Nas, with the benefit of hindsight I now know that serotonin levels are affected by tanking hormones and from what you have said, this could be part of the problem. You definitely need to review your medication/dosage.
As soon as you enter perimenopause and progesterone rapidly decreases, a whole load of stuff starts to happen. Some women develop insomnia, anxiety, depression, panic attacks, IBS, nausea and (in my case) migraines. Next comes oestrogen drop off and as we know, vasomotor symptoms kick in. So the menopause is an evolving situation and HRT regimes can suddenly stop working.
Menopause symptoms can be eliminated with the right type of HRT at the right dose but sometimes you need some extra help with other medication. For example, I was able to control my migraines with hormone manipulation for years but I slightly reduced my oestrogen dose and it stopped working. Long story short, I needed to add an antidepressant (amitriptyline) on a low dose because I needed more serotonin. For me it's been a wonder drug and I feel very good on it with zero sure effects. Amitriptyline not only works as an antidepressant, at low doses, it is a migraine preventative it also helps IBS, generic pain, insomnia etc.
I don't know what medication you are using right now but it's obviously not working and you need some extra help. ADs get a bad press and yes, women have been fobbed off with them when they should be taking HRT but sometimes you need both.
I deeply regret being scared off ADs and not starting them much sooner.
