Hi LadyCC,
I was wondering, have you tried any other form of estrogen than the gel? If you feel meno symptoms are getting worse and you'd need to go back to HRT, perhaps discuss with gynae to try another transdermal (patch or spray), and then there's also the oral option of course. Even tho in all the active ingredient is the same, often ladies feel well on one but not the other, so it could be worth a try.
I haven't had exactly similar situation as yours, but I'm also struggling to find a good balance with HRT. My issue has been that I absorb too fast and get steep highs and lows, which cause side effects and overall make me feel really bad. So far tried gel, then patch, and now back to gel as patch didn't work for me at all. I've also learned along the way that my body does not seem like high estradiol levels, so I'm keeping doses currently quite low (1.5 to 2 pumps).
Unfortunately cannot comment on the over the counter remedies as I've only tried HRT, but hopefully other ladies can add to this.
Take care and let us know how you get on! xxx