Most HRT types come in different strengths so one delivery method is not stronger
per se than another. So if you have Evorel patches - depending on their dose - you will be able to get a higher strength patch. Evorel comes in 25, 50, 75 and 100 mcg. Tablets usually come in two strengths - 1 mg and 2 mg, and gel you can apply any amount. They are all listed here:
http://www.menopausematters.co.uk/treatafter.phpIt also depends on how well you absorb the different HRT types. Some women find they do not absorb the oestrogen so well with tablets.
I presume you've had a hysterectomy as you are on oestrogen only or maybe have a Mirena for the progestogen part?
Re the VA - if you are already using systemic HRT as in the Evorel then additional local oestrogen is likely to be advised as it targets the vaginal tissues specifically where it is needed. You may need to use more often than twice a week. Failing that there is a product called Estring which you insert and which delivers 50 mcg per week approx (wheras Vagifem twice a week is only 20 mcg). You can also use estriol cream on the external areas in addition to Vagifem and systemic HRT (and use moisturisers in between as Annie0710 recommends).
http://www.menopausematters.co.uk/local.phpHave a look also at Maryjane's posts as she takes HRT and local oestrogen purely to control VA. Also Look in private lives section at "The Burning Club" thread Dancinggirl started.
Hurdity x