I am 49 had a hysterectomy and kept my Ovaries about 3 years ago. One year ago I started taking estrogen pills to help with hot flashes. It worked up until a few months ago. I suddenly had extreme hot flashes , exhaustion and mood swings. Past three months using gel(thought it might be better for my liver). Two pumps every morning. I feel tons better back to my normal self. One side effect my arms where I put gel are sometimes hot,pill was easier. ? Is the gel truly a lot safer, because I could go back to pill with an increased amount. .? P.s. my grandma took estrogen until she was 98 she claimed it was what kept her young. My mother is in her 70s has been taking the estrogen pill sense she was 45, says she will never stop because she feels great.