Choose the lowest dose that works
Research has shown this to be 0.625 mg for the Premarin oral tablet,
made from conjugated mare’s urine, and 0.05 mg for the estrogen
transdermal patch (brand names of these made-from-plants estrogen
delivery systems include Alora, Climara, Estraderm, FemPatch,
and Vivelle). Starting at higher doses increases the likelihood
of side effects such as anxiety, mood swings, fluid retention,
and breast tenderness. Some women find that even the tiniest dose
of estrogen, 0.3 mg, provides adequate relief from menopause symptoms.
If you choose to use a progestin, again start with the lowest
possible dose to avoid side effects such as headaches, depression,
acne, fatigue and bloating. That’s usually 5 to 10 mg for Provera,
the most commonly prescribed synthetic progestin, or 200 mg of
the natural oral micronized progesterone.
In general, you are better off with natural progesterone,
synthesized from plants in a lab, than with the synthetic progestins.