Due to an autoimmune issue, I hit menopause like a wall when I turned 45. At first, I thought the menopause symptoms were just a new part of my autoimmune struggles. After my ob/GYN did blood testing, we decided on a (not bio-identical) hormonal patch, which did little to alleviate symptoms. After 6 months on the patch, I developed a melanoma about 6 inches from the patch site. I started researching and decided to try bio-identical hormone replacement instead. These have alleviated my symptoms (hot flashes every 5 minutes, debilitating panic attacks, and night sweats). Honestly, I had no idea how miserable menopause could be, and how it could affect every aspect of life. I wish I had started with bio identically and avoided the suffering I endured for several years before starting. Truly a lifesaver.