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23 The anti- androgenic effects are achieved through several mechanisms 1 competition with testosterone and DHT for androgen receptors, thereby decreasing androgen- stimulated sebum production; 2 inhibition of androgen synthesis decreasing type 2 17B- HSD, thereby halting the conversion of androstenedione to testosterone; 3 inhibition of 5О±- reductase, thus halting the conversion of testosterone to DHT; and 4 increasing the level of SHBG alternatives to tamoxifen In Structural Heart, Vol
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