For women in their later 40s, a more natural estrogen is preferred for bone prevention, whereas synthetic estrogen is acceptable for younger women needing birth control without specific contraindications.

“I still have favorite pills and — within that category, I still — have pills that I like. And historically, if you interview patients, they may be able to tell you, oh, I did well on this, you know, synthetic estrogen. So as we sort of get into the later 40s, I care more in terms of getting them back on a more natural estrogen for the reasons you mentioned in terms of bone prevention. talking to a 28-year-old woman who just needs birth control. You don't have a concern with putting her on a synthetic estrogen.”