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Lastly, despite PDE5i treatment has been proven a cost-effective therapeutic strategy, compared to no treatment [62], the relatively high cost of a chronic treatment with some reference/equivalent pharmaceutical formulations belonging to this category of drugs might still represent a limitation for patients with economic constraints, by contributing to treatment discontinuation

doi: 10.1136/bmj.l4897

an acidic pH can impair sperm function

Additionally, epigenetic regulation through DNA methylation and histone modifications may underlie increased long-term susceptibility to changes in bone and BMAT (193)

Greenberg, D