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These studies lead to the interesting question of why testosterone might affect blood sugar levels

doi: 10.1016/j.preteyeres.2022.101136

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[56] The inclusion of spironolactone in this formulation raises particular concerns during pregnancy, as systemic spironolactone has antiandrogenic properties and has been associated with feminization of male fetuses in animal studies, though the risk from topical application would depend on the extent of percutaneous absorption, which has not been thoroughly characterized