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Thyroid Hormones : Active and secondhand smoke have been linked to decreased levels of thyroid-stimulating hormone (TSH), posing risks for thyroid-related disorders and impacting metabolism regulation

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Although ED is often underreported in African countries due to cultural stigma, lack of awareness, and limited data, its estimated rate of occurrence in Sub-Saharan Africa and different African countries are shown in Table 1 below: Table 1: showing prevalence of erectile dysfunction in some African countries and in the sub-Saharan Africa region