Amanda, I totally agree re the patch, I hated having it there as a constant reminder too and it often didn't stick properly which is why it didn't work. I was worried about having to wear a patch for years on end so it was a huge relief to come across Oestrogel and the fact it worked so much better was a added bonus. I am shocked that you have not been offered Oestrogel, it has been widely available for many years.
It would be helpful to have blood tests to find out how much oestrogen you are getting into your system at the moment via the patch. The fact that your oestrogen is coming from an outside source is irrelevant, you need to know how much you are getting into your system and if you had some indication, it would at least give you an idea as to how well you have been absorbing it - or not.
Because you are young, it is important to get a good dose of oestrogen into your system to protect your bones, heart and also to feel good. When I was using 3 pumps of gel everyday, my blood readings were always in the 800s (pmol) and now I have reduced to 2 pumps everyday, it is in the 700s. You need to use the gel everyday and I split my dose by using 1 pump in the morning and one in the evening - I have to keep my levels very even to prevent migraines. I also split the location by using one pump on my upper, outer arms and one pump on my upper inner thighs which has really helped with my (very mind) VA. It is very easy to use, you simply rub it on your skin and wait for it to dry which takes a couple of minutes.
My guess is that they would start you on 2 or 3 pumps of gel everyday.
Some specialists recommend oestrogen implants for younger women like yourself who have had a hysterectomy but before taking this route, you would need to know how much oestrogen you need to feel good. The gel would be a good way to find out because it is very flexible, easily absorbed and you can easily adjust the dose up or down. Again, you would need to have blood readings to establish the dose of the implant.
If you don't get any joy from your existing specialists, I suggest you find someone else. I'm a patient of Professor Studd and you might want to check out his website.
I think you would do well on the gel but please do come back with more questions if you need to.