About 20 years ago I started to go through pre-menopausal change. My M.D had me take pills specifically for this. However, I can't remember the name right now. When I started the medicine it affected me terriblly. I thought I was having a nervous breakdown, I couldn't sleep, anxious etc. I really went into a tailspin. I just happened to read a book on hormone replacement and discovered that the medicine she gave me caused these symptoms. So I immediately discontinued. I read about a more natural protocol and starting researching. I found a doctor who was a hormone specialist. She got me started right away on a different path. After that I didn't have any adverse affects and I've been using the cream for years. Not everyone can take medicines that a M.D prescribes. One pill doesn't fit all. Every woman's body is different and you have to know your body.