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Stress: While sex can be a stress reliever for some, for others, factors surrounding sex (like performance anxiety, relationship stress, or fear of pregnancy/STIs) can cause stress

This is why growth hormone therapy requires monitoring blood sugar and sometimes necessitates diabetes medication adjustments

These tics usually occur in adults but are phenomenologically similar to the childhood-onset tics associated with Tourette syndrome, even associated with a sensory urge prior to the movement

QJM 95 (10), 677683

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Four things then need to happen in sequence