Hi, it could be that your own estrogen levels have dropped and you may need to change to a higher dose, as happened to me. I was eventually, after Dr's experimenting with various hrt types, put back onto Elleste duet 1mg as I had no problems while on it, but discovered that it no longer worked so I was increased to 2mg. This has taken nearly three months for things to level out to a better stage, although not cleared the anxiety or the disturbed nights completely. The dr refuses to change anything until the three month stage, as I asked about the patches again. I get a feeling like something is stuck in my throat after taking my hrt and I also have the shakes in the morning until the hrt kicks in. Ask your Dr how you can increase your estrogen as your body has probably dropped it's production.