I used this cream while going through menopause, it is very effective in relieving hot flashes. I do not know the effects on fertility, so I cannot attest to its effectiveness for that use. I wrote an article on the uses of progesterone cream. In use by itself, an effective supplement for peri menopause, as well as PMS. Whereby estrogen levels are usually too high. The opposite is usually true for menopause whereby the estrogen, as well as progesterone are too low. Hormones have a direct cause and effect of bone loss. The earlier the menopause, the more bone loss that can result. Hormone therapy may be necessary in cases where menopause has set in before 50. Osteo usually is more damaging to those women who are considered small framed, in that they have less bone to loose. I have also wrote an article on osteo, some supplements, and advice for this very painful disease. I hope this helps to answer your question.