Hi felicity10
Whereabouts are you in menopause ie what were your periods and cycle doing in the months leading up to your starting HRT?
That is quite a low dose of progestogen for that amount of oestrogen - but since you are not absorbing it well ( judging by your blood test results) this might not be a problem, although these only provide a snapshot of oestrogen levels and you can't tell a lot from odd measurements here and there. I take it you are post-menopausal and on continuous combined ie take Provera every day?
It could be insufficient oestrogen or it could be the effects of the progestogen - causing you to feel like this - coupled with your own hormones kicking in if you are not yet at menopause. Have you had hot flushes at all?
If you think you are not absorbing the oestrogen then you could change to the gel although I wouldn't go straight to 4 pumps - in case you absorb gel so much better! I would start with 3 pumps for a few weeks and take it from there.
Some women feel better on a cycle so that they don't have to take progestogens all the time (myself included) but you would have to put up with a withdrawal bleed.
Hurdity x