Hi DaisyB - I agree with Roadrunner. Your oestrogen dose could well be too low! The standard starting and post-meno dose of gel is 2 pumps of estrogel which is 1.5 mg, so 1 mg is only 2/3 of this dose. Because Sandrena comes in two doses and sachets with a certain amount - women seem to be prescribed less. Maybe as it is more concentrated it is absorbed better - but still I would defo go for the 1.5 mg for several weeks and see how you feel and maybe even higher dose (can you get the 1 mg sachets?). It seems women absorb from the different methods differently.
Also if the increased gel dose (even eg up to the equivalent of 3 pumps estrogel = 2.25 mg) then have you tried patches - in case you have absorption problems with the gel?
Yes increased exercise and in the open air should help - and hopefully you will feel better once your increased dose has stabilised. Also could some of the symptoms be due to the Mirena ( the prog released)? I know some women don't get on with this - but maybe you know you are OK with it from earlier in your life?
Maybe you are further along the post-meno road so noticing the effects of reduced oestrogen (which drops for two years approx following last period/ovulation and then stabilises at low level with the odd minor fluctuation).
I agree it is better to get the HRT right before taking ADs - as you say there are side effects from these too. Also they are known to depress libido. No point in taking medication to sort out something hormonal if tweaking your HRT can help and especially if your anxiety has no obvious cause. In the meantime are there behavioural techniques you can try eg mindfulness, meditation, CBT type self-help exercises. Try nomorepanic website for ideas ( other than meds).
Let us know how you respond to the increased dose - I am sure others will be very interested, and hoping you feel better very soon
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Hurdity x