I had to have a hysterectomy at age 50. I first tried the patch, but had to keep increasing the dose every year. I then tried the estrogen pill but did not care for the accompanying nausea and it did not take care of all of my postmenopausal symptoms. I tried the troches, based on my lab results and levels, and BINGO! What a difference! I eventually got tired of the goopy troche and switched to the quick dissolve formulation and have been on them ever since. I can't imagine having to try something else, since these are compounded based on MY own hormone levels, not some standard dose that is given out to anyone.