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10.1053/j.gastro.2012.06.036 199 TsuchidaT.FriedmanS
A: Alternatives to estradiol patches include FDA-approved transdermal gels and sprays, oral estradiol (with a different clot-risk profile), vaginal estrogen preparations for genitourinary symptoms, and compounded transdermal estradiol creams from PCAB-accredited pharmacies
Whether this decline is a cause or consequence of aging and disease remains an active area of research
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I even personally know some people who use the drug and never did I encounter a single complaint from any of them
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