HRT question
Apologies in advance for the long post here but looking for advice. I have been on 125 mg of sertraline for 15 years and the last couple years along with change to my menstrual cycle I noticed an uptick in anxiety. Last year my OCD came back with a vengeance, just as bad as post partum, along with the mood swings. My primary increased sertraline to 150 mg which triggered the most annoying side effects of 24/7 earworms (songs stuck in your head all day long / cognitive musical looping). At first I was told it was a side effect and to wait it out. 3 months later psychiatrist put me on Buspar. Eventually increased to 37.5 mg which seemed to quiet the earworms and massively helped with the anxiety however my OCD (pure O / obsessive looping and intrusive thoughts) has still been in over drive even after going back down on the sertraline to 125 mg. So I made an appointment with a functional medicine doctor who supposedly specializes in HRT and she confirmed I am in perimenopause which could be the culprit of my OCD flaring up and mood swings. She put me on 50 mg micronized progesterone which I did great on the first week until I start pmsing and got my period. I was crying everyday, very low mood, intrusive thoughts. Didn't go away until after my period. I was convinced it was the progesterone. Doctor told me it was just my PMS. I have never had such severe PMS. At a follow up appointment she now wants to increase progesterone to 100 mg. She says my estrogen is very high based on blood work at 550. To my knowledge I thought doctors arent supposed to treat peri based on blood work? She won't prescribe me low dose estrogen patch (which I think I would benefit from for mood stabilization) and told me if she puts me on a patch with estrogen that high I could get a blood clot. I am overwhelmed by the difference in school of thought between functional medicine treating peri symptoms with progesterone only and possibly testosterone vs. OB/GYN treating with estrogen and progesterone. I'm 44 years old with a uterus for context. Any advice on how to get this managed? Should I be looking for another doctor?