This is EXACTLY the question I have been trying to find the answer to myself! Jasper, thank you from bringing this up.
I have been on a 25 mcg patch and 100mg Utrogestan (vaginally for 14 days of the month) I only started HRT on 26th July.
Things were going okay, until last Thursday when I started my Utrogestan. All of a sudden I couldn't fall asleep or stay asleep. I had my FSH, estradiol and progesterone levels tested on day 21 of my cycle.
Given my symptoms, I was expecting progesterone dominance to be the problem. I've searched high and low for what exactly is the 'optimum' ratio between progesterone and estrogen. I only found one website that discussed it in detail and the consensus was that the P/E2 Ration should be 100-500.
My ratio was only 77 so that theory went out the window. If this ratio is to be believed, most of us on here are pretty much stuffed aren't we??
I've read both of Doctor Elizabeth Vliet's books from cover to cover and while she discussed ratios, she didn't actually provide an optimal figure. What I DID glean from her book though, was that while my estradiol blood levels were 'acceptable' (IE: Above 100 pg/ml), they were probably not optimal. I upped my patch to 37.5 and in the last couple of nights my sleep has improved.
I'm afraid I'm very cynical about why naturopaths, and the like, talk about estrogen dominance. Basically proper estrogen (as opposed to phytoestrogens) are prescription only, so therefore they can't sell them to you. However, progesterone creams are very easily obtainable, and can even be bought over the counter, and these alternative practitioners make most of their money by selling you stuff.
Dana, I think you're right. I think that maybe this 'magical P/E2' ratio figure is probably touted by the progesterone-cream pushers. At least that is what by body is telling me.