In terms of estrogen exposure, how do transdermal patches compare with combined oral contraceptives?

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Transdermal patches deliver estrogen directly into the bloodstream, bypassing the liver on first pass. Because of this, the systemic bioavailability of estrogen from the patch is higher than that from typical combined oral contraceptives, which undergo hepatic first-pass metabolism that reduces how much estrogen reaches systemic circulation. The patch also provides a steady, consistent release over a week, contributing to higher overall estrogen exposure per cycle. So, in terms of estrogen exposure, the patch results in greater exposure than the pill.