53y F

surgical menopause in 2022.

Tried patch for 2 mos in 2023, HRT pellets in 2024 for a year then stopped

Having headaches and pressure so got back on HRT with estradiol gel for a month and now patch for a month (2 weeks on 0.037 mg then upped to 0.05mg). I have extreme fatigue on days, emotional lows and head symptoms. I have been mostly unwell the last few days and have been resting. Are these debilitating symptoms expected side effects of patch? Should I be stepping down back to 0.037mg patch or stick it out and this is just adjustment? Want to get some advice before I call my doc. 3 years ago on patch I did not experience this.

43F perimeno
Hysterectomy this past June
Before hyst (and still now) taking Testosterone cream (for libido), Progesterone at night (for sleep), and vaginal estrogen for GSM.

The past couple of weeks I have felt completely unhinged. I am exhausted constantly despite sleeping well (I do wake up once around 1am but go back to sleep), my patience is hanging on by a thread, road rage is a new reality for me, I can’t control my thoughts (like I struggle to focus and words are hard) and my libido is non existent. My labs 10mths ago for all the non hormone things looked good (thyroid, iron, blood counts, vit d, etc)

Am I missing systemic estrogen? I went ahead and made an appt with midi (my regular doc cant get me in until dec 30 and i honestly dont think I will make it that long). Is estrogen patch/gel something I should bring up in this appt to help with this shit show I am feeling like 🤪

Thanks in advance for your help ❤️

I could really use some input from those who are pinning Estradiol Cyp and Test Cyp.

for background 62f post menopause was on 1 mg 2x/week patch, 1mg per day divigel and 8mg per day compounded Test cream for 2 years. 200mg nightly Progesterone.

Switched to T injections about 4 weeks ago at 3.5mg Every other day. Have been doing what I thought was great! LOL. Then about 3 weeks ago added 1.5mg every 3.5 days of Estradiol Cypionate. was feeling some low Estradiol symptoms but did keep one of my patches on for about 7-10 days while I transitioned over fully to injections.

As I said everything has been as expected, rather uneventful, a couple of low energy days which I have attributed to the transition to a new delivery method. Have not tested levels yet, will do that in 2 weeks. levels prior to starting were great and I felt good. Total T was 135, Free T 7 Estradiol kind of high maybe? it was 150

Last night I had a hard energy crash post workout. Got a headache and felt really irritable and just "off". Went to bed slept good until about 2 am and woke up really wired but tired. Felt some Central nervous system activation like I was feeling a little "speedy" if you know that feeling. Had a hard time but finally got some more sleep in. Still this morning feeling wired but tired. Trying not to over think but wondering what the cause of this might be.

Any insight would be great. I don't feel many typical symptoms of low Estrogen right now. Thanks!