I take vagifem. It definitely needs a 2 week loading. In some places, I have read that it needs a further 2 weeks alternate days, before you go on twice a week.
I have never got to twice a week. I seem to need 3. My prescriptions say 'one or two twice weekly' and they do keep supplying the repeats, so no problem there.
I have GP troubles too. I decided to try full hrt because of aching joints. I went to the female GP who I had been recommended previously for womens issues but had not been able to see (the one who sorted this out in the end had left). She gave me Elleste duet and did not ask about periods or anything, gave me a speech about it being restricted to 5 years or I would be at risk of breast cancer, and I was out the door. I am not sure I even got the full 10 minutes
I have since seen someone else who may not be an 'expert' but is prepared to look it up and think it through and tell me why. I changed to femeston because I do not like the progestogen in elleste - I have had it previously in a contraceptive pill. So far so good, and it does help with the bladder issues too which the vagifem does not fully address.
My surgery has a lot of gps, but they only seem to be available every 3 weeks. They also seem to stick to protocols like glue, probably to give more continuity between doctors. I am hoping the new NICE guidelines will be less prescriptive when they come out next year and my gps will take note.