But isn't gynecomastia the result of too much estrogen? Ketoconazole blocks desmolase that converts cholesterol to pregnenolone, which is really the starting material for adrenal steroid synthesis such as aldosterone, cortisol, testosterone, and estradiol.
My understanding is that estradiol is synthesized in ovaries by aromatase which converts testosterone to estradiol (a type of estrogen).
So if you block this pathway with ketoconazole, you wouldn't get testosterone, which is the precursor for estradiol, right?
So how do you explain gynecomastia? What am I missing here?
