Yeah, this is the type of concern I ran into, especially around the idea of a consistent dose, how it's that even possible? It's not like all oestrogens are flushed, and then there's how the liver works as well. The real kicker for me came when I had to stop taking HRT after 9 months (3 years ago or something) and none of the symptoms (aches, brain fog, low mood) that had sent me to the doctors in the first place came back. Basically, if HRT was the fix, then where were the problems without the HRT? I don't know, maybe I only needed a short duration treatment. That could be true. I was definitely looking for a silver bullet though. Life was pretty unmanageable. My mental health was in the bin and I had no stamina whatsoever. My youngest kid had become quite concerned about my health because I could barely manage a slow moving shuffle when out and about. I never wanted to be awake. I'm not sure I was 100% convinced I wanted to be alive at this point ...
Anyway, back to your question, I had to build myself consistency, e.g. around routines, and remove all the inconsistency (which involved getting rid of some people in my life). I was literally being run ragged, and had been for years, rushing through life, always at everyone else's beck and call ... The minute I stopped that, and started putting myself first, was when I went into recovery. I'm just not the same person I was 5 years ago, 10 years ago, 20 years ago ...
It's one of the things I really struggled with, because I wanted the old me back, the woman who could keep a million plates spinning and all the balls in the air, who proper liked because I'd do anything for anyone. Unfortunately, it was this old me that had worked myself to the bone. I'm still in the process of finding the new me. Obviously, this is my journey and doesn't apply to anyone else, but you get what I mean.