Hi Hazy
There shouldn't be any problems with the local oestrogen - unfortunately the leaflets and contraindications are exactly the same as for systemic HRT which is crazy but, as I said before, little if any oestrogen is absorbed around the body.
The risk of blood clots and stroke are very small even when taking full HRT. Do you have high blood pressure? I didn't think migraines gave an increased risk of stroke!!!!?
Oestrogen will protect you from heart disease and osteoporosis and can reduce the risk of bowel cancer. If you aren't overweight or suffer from high blood pressure then HRT should still be an option and I believe many migraine sufferers do well on the trans dermal HRT - but I can understand your reluctance as full blown migraines are truly horrid.
The newer types of ADs which are SSRIs don't act in the same way as the older types like clonidine. Have you tried Citalopram? The gynae that I saw told me his wife, who has had breast cancer so can't take HRt, has found Citalopram really helped her terrible flushes and night sweats and with very few side effects. My work colleague who is on Citalopram is in her mid 60s and has actually lost weight, is sleeping better and has more energy.
Do seek advice from a meno clinic if you can - there are things that you can try.
DG x