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Peripherally, it was suggested that yohimbine enhances NO release from cavernosal endothelial cells, producing a relaxation of smooth muscle cells and consequent erection, increasing sexual potency [3,6,237]. Yohimbine is a potent selective α2R antagonist with weaker α1R antagonist activity that blocks the presynaptic feedback inhibition of noradrenaline release, prolonging the excitatory effects of noradrenaline at postsynaptic α1R and β-receptors [237,238]. In fact, ginseng toxicity mainly comes from drug interactions with cytochromes P450 (CYPs) CYP3A4 and CYP2D6 inhibitors and serotoninergic drugs, intensifying sedative effects or inducing cognitive disorders or a serotonin syndrome [229,230,231]. Roman offers an at-home testosterone test you can use to determine whether your T levels are low enough to warrant treatment. Clomiphene doesn't contain any hormones, but it signals to your brain that there isn't enough testosterone in your system, leading to an increase in production. 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