I use utrogestan vaginally, not orally. I also use testosterone. My T was prescribed 6 months after I started the gel and Utro. It is usual that consultants or GP's want the gel and utro to be settled and working before they introduce testosterone. Luckily I do not have to use vagifem, I thank my lucky stars I have avoided VA altogether.
I had an absolutely horrendous time in peri and meno. My anxiety and aches and pains in particular went unregulated for about 5 years or more even though I was on hrt at the time because it was the wrong hrt for me both in the type and the dose. It took 6 goes at different hrt to find the right combo for me which was gel and utro and then after I had started that a full 5 months before I settled into "feeling better". The testosterone helped with libido, brain fog, energy, the rest such as insomnia, anxiety (off the chart type!) panic attacks, flushes, aches so bad I was diagnosed with fibromyalgia!, acid reflux, headaches were all sorted with the gel and the Utro. I am prone to depression so I use the Utro on a cycle, have a bleed even though I am 57 to keep it to a minimum.