I did quite well on it for the first 3 months, the second 3 months not so good - increased anxiety and palpitations etc. I was changed to 1mg Climagest and that was no better. In the end I came off HRT and haven't looked back.
There is a huge wealth of clinical data and patient experience with Prempak but as we are all so different, we have differing needs and even then, what we need one month may not be the same the following months. It really is a 'suck it and see' approach. Give it a try for 3 months. If you are fine, stick with it, if not, change type (oestradiol/oestradiol valerate), route of administration (patch/gel/Estring/Mirena etc)) or try other therapies like herbs/acupuncture.
At the moment, I am settled on Menopace Plus, 1000mg Starflower Oil, 1000mg Vit C,and an extra 250mg Magnesium Citrate. I have my ups and downs but on the whole, am better than when I was on HRT.
Good luck
Galadriel x
P.S. I anticipate things will change for me so maybe I might give patches/gel a try... who knows