As the progestin is in a separate tablet, you could try changing it for another progestin?
In my experience they all give side effects, but those side effects are different for each progestin, so you might feel the difference and get your answer that way?
I'm assuming that it's provera because that is what they seem to give everyone where I live.
It's very cheap and very nasty for some, about 15% of women report intolerance to it.
My friend takes it every day and has no problem with it. I tried it and thought I was close to dying for the twelve days and a few more after it! It basically gives me flu symptoms plus the worst dread and feelings of worthlessness, it's awful, I had to take time off work to recover from it.
My GP persuaded me to try it a second month. I wasn't keen, so I halved the dose from 10mg to 5mg without telling her, exactly the same thing happened, so I gave it up before finishing those twelve days.
My GP has informed me that I don't react to progestins in HRT because they are at too low of a dose for anyone to react to!
I'm apparently imagining it because I reacted to oral contraceptives (she believes that, different doses) and she thinks I'm confused between the two or something. She says women simply don't react to HRT the way I describe it to her, if only it were that simple! She ought to read this forum. I'd guess she's 40, so it's coming to her soon enough, maybe then she'll understand.
Tibolone is a progestin (says wikipedia, derived from norethisterone) that is well known for being tolerated by ladies who cannot tolerate other progestins, including norethisterone, just like me. In Spain it seems tibolone can be used as the progestin part alongside oestrogen, but not in the UK, as it's not proven to work, just ought to work in theory.
Utrogestan isn't proven to work either, just ought to work in theory, but I'm allowed oestrogen if I take utrogestan.
I'm intolerant to all of them I've tried, except tibolone. I asked at the HRT clinic if I could use tibolone as my progestin and it was a flat, no. I can use utrogestan (so what if it makes me ill or suicidal, that's all in my head and they don't care about it even slightly).
So I take tibolone which makes me feel better motivated and takes away anxiety, but does nothing to stop any overheating symptom and I'm soaking at night as well as flushing sweatily during the day since starting 2.5mg tibolone and having to give up 3 daily pumps of oestrogel as a trade off two weeks ago.
I wonder why women in the UK aren't allowed both, the way women in Spain are?
It's not advice, just how I react and it's very very real, if you are intolerant there really isn't much like it to confuse it with, trying to switch to another progestin ought to tell you if it's causing those unpleasant side effects.
I find duloxetine ineffective and fluoxetine great btw, switching about your SSRI might help too because they can stop working after a while.
Our GPs also are only doing phonecalls and no prior appointments, they'll only phone back on a day you phoned them first.
There are no exceptions for people who want a face to face, you only get that if the doctor decides to see you after the phonecall.
I think it's easier for the GPs to dismiss what you are saying and forget about you when it's only a phonecall. I've not been invited into the surgery in person since before the pandemic, I agree it's unsatisfactory.