My peri journey has, like many others, been desperately trying. However, one of the big issues I had was the general idea that whatever the symptom I was having the advice seemed to be to increase the oestrogen. I tried this and became very ill on each occasion, the last occasion a close call to A&E. That was on Estradot 75mcg. 50mcg and I still felt pretty grim some of the time and this I put down to the spikes... I am sure that it did however even out some of the troughs...
I also could not cope with the Utrogestan and it affected my muscles so badly that I couldn't walk on more than one occasion.
Finally, not having been able to gain any consistency with hot flushes, insomnia and really bad muscle pain which was treated with tramadol (a lot)... it was suggested (by one of Nick Panay's team) that I force the reduction of the oestrogen and rely upon supplementation as they suspected I might be the kind of person who fairs much better on a lower and more consistent dosing of oestrogen.
They said it would be like chemical menopause.
At the same time they suggested the Jaydess coil as I hadn't done so well with the Utrogestan.
Long story short... well, shorter anyway... I currently feel 75% of the time like me. I am on 37.5mcg estradot, synarel nasal spray to shut down my own system... one spray twice daily and here's the really interesting bit for me, I am taking additional progesterone and feeling good (6 months ago this would be absolutely unheard of for me).
Of course there are still a few challenges, like quite how to even out the progesterone for the longer term but if the bright spark at NP's clinic hadn't suggested the synarel and the lower dose oestrogen I would still be feeling seriously grim.....
Hope this is of some use to you
xxx