Hi! Well Dr Currie, who began this Forum, I believe works in your region
ADs can help. But as with HRT, it can be Trial and Error finding medication which suits.
Are your mood swings cyclical? i.e. around the time that you would feel low prior to a bleed? Ovaries can still kick out a small amount of hormone apparently. Some find that keeping a mood/food/symptom diary of use to chart progress.
I assume by pessary you have 'vagifem', we have threads about 'bladder issues' and 'vaginal atrophy' too
. You shouldn't need to go private, make a list of your symptoms, chat with a Nurse Practitioner or GP, see how the land lies. If U don't feel supported, ask for a referral to a menopause clinic. Not a Gyane but directly to the appropriate clinic.
Let us know how you get on.