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Long-term use of metformin, a drug commonly prescribed for type 2 diabetes, is strongly associated with vitamin B12 deficiency and lower folic acid levels as it can block absorption, which may lead to increased homocysteine levels and risk for cardiovascular disease

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Pelvic floor muscle dysfunction may manifest as high resting urethral pressure, functional bladder outlet obstruction due to poor relaxation of the sphincter associated with pain-induced pelvic floor muscle dysfunction, and poor contractility due to bladder inhibition from non-relaxing pelvic floor muscles