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dihydrolevonorgestrel dhlng active metabolite progestin levonorgestrel 5a-reductase progesterone receptor progestogenic antiprogestogenic selective receptor modulator androgen androgenic rendering hormone hormonal therapy replacement function action endocrine level prohormone analogue metabolism biosynthesis cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme endogenous contractor human metabolome database hmdb steroid steroidal