Trufflecoat, this is where it get complicated, your blood levels may seem to be normal on paper but that doesn't necessarily translate into decent symptom control. Some women need to have oestrogen blood levels significantly higher than the supposed normal levels in order to get symptom control. As always, it is not an exact science. I have had this conversation with my gynaecologist many times and she agrees. When my level was the same as yours, I didn't feel good at all. Unfortunately, what works for some women doesn't work for others. The only way of knowing what really works for you is to get to a level where you feel good.
By the way, I forgot to mention this before on this thread but my understanding is that 2 pumps of gel is the equivalent of a 50mcg patch but again, when it comes to blood levels, the results for me are wildly different and I get much more into my system from 2 pumps of gel than I did from the 50mcg patch. Much of it is about how well you absorb each product.