It's hard to know for sure, unless you go off the HRT and see if it resolves. If I could take HRT again I'd go with pellet therapy because it's much more personalized (they will check all your hormone levels, including testosterone, and give you the dose that is right for you). The downside is that it is expensive and generally not covered by insurance. I'd still be on it, but had estrogen-sensitive breast cancer last year so they don't want me on HRT. (HRT does not CAUSE breast cancer but can encourage cancer cell growth). There are a lot of benefits of HRT, so I hope you can get this figured out! (I recommend ALL women use vaginal estrogen cream - it's not absorbed systemically so I can take it, it keeps your lady bits youthful and (more importantly) has been shown to reduce UTIs - which are a big problem as we age, I've seen many women with urosepsis (sepsis from untreated UTI - can be fatal). Good luck to you! If your symptoms worsen, get seen ASAP.