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Sulfates are the main circulating conjugates of ethinyl estradiol and glucuronides predominate in urine. The first oxidative metabolite is 2-hydroxy ethinyl estradiol, formed from the CYP3A4 isoform of cytochrome P450. Component of the very first-pass metabolism of ethinyl estradiol is thought to occur in gastrointestinal mucosa. Ethinyl estradiol