I started taking hormone replacement therapy 10 years ago. I always had hormonal issues and with perimenopause it was extreme. I had all of the rare symptoms. I had cold flashes that would last for hours. Mood swings, depression, night sweats. I was becoming a non-functional person. Using blood tests, my doctor and my compounding pharmacist create prescriptions specifically for me to get my hormones to the levels that I need to function fully. This isn't something that can be created over-the-counter or as a generic pill. The combination is needed by a compounding pharmacist. It has been a quality lifesaver for me.