Hia Vicky,
I'm on Oestrogel and Utrogestan.
You tend to start low and work up until your symptoms are stable. Undesirable symptoms come from seesawing hormones, hormone fluctuation which happens most during peri. So starting at maybe 2 pumps, up to what works to keep your symptoms at bay but slowly so not to have a swinging pendulum effect.
We are all different so it's a lot of trial and error finding your own level and it is a moving target as you move through peri to post meno.
If I start getting hot flushes again, headaches, mood swings, insomnia, tearfulness, dry mouth and the rest, then I up my gel a small amount and wait a week or so to see the benefits.
TD