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A review study proposed another mechanisms underlying the potential interaction of the smoking and oestrogen metabolites such as decrease in oestrogen activity, SHBG levels, aromatase enzyme activity, C-20, 22 desmolase enzyme levels and increase in free testosterone levels, hyperandrogenism and the hepatic metabolism of steroid (Reference Ruan and Mueck41)

doi:10.1111/j.1432-1033.1990.tb15431.x