It's understandable to have concerns about the spotting and heavier bleeding you've been experiencing after being period-free for four years. In terms of the coil replacement, it is recommended to follow your doctor's advice regarding the timing of the replacement.
Regarding your concern about potential spotting with the new coil, it's difficult to predict whether you will experience spotting again as everyone's experience can vary. However, if you did experience spotting with your previous coil, it is possible that you may experience it again. You may want to discuss this with your doctor and ask about any potential options to manage the spotting if it does occur.
Regarding your HRT dosage, it's important to note that adjusting HRT dosages should always be done under the guidance of a healthcare professional. Increasing the dose of estrogel may help to manage your symptoms, but as you've mentioned, it can also lead to side effects such as headaches and sore breasts. It would be best to discuss your concerns and symptoms with your doctor, who can evaluate your individual situation and suggest the best course of action for you.
In addition to discussing your HRT dosage, it may also be helpful to discuss your anxiety symptoms with your doctor. There may be additional treatment options available that could help manage your anxiety in conjunction with your HRT treatment.
Overall, it's important to maintain open communication with your healthcare provider about any concerns or symptoms you may be experiencing, as they can help guide you towards the most appropriate treatment options.