Hi Kathleen - I have just caught sight of your post (bit busy at the mo'!)and wanted to reply to wish you well. I've followed your story over the past few years (?) and know you have tried different combinations of HRT without complete success. I also know you started HRT fairly late on in post-meno after putting up with symptoms for some time and I can't remember whether you have ever tried to go back to a cycle? I'm sure I will have suggested this in the past. Only then will you know whether any of your symptoms eg the shakes, and continued flushes are partly due to taking progestogens continuously. There is always a downside and HRT doesn't come without some drawbacks for those of us who still have a uterus - either have progestogens continuously or put up with a bleed.
You may be familiar with what I chose to do - starting HRT a bit earlier than you (almost 54) - but because I wasn't post-menopausal was fortunate to be prescribed a cyclical HRT so was able to reap the benefits of oestrogen only from the start and experience a complete elimination of flushes (with only intermittent protgesterone) - this was on 50 mcg Estradot - and if you're going to use patches then these are the ones! I decided to maintain a cycle and now in mid 60's still have a bleed - but because my dose of oestrogen is not high, and there are no problems with my womb so far ( apart from small fibroid) I am able to have a long cycle (for the past 6-7 years).
Of course you need to make sure you have no other health problems but all being well you should be able to find a regime that eliminates the flushes and doesn't cause the shakes etc.
In your position I would firstly want to have a scan to check on my womb lining after being on Tibolone, and if it was thin enough - to start a cylical HRT - ideally oestrogen only for say 6 weeks and see how you felt - and from then on taking a progestogen cyclically (eg vag Utro) - but that means having a withdrawal bleed. If you went down this route you might have to start with a conventional length cycle to see how your womb lining behaved - and gradually extending it if possible.
I am sure others have suggested a Mirena coil before and can;t remember if you have considered this route? There is some systemic absorption but at least you could then go higher with your oestrogen knowing the womb was protected.
Just a few thoughts and I'm sure I've said them before - but hopefully it is helpful now too?
AS always you should be able to get the right treatment from your GP but it is a question of trial and error and finding what works for you - but sometimes also making a compromise - what you are prepared to put up with (ie bleed vs potential prog side effects) to feel as well as you can.
Ramble ramble - sorry - it's late - but wanted to post to you - all the best
Hurdity x
