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Autonomic dysfunction including bladder, bowel and sexual dysfunction, and cardiovascular dysautonomia, usually precedes motor symptoms, but become more relevant with disease progression 160

76 In postmenopausal women, daily supplementation with melatonin, at a dose of 3 mg in the morning and 5 mg in the evening for a period of six months, significantly improved overall symptoms at four and six months compared with placebo in those with constipation-predominant IBS

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