My liver cannot process estrogen (I have all DNA genetic documentation to prove this). It also cannot handle over 300 prescription medicines. So, compounded estrogen cream has tamed, although not eliminated, my hot flashes over the past 10 years. My mother and my sisters suffer from severe hot flashes for over 20 or more years. This is not normal but it is our pattern. My life would be miserable without the relief I get from compounded estrogen cream. I have tried to go off of it but nothing else gives me relief.