Hey robotwars
You've got quite a few transdermal oestrogen options to try still. Hopefully they won't all cause irritation. They normally don't. Here's a quick list of what's available on the NHS right now:
Gels - Oestrogel/Sandrena
Patches - Estradot, Estraderm, Evorel (these are the only ones I've been told are available, but I think there are more)
Spray - Lenzetto
I'm an unusual case and seem to be allergic to bloody everything. I've only got one left to try - Sandrena - but I'm not holding out too much hope. Estradot is the least bad option of the lot. It irritates me a bit less and is tiny compared to the other patches. One thing that does helps a bit. Nasal spray containing fluticasone propionate. Brand name Pirinase. It's available over the counter. I apply a couple of sprays one hour before placing the patch. It's still gets red and a bit itchy but much less than before and when I remove the patch the skin heals up more quickly. I can't imagine this will be sustainable for me in the long term but while I'm waiting to find a better solution it does help. I also use hydrocortisone ointment on the skin where the patch was to help it heal as quickly as possible.
One more thing that has helped me is avoiding the buttocks. Maybe I sit down too much and this makes the patch get hot and possibly release more of whatever is irritating me. I find that placing it just beneath the hip and further down my thigh causes less irritation.
After speaking to a menopause specialist at Kings College today I got her to write a letter to my GP asking her to refer me to a dermatologist for allergy testing so I can avoid whatever is causing my skin irritation in the future. My GP was very dismissive for some reason when I suggested it, but hopefully the letter from the specialist will be enough to convince her. I also wonder whether the derm might be able to suggest other ways of making my skin less reactive.
If all that fails, my next option would be pellets I suppose. I'm not crazy about the idea because apparently they have to make a new incision every six months, so you end up with lots of small scars over your abdomen. I would choose this over oral oestrogen though to avoid all the clotting risks. I am also wondering whether it's worth looking into oestrogen creams (and maybe lozenges) made by compounding pharmacies, but I'm obviously wary as I'd rather use something that's well regulated.