Hi Morwenna
Sorry to hear this - the answer is I don't know and I think the extent to which symptoms settle after a reduction in oestrogen dose depends on the individual's response. It's always better to reduce oestrogen gradually (although there was a piece of reserach to shwo it made no difference to the eventual outcome - whether flushes or sweats returned), and easier to do this when on patches by cutting little bits off.
I know I tried to reduce from 50 mcg to 37.5 mcg almost 2 years ago but even that small reduction caused a return to flushes. because I was ( am) working, albeit part-time - I wasn't prepared to wait and see if it settled - eg this might take a year or never. I went back up to 50 mcg and still there. Disturbed sleep is one of the most debilitating symptoms.
Is it not possible to ask if you can double the dose? It's deliberately kept to a medium dose because the idea I presume is that post-meno women should not be on higher doses and makes it more difficult eventually to reduce - but depends on your personal circumstances as well as your general health too.
Sorry that's probably not much help!
Hurdity x