Hi
I went from hating utrogestan in my late forties, to counting the minutes until I can take it (I take it sequentially). You can take it vaginally, or alternate by mouth and as a pessary (without being TMI it's messy and tastes horrible, which isn't great if you have a busy intimate life!).
However, 1 pump of oestrogel sounds incredibly stingy, so some women find it's not just the P, it's the ratio of E to P, so I'd say if you have some teething issues, rather than throw your hands up and blame the utrogestan, it's highly likely you need more oestrogen.
I'm on four pumps and I'm only just 50, my sis in law is younger than me but had a total hysterectomy, she's on six pumps and a patch (she's under Nick Panay, her GP is frothing with rage, but 'sorry, are you saying you know more than Mr Nick Panay? shuts him up!).
I'd really recommend getting your head into some menopause stuff (there's some good books now and some fab fact sheets on Louise Newsom's website) as GPs tend to have a riduculously cautious (and I'd say quite sexist) view of HRT and middle aged women. It's worth knowing and being able to fend off some of the utterly bonkers and clueless things they come out with. Menopause is a hormone deficiency, not an endurance test, we're not evolved to live much beyond our fertility, women run on oestrogen.
xx