If it's of any help, here is what I'm aiming for.
I had a TAH-BSO in 1997. I took oestrogen (Premarin as far as I recall) and all was well until about 2003 when my new GP refused to prescribe it because she was spooked by the flawed millennial studies. I was about 53/54 then, and eventually things started to go downhill, mainly with joint pain, but other things as well. I developed (or should I say, became aware of) VA a couple of years ago. I was interested in restarting systemic HRT to help with the VA and also to prevent osteoporosis, which my mother had. I was refused initially because of my age, which was 67 then. However, I was eventually given Tibolone, and also got a referral to the Chelsea & Westminster menopause clinic. They ditched the Tibolone and gave me Oestrogel and Vagifem, and also ordered a Dexascan which revealed osteopaenia.
On 2 pumps of Oestrogel I achieved only 89pmol/l, and on 3 pumps still <100 pmol/l. I was switched to Sandrena, 2 x 1mg sachets per day and had a slight improvement reaching 140 pmol. What I am aiming for is 200-250 pmol/l to prevent osteoporosis. It is also thought that if I can get my oestradiol levels beyond subtherapeutic, this will improve the VA. I am now using 125 mcg Estradot patches, and will get another hormone profile done in April.
My local oestrogen regime is the Estring plus daily Vagifem. I would like to add Ovestin for external use, but it usually makes me itch and last time I used it I had an allergic reaction of itching and swelling. So that one's on the back burner for the moment.
Since I have been back on systemic oestrogen, my joints have improved a lot. Mood is also generally better, with little anxiety these days, and sleep is much improved. Stamina is up and down. VA still bothersome, although better than it was. The urinary side of things is better but not perfect. Vulva still sore although I do have a few good days now.
At some stage testosterone was added to the mix, but it is hard to say how much difference this has made. It was prescribed to improve stamina.
So TC, I guess it's all a question of finding the right regime. I will have fingers and everything else crossed for you and hope your new one gives the desired results!
JP x