I'm 54 and started HRT just before the start of the pandemic. It helped me a lot, I was calmer, my mood swings improved, I started sleeping better, there were lots of improvements. I was already on anti-depressants (have been for a long time), which is why I think I managed to cope with peri & menopause for so long. But as I've always had a tendency towards anxiety/depression it didn't completely eradicate my tendency towards that, life still happened and after 2 years of a lot of stress this time last year everything got too much.

So basically what I'm saying is, for me, HRT really, really helped. But due to a lot of life events, anxiety was still very much present.

Keep the lines of communication open with your doctor, try the escitalopram, look at other ways you can reduce the stress/anxiety in your life, try doing things like guided meditation, yoga, mindfulness etc.

HRT isn't for everyone, some people don't get on with it at all, for me it helped - but it isn't a cure all.