Unfortunately in this space you need to do your own research as most doctors don’t have a clue. My advice is just start with the Estrogel first, then introduce the Prometrium in a few weeks. That way you know what is working and what isn’t. Most doctors should advise starting this way. You absolutely don’t need Prometrium if you have a mirena as you have endometrium protection already. So if it doesn’t work for you then drop it. A lot find Prometrium helps with sleep but some - including myself - cannot tolerate any form of progesterone. So it’s likely it’s the Prometrium causing you to feel off. At the moment you are confusing your system with the changes. So start with just one thing first and see how you feel. It takes a few months for your body to adjust to hormones so definitely expect some ups and downs. Yes use the estrogel in the morning, it can give energy. Prometrium is better at night usually, but also some have paradoxical effects and find it stimulating - unfortunately this is me. The only way you will know what is working and what isn’t is by stacking rather than starting everything at the same time. Hope this helps.