I had very heavy bleeding and took tranexemic acid for a few months before getting the mirena coil. Your oestrogen is probably too high as your own levels can be at play along with your high dose of patch. Prior to getting the coil I was on a 25mg patch which had been reduced from 50mg to try and control the bleeding. After 6 months on the coil I tried to increase the patch to 50mg again but bleeding became an issue along with cramps, so I reduced to 25mg again and am on that since. While I do have symptoms that could well be relieved by a higher patch, for me the reduced bleeding is much more beneficial. I think there are times we might have to trade some symptoms for others. Taking HRT doesn't always alleviate every symptom and can even make some worse. Ask your gp about tranexemic acid to help stem the flow for now. Since you have reduced your patch, hopefully things will settle soon.