Hi Cotts,
My thoughts are that if you tolerate 200mg every day (which many women do) then I would stick with that. It sounds like the patches might be giving you more oestrogen than the gel. I would not panic about the bleeding and hopefully the scan will give you some peace of mind.
The time zone thing also bears that out since you say you would bleed due to that change. I am someone whose body is very sensitive to flying and changing time zones. We used to live in USA and it always affected my menstrual cycle when I flew. This was when I was in my thirties.
In my mid forties, I took a lot of domestic flights with work in the UK. I was guaranteed a 'period' after each one (was not on HRT then).
I think, like me, you might just be someone who is particularly sensitive to even small adjustments in the body caused by or linked to shifting hormones.
Hope the scan comes soon. X
