Hi there. I have been in perimenopause for two or three years now, but my symptoms really increased last spring and I had hot flushes and really disturbed sleep, which lead to me going on long term sick due to fatigue. I started HRT and found that the hot flushes went straight away. The disturbed sleep has stayed with me unfortunately, although I do feel much better than this time last year. I think some of the sleep issues were related to anxiety as well as hormonal changes. I have an appointment with a gynae tomorrow to discuss menopause and whether it is related to my sleep issues (I think it is but many GPs want to put it down to depression, which I am sure is not the problem). I will let you know how I get on, but I suspect that the disturbed sleep is one of those things I will have to live with - although I am getting more used to it now.
Ask your GP for blood tests. It turned out that my ferritin was low, and iron tablets did help to improve the fatigue.