Hello Kathleen - I disagree with comments about high dose of oestrogen.
I have commented before to you about what might be causing your feelings - there was another thread about the jitters which I'm not sure whether you started?
Anyway I will say it again.
Firstly the patch you are on (50 mcg) is not by any stretch of the imagination a high dose of oestrogen. It is a medium dose and will correspond (if you absorb it properly) to the oestrogen levels in the first or second half of the cycle, excluding the ovulatory peak. Aside from how different we all are, and that you are replacing your oestrogen through external means, it is very unlikely that this dose is too high that it is causing the jitters - especially as you have been on it sometime. it is the standard post-menopausal dose which should if possible relieve symptoms.
My view is that your feelings are either due to the continuous progestogen or oestrogen is too low.
I have said before and it is well known by gynaecologists that the consequence of taking continuous progestogens and especially the synthetic ones like norethisterone such as in Evorel conti, is the possibility of continuous low grade progestogenic side effects, of which depression, nervousness and headaches are some examples ( and listed under the product info). This could explain all your symptoms. This is the penalty of a no-bleed regime. Many women ( including some on here) not surprisingly find they don't feel too good on the whole patch and mistakenly believe they should cut down on the oestrogen - so cut the patch in half - and sometimes feel a bit better. Well this is because they are getting half the dose of progrestgoen - but unfortunately half the dose of oestrogen too!
Unless you are generally a nervous jittery type of person or have issues in your life or have had throughout your life that make you feel like this, that are not hormonally related I would very strongly suggest you do not go down the AD route at all until you have tried different types of HRT. I mean it would be counter-productive to take HRT and then take something else to counter the side effects from it - notwithstanding your experience dazned and that you feel better under your regime - which is great
Many of us put up with a bleed for this very reason. Also if you take separate progestogen and oestrogen you can then adjust the oestrogen as required until you find the dose that suits you. As you are post-menopausal your hormones levels should be stable so it should be easy to find the right dose and product to help you to function without these negative days. I doubt whether synthetic progrestogens are ever calming but in low doses some women seem to find this on Utrogestan ( "natural" progesterone) - unless they are sensitive to all types of progestogen.
I know you asked this question of dazned but I have used Estradot 50 mcg for almost the whole of the last 9 years since starting HRT in late peri-menopause and have never had any of the feelings you describe - apart from what you expect to feel in normal life's ups and downs. The only bad days I have (that can be attributed to HRT) are at some point sometimes on the Progesterone part of the cycle ( I take 200 mg vaginally so quite a high dose) and if I get a migraine.
The other thing is I have started taking norethisterone once a year to "strip" my lining - as recommended by my gynae GP - admittedly much higher dose than HRT and it is the only thing I take orally - but I have noticed flushes returning towards the end of taking it.
There seems to be a phenomenon whereby some strong progestogens interfere with the beneficial effect of oestrogen on the brain and on some of the symptoms oestrogen should alleviate - and I remember reading about this somewhere - apologies for forgetting where - so the continuous synthetic progestogens could be doing this in your situation meaning you would need a higher dose of oestrogen than you would normally need. As Evorel conti comes as a combi patch there is no way of adjusting this.
Please do give these suggestions a try eg continuous utrogestan or trying a cycle! You may be pleasantly surprised. Oh btw the downside of a cycle aside from the bleeding is obviously your prog goes up and down but those of us who do this feel it is preferable to having the continuous sdie effects....
Oh I got carried away agin but hope this helps
Hurdity x
