Blue Kingfisher, perhaps you could ask for the low dose coil off licence and agree to have regular uterine scans. You could offer to take responsibility for it yourself and sign a disclaimer. I would not want to start with the high dose and then have to face getting it removed if it didn't work out. I had a Mirena coil with a 50mcg patch and had over thinning of the womb lining and endless infections. I think the dose is too high for a lot of women.
In the meantime, have you tried to get hold of the Evorel patches?
Tinacros, like Blue Kingfisher said, go for it and just add the gel. That oestrogen level of 111 (pmol I assume) is way too low to do anything meaningful.
I was topping up my Angeliq oral HRT with a 50mcg patch for ages it worked very well as far as womb protection was concerned. The Angeliq ratio was 2mg progesterone and 1 mg oestrogen so no wonder it didn't work and I had to top up the oestrogen. Interestingly, the US brand of Angeliq is 0.5mg progesterone and 1mg oestrogen so it probably works much better because it's not overloaded with progesterone.
My gynaecologist and menopause doctor both agreed, if you take progesterone every day/have a progesterone coil but the dose is too low for the amount of oestrogen you are taking, you will bleed and probably a lot. This will be a sign that your ratios are wrong and obviously you will need to take action. If you don't take progesterone every day, do not have a progesterone coil and you take too much oestrogen then you may get womb lining build up.
The best way around all of this is to have a yearly scan and then you will know exactly how much progesterone you need (or establish how little you can get away with?) and you will not have to keep guessing.
Flexibility is the key to success.
