Just to reiterate what Aude said, I had very bad perimenopause symptoms hitting from 45 onwards. Absolutely crippling incredibly heavy weeks-long periods, tingling in my fingers, nightsweats, being hot all the time, sudden feelings of doom - a really chemical weird sensation - that I was able to observe in a fairly detachable way. My mother had gone through all of this and it was at the time of particular concern about the increased risk of breast cancers and dual hormone HRT (particularly tablets, which flood the body, rather than targeted patches) and she missed the window and really regrets it.
I eat very very healthily , run long distance, meditate, drown in my own kefir and kombucha etc etc and keep a really regular sleep schedule. I've had Asherman's Syndrome followed by two babies so I am used to what obs pain can be like but this was awful and hard to live with.
The NHS referral took a while (including a young male doctor telling me 'it's what women have to put up with' - thanks!) but after a year or so and a couple of hospital appointments and a mirena coil and estradiol patches I feel great. Basically the absence of all those symptoms makes me feel great. Still get some period pain and lower moods but it's all in a normal range, very mild in fact.
On a side note, it is a great pity that endocrinology doesn't overlap more with gynaecology and psychiatry because I suspect that many women's mental health issues have a strong hormonal etiology. They get told they're depressed or bipolar or BPD when in fact hormone dysfunction is at play.