Hello ,I too am on gel and progesterone and find the combination works well ,these are just as good as patches although a little more of a faff I suppose compared to a stick and go patch .I would say that for the atrophy you will need vaginal oestrogen as well as the hrt did not relieve this fully .
I am 70 and I use Estrodot 75mcg patches they are very small and stick firmly. It takes 3 months for you to feel the full benefit and you can up the dose if need be. Transdermal Hrt is very safe it is body identical it is the Oral Hrt that carries a small risk of clots but the benefit outweighs the risk for many women. For vaginal atrophy you will need vaginal estrogen pessaries or cream you insert it every night for 2 weeks then 2 times weekly . Hope this information helps.x
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