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dihydrotrengestone dhtg progestin progestogen active metabolite trengestone prodrug progestogenic 3d hormone hormonal therapy replacement function action endocrine level prohormone analogue steroid steroidal endogenous metabolism biosynthesis cycle mechanism pathway path catabolism biosynthetic intermediate biogenesis substrate precursor synthesis derivative bioprecursor metabolic enzyme human metabolome database hmdb bioactive cell biochemistry biology biomolecule