I was forced to have a total hysterectomy just after my 40th birthday because of severe endometriosis. About two weeks after surgery, I started having severe menopausal symptoms, in particular extreme hot flashes which occurred every several minutes, night and day. Unable to take any hormones for 9-10 months after surgery, to make sure all endometrial patches not removed during surgery had dried up, I tried all the herbal remedies for relief, e.g., black cohosh, dung quai, valerian root, etc., but to no avail. The unrelenting hot flashes caused such severe sleep deprivation that I regularly experienced microsleeps, one behind the wheel while driving causing a minor accident. These microsleeps were a daily occurrence and very dangerous since I traveled about 12 miles on the highway to get to work (still do). Most disturbingly, I was having suicidal thoughts because of the sleep deprivation and the never-ending sweating and then chills which would follow. It was exhausting. By the ninth or tenth month after surgery and after extensive research on my part regarding bioidentical hormones (I have a Ph.D. in counseling psychology), I found a holistic physician who prescribed the compounded estriol and progesterone I take to this day. The relief was immediate, most notably for the hot flashes. My sleep quickly returned to normal and I ceased having dangerous microsleeps. I was never interested in the pharmaceutical hormones and have never taken them because of their side effects, the cruel animal research involved, the increased cancer risk and my sensitivity to medications. The bioidentical progesterone has been available and paid for by my employer-provided health insurance for some time now. But I can't imagine being suddenly deprived of the compounded estriol and returning to a life of such extreme exhaustion and sleep deprivation that I would consider suicide again.