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One participant, age 41, reported that adding box breathing (4 seconds in, 4 hold, 4 out) before PFMT sessions noticeably improved his ability to feel the contraction and maintain erection qualitya correlation that makes physiological sense given the role of parasympathetic tone in erections

There were evidenced-based studies cited that showed that combination treatment is more effective than monotherapy with the combination of hydroquinone 4%, tretinoin 0.05%, and fluocinolone acetonide 0.01% or other variations

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