Hi folks, thanks for the replies. Update: I went to a private gynaecologist because 2 visits to different GPs had resulted (in my opinion) in dated or incorrect HRT. I know that sounds arrogant on my part but I was happy to pay to get more time than the rushed 8 min NHS consultation. What resonated with me was that the consultant said I would have to go through the hot flushes at some stage. I tried the patches but was v frustrated at the sticking ability, I had looked through the forum for tips, hairdryer, sticking plaster etc. I wouldn't say the patches were a wonder drug & after a few weeks I reflected that my flushes were really subsiding & my real issue was the vaginal dryness; the vagifem def worked for that so I requested a repeat from the GP (the consultant had written to the GP to say what she had prescribed & her reasons; I had a copy of her letter). Anyway, the GP wouldn't give vagifem on repeat, they would only give me the patches! I had to make another appt (one month wait) to see another GP (best one in the practise), & he reluctantly gave me vagifem, but was worried about giving oestrogen with no opposing prog. After a discussion & my assurance that I would return if I had breakthrough bleeding, he agreed to do vagifem on repeat. I really feel my flushes are at the end, my sleep isn't brilliant but I have no mood swings or depression so for me, I feel like healthy diet & lifestyle supplemented by vagifem is sufficient.