Hi, thanks for posting your concern in the HCM. The symptoms you mentioned are very common in perimenopausal state. As you are known hypothyroid and known diabetic, a poorly controlled hypothyroid status too can produce similar symptoms. For the perimenopausal symptoms hormone replacement therapy may be considered. The type of therapy (sequential, long cycle or continuous combined) or necessity of Mirena insertion may be considered and evaluated by your gynaecologist depending upon the history of whether you have any bleeding at this point of time, or the duration of menopause, your current age, presence of any other comorbidity etc. So, get one HBA1c, fasting plasma glucose and fasting TSH done and consult Your gynaecologist for further evaluation and treatment. Regarding the progesterone issue, I would say that they are actually needed, but in HRT they are combined with estrogen and mirena is an IUD which serves progesterone. So, without listening to too many advices, please consult your doctor or write back to us with a more detailed history regarding your menopause and the investigation reports for further advice. Regards. Dr. Kaushik