It happened very quickly. All of a sudden the hot flashes started. I couldn't sleep therefore everything else started to suffer - my work, my family, my marriage. My doctor prescribed bio-identical hormones from a compounding pharmacy and within a few days, I was my old self again. I can't imagine living without them. It took a few tries to get the dose exactly right, which we were able to do because we were working with the compounding pharmacy. If I had to buy an "off-the-shelf" product, it would not have been individualized for me.