Hi Marie62
Where to begin! Sounds like you would benefit from trying a different HRT from what you say.
If you have never suffered anxiety or depression before then you should not be prescribed sertraline in place of HRT and probably should not have been given Valium if your anxiety is hormonal ( or due to the progestogenic side effects!).
Some women only begin to experience menopausal symptoms - of which anxiety and low mood is one (from low oestrogen), when they reach menopause, and for some like in your case - the symptoms of low oestrogen do not become apparent until some years later. Oestrogen levels drop on average for two years following the last period so often women experience worsening (or initiation) of symptoms at this stage.
The fact that your flushes have ceased indicates that you are probably on the right dose of HRT (oestrogen). Unfortunately Kliovance and Elleste Duet conti contain the same synthetic progestogen - norethisterone - which is androgenic ( and can cause symptoms such as hair loss) and also because you are taking it all the time can result in continuous low-grade progestogenic side effects including headaches, anxiety etc.
https://www.menopausematters.co.uk/perimeno.phpYou options are to return to a cycle - so that you only have to take progestogens for part of the month - but you would need to have a withdrawal bleed), or to change progestogen and see if this makes a difference. It could also be that your oestrogen dose is not high enough.
You could try a transdermal HRT - such as Evorel or Femseven sequi ( Evorel contains the same progestogen as you are taking now - so probably best not due to hair loss) which would give a monthly withdrawal bleed, or you could have a separate oestrogen patch and progestogen ( either progesterone = utrogestan, or Provera) - continuously or cyclically.
The other alternative if you prefer to stay with a tablet is Femoston - the progestogen is not androgenic and is better tolerated. This comes as continuous combined preparations ( 0.5 mg or 1 mg) or cyclical (1 mg or 2 mg).
All the different types are listed under Treatments/HRT preparations (top tabs pale green banner).
Do not give up yet - there is surely something out there that will suit you! I started HRT just a bit younger than you ( almost 54) and I am still happily taking it 10 years later.
There is also a site nomorepanic which might contain some helpful tips about coping with anxiety that do not involve taking meds.
I hope this helps
Hurdity x
