Hi Donna, I've been taking Macafem for around 1 year, started off with 3 tablets 2 times a day for a couple weeks and then went to 2 tablets 2 times a day. It didn't work right away for me but it did start working eventually. I think it's better to help your body make its own hormones than to replace the hormones with estrogen herbs or drugs. Recommend Macafem to all of you.