I also think sometimes it doesn't matter what HRT or dosage you are on you will always get ups & downs. When I first started on HRT 9 years ago I really thought it was a miracle cure for everything & maybe for some women it is. I would start a HRT & after a week or 2 if it wasn't working then increase or change always looking for that miracle. I stopped all HRT 10 months ago because of the ups & downs & realized without it I was much worse. I just restarted it 5 weeks ago & I have decided I am not going to increase or change anything for a good 3 months. I don't think it will be that miracle for me but if it keeps me on a more even keel then I will be happy. Kathleen hope you get some relief soon