I don't really recommend doing things via your GP if you get to this stage - because they can't/won't help you beyond the max licensed dose anyway.
They can prescribe up to 100mcg patches or 4 pumps of gel, but they won't prescribe more because that's above the licensed dose. They might offer to refer you to an NHS menopause clinic, but the wait times on that can be ridiculous - like 2 years isn't unheard of.
Instead, much better to go to a private clinic like Newson Health. Pay for the initial consult and they write a letter to your GP and tell them what to prescribe so at least you get meds on the NHS.
It is also very hard to make sense of all this during peri using blood tests. Even on 50mcg patches, I didn't test below about 230pmol and my NHS GP seemed to think I should feel great with that and my symptoms couldn't possibly be due to needing more estrogen. She even said 'at some point you just have to live with the symptoms/medicate the symptoms'. (By that point I'd had an iron infusion and B12 shots. I've since trialled thyroid meds which did nothing for this.)
I'd probably literally have killed myself by now, if I had only had access to NHS "care". (In quotation marks there, because really it was NHS negligence, not care.)
On 6 pumps of gel my serum estradiol was 330pmol, which again most people would tell me should be absolutely fine and I shouldn't be experiencing this. (Tested during my period in an attempt to see what I was getting from HRT.) On 12 pumps of gel, my serum estradiol was about the same, 325pmol. So - I wasn't absorbing the extra 6 pumps of gel. Which matched my experience, since I noticed nothing (good or bad) when increasing it.
I had increased since I was on 4 pumps of gel, though. So I was getting more from 6 pumps than 4... but I couldn't get higher with gel.
By this point, I just wanted to trial and see what the heck I would feel like if I got my estradiol decently up into the 450-650 range. I mean, maybe it wouldn't do anything - but it had to be tried. It was what my Newson Health doctor said as well. So now I am going up on the patches and probably down on the gel to 6 pumps again, seeing I can't really absorb more gel than that.
Since I wrote the post above about 5 days ago, it hasn't been consistently that good - but I had another good night last night, sleeping from 1am till 6.45am right through. This is a record for me, over the last 3 years since all this began. It's not 100% right yet though. I think I am going to increase to 125 tomorrow...