Hi Helenabyr
Sorry to hear about your extreme symptoms.
When you say how do you tell if it is menopause: over the age of 45 if a woman is experiencing flushes and sweats and her cycle has gone awry - and varying in length each time or skipping periods - then that alone is usually enough.
In the last reproductive stage before peri-menopause starts - many women experience worsening pms symptoms and some unfortunate women also start to get flushes and sweats at this point - even when periods are still regular. You haven't mentioned periods but because you are wondering if it is peri-menopause approaching I presume yours are still regular?
The fact that you also mention PND sounds like it could be hormonal. You might be interested to read about the work of John Studd who has published papers on reproductive depression and treated women with hormones rather than psychiatric drugs.
http://www.studd.co.uk/depression.php If your anxiety/depression symptoms and issues are hormonal then adding oestrogen rather than anti-depressants should be the first line of treatment.
Do try the HRT - which type have you been given? Hopefully it will help you through this phase.
Sometimes women find that it does not control the cycle sufficiently so some gynaes prescribe the newer birth control pill (QLAIRA) which is similar to HRT and only has two tablet free days so avoids the oestrogen crash of conventional Pills which have a pill-free week.
You will find plenty of help and support here so keep posting and let us know how you get on
Hurdity x