Great analogy GypsyRoseLee!
Hi
libra62 - did you ever read the article on this website entitled "The Perils of the Peri-menopause" which explains so well what is happening to your body during this time? Do have a read if not:
http://www.menopausematters.co.uk/article-perils-of-the-perimenopause.phpThe thing is during peri although your hormones levels fluctuate dramatically - there is overall a gradual drop in oestrogen and cycles where you do not ovulate - meaning you get occasional high levels of oestrogen but then massive lows as well. Also the cycles where you don't ovulate there is no progesterone produced so the womb lining continues to grow hence the heavy period. As you produce less and less oestrogen and ovulate less often your periods will become lighter.
As GypsyRoseLee says most HRT is bio-identical and there is no comparison between the large doses of synthetic oestrogens in the CCP, and oestrogen in most HRT. Also - as you have been given - oestrogen in patch or gel form is much gentler on the system, and less likely to produce headaches than tablet HRT.
I can understand your reservation about Evorel conti as the progestogen in synthetic and if it doesn't agree with you, you are taking it all the time - although you say you tolerated the mini pill very well. I would suggest you would benefit from the additional progesterone - because of your heavy periods, but also as you are missing several periods, and suffer night sweats and some low mood - an oestrogen top-up should also help.
The other alternative is to try the only CCP (as far as I know) which contains bio-identical oestrogen (estradiol as in our own body and most HRT) and that is Qlaira - but it is a tablet obviously! The mood dips are reduced because there are only 2 or 3 tablet free days. The progestogen is synthetic but you may well be happy with that.
Otherwise maybe an oestrogen patch along with progesterone (Utrogestan) taken on a monthly cycle - would give withdrawal bleed but at this point a slightly higher dose of progesterone might prevent the heavy bleeding. Some women find utrogestan too sedating at higher doses though.
Just a few thoughts which I hope are helpful!
Hurdity x