dehydration-induced acute kidney injury (especially in hot Indian summers with vomiting or diarrhoea), and even diabetic ketoacidosis in susceptible individuals

The evidence bases are comparable in quality and scale, with both lacking large-scale randomized therapeutic trials

doi: 10.1210/en.2019-00450 199 FrssingSNylanderMChabanovaEFrystykJHolstJJKistorpCet al

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The Honest Answer At normal therapeutic doses, supervised by a qualified doctor, with branded pharmaceutical-grade vials, the safety profile is reasonable