Hi EmmsieB,
I am almost 43, had one ovary removed after a benign tumor when I was 38, and immediately after my other ovary didn't work ("premature ovarian failure"), so I went into menopause. I still have my uterus also, but my one remaining ovary isn't functional. So I'm a bit like you!
I have been on estradiol patches and oral progesterone (I am in the US). I was first on continuous, and almost got a hysterectomy b/c I did not stop bleeding and developed adenomyosis and very painful, near constant cramps. I was bleeding every other week most weeks, for a couple years. It was awful.
I finally got a new reproductive endocrinologist who switched me to cyclical HRT, which has worked much better for my body. Now I don't bleed or have cramps unless I have a bleed on my own (occasionally happens, unclear as to why), or I trigger one with progesterone (currently, vaginal Crinone gel). The pattern is that on the 1st of a calendar month, I ask myself "did I bleed last month?" If the answer is no, I take 12 days of 8% crinone gel, and then bleed after I stop. I wear an estradiol patch all the time, my dose is 0.075mg these days.
I feel about 75% myself on the patch plus cyclical progesterone. But there are a few areas where I'm still struggling--vaginal atrophy (VA), sexual response, loss of muscle strength, and increased social anxiety.
For the VA, I am currently trying an Estring + nightly Vagifem and external estradiol cream as needed. I've had a very rough time with VA since the beginning of my ovarian/hormone trouble. And lots of local estrogen seems to help, at least some of the time.
I also had almost total loss of libido. It's now back, but my response seems very dulled. I am trying a very low dose of testosterone gel. I tried it a couple years ago and it really helped, but I had thought it was causing hair loss. My hair loss has continued to be awful, so I know it wasn't just the T, and am giving it another go.
Have you tried testosterone?