Hi atalanta
It is difficult to find the right HRT balance - however with proper professional supervision (specialist gynae) you can have some flexibility but one often has to pay privately to do this safely. There will be some who will advice you to use Utrogestan for the progesterone and many find this very good, however it does have a sedative effect so may not be suitable for you. Being sensitive to progesterone is an issue for many women. To be honest, I don't believe we can expect to feel good every day and supplementing our bodies with hormones won't actually replicate what we made ourselves naturally so HRT will be about compromise - it controls flushes and many meno symptoms but it can't turn the clock back. Femoston does have a kinder progesterone so brings fewer side effects. The HRT combined patches have strong synthetic progesterones so may not be suitable for you if you are sensitive to these progesterones. The Mirena could be a good option for you as, after an initial settling in time, it does tend to bring fewer side effects generally and any bleeds usually stop after the first few weeks which can be a big plus - to be bleed free is great. You could try using Oestrogel which you apply each day to inner thighs and then use Provera for 10-12 days each month - you might be able to do a slightly longer cycle this way - so maybe 3-4 weeks of oestrogen only and then 12 days of Provera to induce and bleed - this is best done under the supervision of a professional with regular scans. Instead of Provera, there is Utrogestan, hailed by many as the best progesterone to use but some find the sedative effect troublesome and I found it gave me problematic bleeds and spotting. Nothing will be perfect, particularly in the peri stage.
Sadly HRT can only do so much and taking life a bit more easily, doing plenty of relaxation etc. is the way many, and certainly I, cope with the roller coaster ride that is the menopause. DG x
