It's hard to say. When I was first told I was in peri, I had all that you mention and while it was annoying, it was not so bad that I felt any of it needed to be "fixed". I just rolled with the hormones. Other than the bleeding, that part was bad and was the reason I was in for ultrasounds and biopsies and eventually told it was peri. Had my periods just faded away from there, with no worsening of symptoms, I would have skipped the hrt. For some women it never gets worse. Unfortunately for me, it did get worse. (That actually could be a blessing in disguise as I have since learned that because I'm so young I needed the estrogen anyway.) I had already tried Mirena years ago for contraception, so that wasn't an option for me this time, although it would have been my gyne's first choice for my bleeding issues. If you get on well with the mirena, as dazned said, you'll be halfway there if you find you still need hrt. You'll only have to add estrogen if you need it. The Mirena worked beautifully on my periods when I had it. I actually wish it was still an option for me, but I developed migraines and was generally unwell on it after the first year. Before it caused problems for me it was perfect though. Anyway, it sounds like your GP is guiding you in the right direction, checking first for problems and offering the Mirena.
