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Transdermal estradiol, delivered through patches or gels rather than oral tablets, bypasses the liver entirely, avoiding the first-pass hepatic metabolism that oral estrogen undergoes and that is associated with increased clotting factor production and thrombotic risk

This method allows one to adapt slowly to the substance and reduce the likelihood of adverse reactions and maximize the potential benefits

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Government-insured patients may use this program if they self pay and process outside of their insurance

Biochem Eng J 41(3):234240