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Conservative avoidance deserves serious consideration in this group

Small variations in raw material sourcing, extraction conditions or storage can lead to measurable differences in finished product composition

Experimental studies have led to the identification of various cancer cell-intrinsic resistance mechanisms, e.g., activation and/or overexpression of drug transporter proteins (e.g., P-glycoprotein), altered expression of detoxifying enzymes (e.g., glutathione S-transferase) or resistance to apoptosis/senescence pathways [239-242]

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Assessment: subjective sexual responses (Female Sexual Function Index), physiological markers, side effects