Hi sanchez
![welcomemm :welcomemm:](https://www.menopausematters.co.uk/forum/Smileys/extended/welcomemm.gif)
You are right that if you have a Mirena then it can be difficult for doctors to tell how far into menopause you are - as it will stop periods before they would otherwise stop. Doctors usually can tell through a combination of symptoms and periods.
Unfortunately for you the docs have prescribed ADs on the basis of the stress without looking at the bigger picutre which you yourself have done. The new draft NICE guidelines on menopause say that docs shold not prescribe ADs for menopause symptoms, but HRT - although first the doc has to recognise that this is also going on. Blood tests can be helpful sometimes but if you are not having periods then you won't know where in the cycle you are (which can make them difficult to interpret) and a single blood test may well be meaningless!
You might want to discuss with your doc stopping the Mirena for a while to see what your periods are doing and then depending on the outcome perhaps thinking about HRT, with the Citalopram as a short-term stop-gap maybe? The good news is that if you tolerate the Mirena well - then it's very easy to start HRT as you just add oestrogen - the progestogen in the Mirena will protect your womb.
It is too easy for doctors to look for stress (which many of us suffer due to life events - at some time or another) and then just dish out ADs to calm us all down - without looking at other things like menopause!
Do ask if there is anything you would like help with - as sparkle says - there is a lot of support on here from women going through the same - or having done so!
Hurdity x