Disclaimer – I’m not a doctor or a pharm but I’ve worked in a national pharm for 15 years…
HRT is simply hormone replacement therapy, it’s not the name of a specific medication. You need to find out which estrogen you’re on (manufacturer). Although all medications (at least in the USA) are required by law to have the same amount of active ingredient you may do better on a different manufacturer with different inactive indgredients. Also, horomones are tricky things. Even though every version has the same active ingredient you might do better with active ingredient from manufacturer B than you do from manufacturer A. It’s going to be trial and error.
How old are you? This is an important consideration in terms of medications you take because you shouldn’t be on any hrt for more than about 10 years. There are serious, long term possible side effects that need to be considered. Also, did you have a hysterectomy only? Or did you have a radical hysterectomy with the removal of ovaries? This is also critical. If you still have ovaries the hrt may not be needed or may be able to be drastically reduced since ovaries produce the hormones being replaced. Removal of the uterus (hysterectomy) only shouldn’t cause major problems in terms of hormones. The thing is, many doctors automatically start hrt with a hysterectomy without waiting to see what is actually happening with patient. You may not need hrt or may be need a small dose rather than a full replacement dose. You might want to consider a trial of no medications, see where your body actually is, and make decisions from there. It could be you do better with no meds.
Menopause often causes skin problems. Dry, itchy skin is fairly typical of menopause in general and probably is not being caused by hrt. I’ve heard from others that OTC soy-based menopause products may help with skin issues more than actual hrt. And, of course, there’s always the option to change your skin care routine to include a heavier skin cream in general, something specific for dry skin issues that has oatmeal in it may be worth trying. I, personally, am hooked on the Bath and Body Works skin cream (not lotion, cream).
Swelling in ankles is probably a medication side effect. If it doesn’t decrease within a month you’re going to want to look into switching, assuming you can’t live with it.
HRT meds come in many different forms. Pills. Creams. Patches. Vagina inserts. You may do better on a different form of the same med. I think it’s worth trying different forms of the same med to see what happens. I’ve heard of woman doing better on birth control for their hrt than straight, traditional hrt meds, but again, this is very indiv and personal in nature.
Before trying any biologic med or “all natural” med or compound check with your insurance (USA) as insurance companies perfer meds that are pre-manufacturered as well as tried-and-true to any biologic hormone or compound. Personally I would stay away from any compound at this point, they’re much more expense, your insurance won’t want to pay for it, and the compound is only as good as the person making it. I perfer my meds to be made via automation where as much of the human error element can be removed as possible.
I also am extremely sensitive to meds, which is a blessing and a curse. If a med is going to work for me, it’s REALLY going to work at a very low dose. But if it’s not going to work or going to have side effects it’s going to REALLY have side effects. I preach to everyone “low and slow” … start off on a very, very low dose, even well below what is considered standard theraputic dose, and increase slowly from there, listening to your own body doing it’s own thing. As an example, I take a medicaiton for nerve damage/pain. I take 100mg twice a day and get complete relief. The starting standard theraputic dose of this med is 300mg three times a day. I’m so far below standard it’s almost like I’m not taking the med! But it works for me, and what works me is the critical thing.
Listen to your body. Start low, start slow, increase gradually. Good luck.