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segesterone steroidal progestin 19-norprogesterone acetate ester metabolite segesterone acetate sga progestin medication progestogen progestogen birth control endometriosis vaginal ring implant synthetic subcutaneous pellet progesterone receptor glucocorticoid contraceptive ovulation-inhibiting endometrial transformation rendering contraception hormonal contraceptives gynecology obstetrics woman female sex hormone gynecological conditions hormonal therapy replacement function endocrine endocrinology level prohormone molecule molecular formula skeletal structural