Hi Linda, Well, depending on where you live in MN, you might want to come to The Menopause Center in St. Paul.  We see women from all over the state.  See my home page for contact info. Otherwise, though I can't give specific provider's names here, it sounds like you need to call a compounding pharmacy in your area and ask who prescribes bioidentical hormones.  Those who do tend to be the ones who are most knowledgeable about hormones and perimenopause/menopause.  Unfortunately, I have found few endocrinologists who even want to get into hormones.  Check with friends as well...one may have a good referral for you. Also, you say you're on Vivelle dot but don't mention progesterone.  If you're not on progesterone as well (or even if you are and it's not the right one) hormone imbalance could be a key to why you're having so many symptoms. I hope you'll be persistent in getting the help you need.  It's out there, just not always easy to find. Best of luck, Sandy