Hi Heidi1
Sounds like your surgeon is an expert. However my understanding is that women who have had severe endometriosis might need a progestogen if taking HRT - even without a uterus - due to the possibility of it regrowing.
This is what it says on this website:
There is a small risk of reactivation of endometriosis with HRT use and any recurrence of symptoms should be reported. If a hysterectomy has been performed for endometriosis, the choice of HRT use thereafter should be influenced by the extent of endometriosis at the time of the operation. Since hysterectomy often causes a premature menopause, it is often advised to take HRT until the average age of the menopause; 51 years. HRT after hysterectomy usually consists of estrogen only. However, in the presence of endometriosis, estrogen may cause stimulation of residual deposits and consideration should be given to using continuous combined (estrogen plus daily progestogen) therapy, or tibolone, though little research has been done on the effect of different types and duration of therapy. Medical treatment of endometriosis often involves ovarian suppression which, along with ovarian removal, may increase the risk of osteoporosis. https://www.menopausematters.co.uk/atoz.phpPresumably your surgeon has weighed it up and decided you don't need it - and I presume can monitor it somehow - at least this is a question you should ask him? However you will most likely feel better without the prog so if you can avoid it then that's great. You might also want to think about testosterone replacement in your circumstances.
https://www.menopausematters.co.uk/aftermeno.php - scroll down to this:
Role of testosterone after hysterectomy
If the ovaries are removed at the time of hysterectomy, as well as the estrogen level falling, there is also a 50% decrease in testosterone production. Some doctors recommend testosterone replacement along with estrogen replacement; testosterone helping energy levels, mood and libido. However testosterone replacement does not seem to be required by all and the ideal route and dose of testosterone for women is still being researched. It is therefore not routinely recommended following removal of the ovaries but can be considered for some women who do not fully benefit from estrogen replacement alone.That's right the vaginal oestrogen should not affect the endometriosis as the dose is so low.
Hope this helps and hope you are more comfortable soon
Hurdity x