Hi southerngirl
To me the irregular bleeding while on Elleste Duet implies that you still have some oestrogen of your own cuasing your own cycle to break through. Alternatively maybe something else is causing the irregular bleeding that perhaps the doc could investigate eg a small fibroid?
It is very unlikely that 2 mg estrogen in tablet form would give you too much oestrogen - especially at age 54!!
Also - have you thought of going onto patches rather than pills? By taking pills all the oestrogen has to be metabolised by the liver, much of which is converted to estrone and is excreted. With patches, the estradiol ( which is the type of oestrogen we need to replace during and after menopause) is absorbed straight into the body and the levels are more consistent than with pills.
There are no bleed patches - Evorel conti (which contains the same constituents as Elleste) and Femseven. Some women (like myself ) even though over 54 ( I am 60) still remain on cyclical HRT though, because we prefer not to have continuous progesterone due to undesirable side effects.
Alternatively you could use an estrogen patch along with the bio-identical Utrogestan as your progesterone - which has fewer pms side effects for many women that use it.
Looking at your symptoms - oestrogen does not cause fatigue - it is usually the progesterone which does this, if anything. PMS is also not caused by oestrogen - it can be due to either the progesterone itself, or the drop in oestrogen or the drop in progesterone - so feeling pms for the few days after stopping the progesterone part of the pills is not because the oestrogen doesn't agree with you This also happened to me and lots of other women too. It is just what happens in the normal menstrual cycle!
Re gallstones - this is exacerbated by the mode of delivery. Using patches is better if you suffer from these.
This is what it says on this site under health conditions
http://www.menopausematters.co.uk/atoz.php#GlossGGall Bladder disease
HRT has been shown to increase the risk of gall bladder disease, particularly gall stones, thought to be due to an effect on bile composition. Transdermal (patch or gel)HRT is usually recommended with a history of gall bladder disease. Hope this helps
Hurdity x