HRT not working?

So, I'm 48, and have been in peri for about 2-3 years. I've been on the estradiol patch for about a year and a half, steadily increasing the dose to .1. I also have a Mirena IUD. But I'm still experiencing night sweats, hot flashes, terrible mood symptoms...I could go on and on about the symptoms, but you all know the drill. My doctor suggested a low dose BC pill, but it's not covered by my insurance. I tried a higher dose BC pill last fall, but it gave me terrible migraines. She says I can't go above .1 on the patch.

I'm wondering if anyone has any experience going above .1 on the patch, or has any suggestions for how I can go about increasing/stabilizing my estrogen replacement. I feel like it helps so much initially, but as I continue to get deeper into peri, it stops working. . .