Hi and welcome to MM cheezel - I had a premature meno which started in my mid 30s. Clearly you are having difficulties as your own hormones sent to be still kicking in at times that must also be having an effect.
I believe there are number things going on here. Yes, you are menopausal and at your age you do need HRT to protect your heart and bones for the long term. Finding the right HRT is the challenge. Early on in my meno journey I tried a variety of HRT types and strengths all of which gave me headaches and other side effects. I was eventually put on just one ump of Oestrogel each day with 10 days of progesterone each month which then gave me a short withdrawal bleed (about 4-5 days). Provera is one of the better progesterones but you may find Utrogestan better but I'm afraid the PMT when you come off any progesterone is common with most women and may be something you simply have to cope with - I certainly get this - headache and nasty cramps for a few days each month. It's all about balancing the positive with the negative and fro you I think a continuous HRt regime would not be an option due to your sensitivity to the progesterone. If you expect to feel good every day then I personally don't think that is realistic.
Unfortunately Evoral conti is probably not the right one for you as it is a medium dose (so possibly too high) and the progesterone is one of the more synthetic ones which is tougher to tolerate.
I personally like Oestrogel as, though it can be a bit of a nuisance applying it each day and allowing it to dry for 10 mins before dressing etc. - it seems to give me the more consistent dose and it allows adjustments, so you can simply increase the amount you use if need be.
If I were you I would definitely start fresh - so give yourself a 4 week break. Ask for Oestrogel and just use one pump per day - it may be best you use this either morning or evening on inner thighs (you will need to be careful not to allow you children physical contact with the area you have applied this to for a couple of hours) then either use Provera (just 10mg daily ) for 10-12 days each month after which you will get some PMT and a withdrawal bleed but on this low amount of oestrogen it shouldn't be so bad. Ideally you should try Utrogestan (it's called
micronised progesterone in the medicine book) - I am surprised you can't get this as it used for IVF which I'm sure is available in Ireland? It's worth pointing out that is it 'micronised progesterone' to see if you GP can find it - however, do bare in mind that Utrogestan gives side effects as well so doesn't suit everyone. Negative reactions to oestrogen is very, very rare as most women feel really good on this, however I've always preferred the Oestrogel as I don't get a consistent dose with patches.
May I also comment that your lifestyle does sound absolutely bonkers. To work 70 hours a week, go to the gym at 5.30 am and cope with 3 small children - Something, somewhere is going to give. Where on earth is your relaxation time?

?? Relaxation is just as important as exercise. Please, please be kind to yourself. I am 60 now and 25 years on I'm still using HRT - it is a compromise as I do get ups and downs (hate the tummy cramps) but I've tried life without HRT 3 times and that is really NOT GOOD. BTW I get horrible headaches around the eyes without any oestrogen or if I'm using too much - it's about finding the right amount, so just do one pump per day for 4 weeks before changing.
I'm sure others will be along with help but do try the sequential regime I have suggested. Dg x
Dg x