I ad a complete hysterectomy at 50. For 15 years I lived in misery. I couldn't sleep, brain fog, no energy and general malaise while on Premarin and then patches. I started using a combination troche at 65. I'm now 75 and my life is sweet. I sleep well, am very physically active and brain fog is gone. I lost 15 years of my life on Premarin and patches because they aren't geared specifically for me and my body, as my combination troche is. If it is taken away and I have to go back to those "one fits all," commercial hormonal therapies, the quality of my life is greatly diminished and basically is over as I know it