Just here for empathy
46yr old male…. Took a noticeable haircut this year in many ways. Eyes, fat storage/burn, sustained power output, and recovery all took a noticeable hit all at once - which studies have backed.
Anyway… what a drag it is getting old. 
So iv just stuck on a patch of evorel. Having been prescribed HRT, after being diagnosed with PMDD…. My doc tried to give me sertraline anti depressant but I declined, having learned my lesson from the Citalopram. I am hopeful this steady dose of hormone will help (period arrived today so felt a huge relief despite the pain) I also have progesterone tablets to start at day 14 u til day 26. During the danger weeks as I call them. This last fortnight has been especially bad and taken me to a dark place mentally (I do have a history of mental health as I am auDhd, although interesting the doc said that neurodivergent people do suffer more with PMDD as we are more sensitive … this is something I had never considered before yet makes absolute sense now… and also why the anti depressants never work !) anyways . Here’s hoping for some relief .and getting back to training and maybe even a training plan again!
UPDATE :
so 3 weeks in now with the patches and been taking the progesterone nightly for a week … I have to say I feel SUCH A DIFFERENCE!!! There has so far been zero disruption to my training !! No emotional and mental “drop” after ovulation and haven’t missed any workouts . I’m aware it’s not a miracle cure as Iv had a few flashes of the rage the last few days but nothing like before 
and I soon bounced back … most importantly also I am sleeping much better !! Honestly cannot believe the difference in such a short space of time , hopefully it will continue to improve as my doc said give it up to 6 weeks to really settle in - but just in 3 the estrogen alone has made such a difference . To any women concidering it please give it a go. I know I am young at 43 but Iv clearly suffered alot for way too long and as I knew - antidepressants for me, really were not the answer . Estrogen 
Isn’t it crazy how the response is so quick? I had something similar. It was wild. I’m so glad you found something that works for you! I still find it bizarre how hormone fluctuations can manifest in such a wide variety of symptoms, and it’s often different for each of us.
my wife is 43 and went see her primary care doc with a checklist she completed due to her feeling like she is experiencing perrmenopause, but they ruled against prescribing her anything. needless to say she’s a bit disheartened. She has had to schedule with a specialist but that won’t be until Feb, quite frustrating. Glad your treatment is positive so far
That’s awful 
she must ask for a second opinion and seek another doctor , it absolutely is real at 43, my symptoms have completely interfered with my life particular my work life , this is something important to mention , but definitely find a female doctor and don’t give up . We should not be suffering unnecessarily and it’s absolutely treatable at this age .we are all so very different and there isn’t one size fits all when it comes to perimenopause or even menopause , keep pushing !
I’m not sure what country you’re in, but I ended up self-diagnosing and trying an OTC cream, which is what I’m continuing to use. Ideally she’d get her hormone levels tested ahead of time, but I just went ahead and did my own thing, and that’s what I’ve continued to do. I wanted to use something that I could easily adjust or stop, and go with the minimally effective dose, so I could start low and increase if needed. Sorry that she’s having to go through the headaches. It’s really too bad that we aren’t better supported.
I started estrogen replacement in the last week and it is a game changer for my perimenopause symptoms! I was already on progesterone through my GP to try to help my insomnia (it didn’t work) but she didn’t want to put me on estrogen. I’m so grateful that my gyn is totally pro-HRT and happy to help me try it out. I’m starting with a low-dose patch to see how I feel and after just a few days I have emotionally evened out after increasing anxiety for the last year or so. I didn’t have any training issues before starting and did a hard push (2nd best 30 minute power ever) last night with no issues there either. Early days still but I am very optimistic!
So glad it worked for you. I totally used to be of the mindset that it was all just “part of life” and looked down on hormone replacement. I started low dose testosterone about a year ago and my FTP went up 10-15W in literally two weeks. I had routine lab testing (at my request to get a “baseline” hormone panel since I was 46 at the time but still had no real perimenopause symptoms) and my T was literally undetectable. My provider suggested starting it. 2 months later when I re-tested it was 0.4… so still pretty low but performance wise it really helped. As soon as I have any symptoms I plan to ask for estrogen and progesterone! My sleep isn’t all that great though and I hear estrogen really helps with that - your post made me think maybe I should ask about that now