Hi Dandelion, I have emailed Dr Currie, unfortunately she said that she couldn't categorically say that it is ok for me to have 5 pumps of gel, as it is indeed a high dose. However, she suggested that I may not be absorbing the gel well and it's possible that a patch may be better, and although she doesn't usually recommend blood tests as a way of diagnosing meno symptoms, she said that in this case it might be worth having one to check my estradiol levels. If it is less than around 300-400 then I'm probably not absorbing well.
I think I'm going to ask GP for a blood test, and if it comes back that my estradiol levels are not low, also referral to a menopause clinic/specialist, since I know that my GP won't know what to do with someone who obviously needs more than the recommended dose! 
I am sorry Dr Currie did not categorically say you could have 5 pumps of gel.
It must be frustrating for you.
Why wouldn't blood tests be a way of diagnosing meno symptoms, if oestrogen levels are low, then surely that would mean you need more?
On the other hand, do the levels fluctuate, so are they unreliable? I can't answer that question.
I upped my patch to 50mcg as IBS came back, and I dont want to go through a colonoscopy if I need to up my hrt to 50 instead of 25, so I kind of know how annoying all this is, well I hope I understand you.
You could tell your GP you spoke to an NHS Gynaecologist on here, they may listen more, my GP's were intetested when I told them I spoke to an NHS consultant, as I am autistic, I wrote it down and gave it to her, as I get tangled up verbally in real time.
It's good you have a menopause clinic, here, our GP refers us to the gynaecology department. We don't have a meno clinic.
I do hope you get this sorted out.
Oh, one other thing, you could look at non hrt meno solutions in the thread on here, and see if you can use anything in addition.
I tried menopause, it did nothing, but non hrt solutions may have worked for other women.
I wish you the best.
