Hello again Twirl, the other ladies have given great advice but I just wanted to add that if you decide to give the Evorel Conti another go, which incidentally was my first HRT too, you could do what many of us do & start on half a patch for a few weeks to give your body a more gentle introduction to the new influx of hormones. I also remember experiencing mild pelvic cramps when I first started HRT & a little mild nausea. Though a bit unnerving, it wasn't debilitating & passed after a few weeks. Like you I was very nervous about starting HRT several years postmenopause, having hoped to avoid it, but I've since kicked myself for not starting earlier as again like you, I'd had difficult symptoms for many years. It hasn't been a panacea but I am better with it than without & at this stage of life I need all the help I can get
& I'm grateful for that.
As the others have said, a vaginal oestrogen product such as Ovestin (estriol 0.1% cream) or Vagifem (estradiol pessaries) can be used alongside systemic HRT & these are all very low dose. As Flossieteacake mentioned, Ovestin cream can be used internally & externally, but if you prefer to use Vagifem internally, then many of us also have a weak & soothing form of estriol cream simply called Estriol 0.01% to apply thinly to the vulva.
Glad to know you have a pelvic floor physio appointment booked; the advice of the very skilled women who choose to specialise in pelvic floor disorders can be invaluable & the one I saw was lovely. I'm sure she'll soon put you at ease as they are used to helping women like us & know that it can be hard to pluck up the courage to go along.
Wx
