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3,210 Multiple randomized controlled trials and meta-analyses have shown letrozole has a similar safety profile and is more effective than clomiphene citrate in women with PCOS

10.1016/j.metabol.2010.03.010 56

Histamine binds to receptors on small blood vessels, making vessel walls more permeable (which allows fluid to leak and form the raised wheal) and dilating the vessels (which creates the surrounding redness)