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nilestriol nylestriol ly-49825 ethinylestriol cyclopentyl ether ee3cpe estrogen synthetic estrogen 3-cyclopentyl ethinylestriol prodrug postmenopausal osteoporosis rendering contraception birth control hormonal oral contraceptives mother gynecology obstetrics woman motherhood birth fertility fertility medicine reproduction reproductive female sex hormone menopausal hormone therapy gynecological conditions pregnancy art assisted reproductive technology infertility hormonal replacement function action endocrine endocrinology level prohormone analogue