I was on bioidentical hormone crème for 20 years with good results for menopause…no symptoms. I went on pellet therapy 8 months ago on a low dose…there are 10 levels. My integrative medicine dr does bloodwork every three months. I am doing this for my bones but I have to say I feel more mental clarity and energy. I will post my dexa results in Feb. I will not go on a higher dose. Now I am on 67 and the average dosing is 100. My blood levels are good at this time. If you choose this path please use a reputable integrative medical doctor with a lot of experience. Dr Erika Swartz in NYC is an expert in the field. In Philadelphia De Anthony Bazzan at Jefferson is excellent. Both are published and highly regarded. One thing to keep in mind is that big pharma gets nothing from bioidentical hormones so it is not approved. $$$$