Hi Dotty,
I am with the others on this one, I am also peri and I am certain our now fluctuating hormones are a factor in our hrt being either to high or too low depending on what our own hormones are up too. I try to think of it as a more intense version of before we hit peri, to simplifying thoughts I know my body pre peri cycle had its ups and downs every month during a normal menstrual cycle. Now add in the perimenopause when hormones to crazy in it's fluctuations then add in the extra hormones from our hrt and it's a bit of a perfect storm. The hormonal fluctuations are so much more intense.
I don't know if this is the right way but sometimes I just think to myself, which is th easiest to live with? Physical symptoms or mental\mood health and try to keep the hrt at a higher level to help the worse. For me, I have sore boobs, weight gain, which Inthjink are from a higher estrogen, which I can live with or try to treat supplement wise, which is far better for myself and keep my moods more stable. ( I also use a low AD).