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Estradiol sulfamate is a synthetic steroid, specifically a C3 sulfamate ester of estradiol. It was initially conceived as an orally active prodrug of estradiol, designed to achieve higher systemic and reduced hepatic estrogenic activity compared to direct estradiol administration. While it can accumulate in erythrocytes and undergo systemic hydrolysis to release estradiol, subsequent research, particularly in humans, has revealed its potent steroid sulfatase (STS) inhibitory activity. This inhibition prevents the conversion of inactive steroid sulfates into active estrogens, including its own bioactivation into estradiol, thereby effectively abolishing its estrogenic activity in humans and leading to anti-estrogenic effects in certain tissues. It has been investigated for applications in hormone replacement therapy, fertility control, and endometriosis.
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