Many women don't absorb oral estrogen as well as they would a transdermal estrogen and vice versa.
When you take estrogen orally, the liver deactivates approximately 95% of it when it enters the digestive track, gets broken down and then transported to the liver.
When you use estrogen transdermally (such as a patch or cream) it does not go through the break down process. It enters the blood stream and circulates throughout your system. You also are able to use a much lower dose this way. So it may be worth a try to use a different delivery system in your case.
Some doctors think that we only need progesterone to protect the uterus from unopposed estrogen. Women who still have a uterus do need to use progesterone with their estrogen to protect against uterine cancer. So they think no uterus-no progesterone. There are progesterone receptors throughout the entire body and many women find that they still receive many benefits from using progesterone.
I have tried the OTC progesterone creams before. For me they were not strong enough, so I choose to use a prescription strength.
They can and do work for many women. You just need to be sure that you are buying the real stuff. Some creams claim to contain progesterone, when in reality there is no real progesterone in them. You would want to make sure it says USP progesterone on the label. Also the strength should contain at least 450 mg of progesterone per ounce of cream.
There is no need to take a week off the progesterone if you do not have ovaries that are producing progesterone. The direction on the labels are for women going through natural menopause. They need to cycle their progesterone because they are still producing estrogen and adding progesterone may cause their menstrual cycles to return, also they need the lining of the uterus to completely shed each month. The shedding takes place when the progesterone levels drop.
Women without ovaries may experience fluctuating hormones if they cycle it.
It may be helpful to keep a journal and track your symptoms if you start making changes with your current HRT. This will help you to know what hormone and doses help to relieve your symptoms.