There are far more knowledgeable posters on here re different HRT regimes and meds than me on this forum.
I have just started using the Estrogel/Utrogestan regime via a private consultation with Prof Studd, albeit only in the last two weeks and already feel better than I have done for months/years, re low mood, anxiety, 'brain fog', lack of libido, etc.
I know this regime can also be prescribed on the NHS, and from my reading of all the formal research, it seems that low oestrogen levels (and co-occurring low testosterone levels in women) causes hot flushes, sweats, low mood, anxiety, lack of libido, low bone density (and therefore joint/muscle pains) recurrent 'cystitis', painful intercourse, etc.
No knowledge at all about Livial but I'd suggest other more informed posters on here will no doubt ask if you have had your hormone levels checked recently, what they were, and your prescription level of Livial.
But I'm sure you'll get some good advice!