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There is no direct dose equivalence between the two compounds because they work through different receptor profiles

Side effects are mostly GI symptoms, and these are much less problematic at lower doses with slow titration

PubMed Kovalzon VM, Tsibulsky VL

12.2 Pharmacodynamics Generally, a serum estrogen concentration does not predict an individual womans therapeutic response to the Estradiol Transdermal System nor her risk for adverse outcomes