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[24] [25] This effect may potentially result from increased sympathetic nervous system activity, effects on cardiac pacemaker cells, or compensatory responses to vasodilation and reduced blood pressure, though these mechanisms remain hypothetical

The honest reading of the literature is that response, where it has been reported in small studies, is gradual, variable between individuals, dependent on formulation, and often confounded by the presence of other actives

11.Wharton S, Freitas P, Hjelmesth J, et al

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A denial often comes down to the indication and your plans rules

Likewise, the hydrogel device Plenity is contraindicated