It does sound like you're having symptoms of estrogen dominance. The same thing happened to me. It could be that you could find relief from either lowering your estrogen dosage, adding progesterone, or both. It's kind of a complicated dance finding the right balance.
There is a combi patch, but it does not use natural progesterone. There's no patch that combines bioidentical estradiol and natural progesterone.
You can use progesterone in the form of a cream or capsules taken orally. Creams are available either OTC (at health food and drug stores; look for "USP Progesterone" in the ingredients list) or by prescription through a compounding pharmacist. Oral progesterone is available by prescription, either at your regular pharmacy (prometrium, 100mg micronized) or through a compounding pharmacist (whatever dosage your DR orders).
I started out on just the Vivelle dot 0.1, which is the same dosage you're on. I've found that when you add progesterone, you can also reduce the dosage of the estradiol patch, which is an added advantage since I'd like to be using the minimum dosage that takes care of the menopausal symptoms. I'm down to the Vivelle dot 0.025 now, which is the smallest one (it's REALLY tiny). I'm still not all the way balanced but I'm getting closer all the time. I was using OTC progesterone creams, which is a great way to try progesterone to see if it helps you, but I had a problem with them losing their potency before I had finished using the whole amount; it turns out the oral compounded capsules are cheaper and have the added advantage of being easier to control the exact dosage you're getting. Also, my insurance did not cover the OTC creams but they do cover part of the cost of the compounded capsules.
I think it's great that you're getting prepared to talk with your DR. Another great source of information on balancing your hormones is the website called Survivor's Guide to Surgical Menopause
If you find that your GYN is not open to working with you on the compounded hormones or natural progesterone and instead wants to prescribe progestin (aygestin, provera and the others), you could try your GP/internist. Some ladies have better luck working with their family DR on this issue than with their GYN.
I hope this helps... good luck finding what works best for you!