Thanks for the update, Tereza, and glad this thread helped.
In case it helps others I'll add a bit of my own experience with menopause. First, I'd like to highly recommend people get their bone density tested (via DeXA or REMS) early--preferably before age 30 as a baseline, but certainly by the cessation of menstruation. And I also think it'd be a good idea to keep an eye on it afterward. This is something that can be affected without symptoms to alert you.
Perhaps due to reasons Sylvia suspected (having a raw v*gan diet), or perhaps just 'cause PMS was never an issue for me and bleeding light (even when eating differently), but most would consider me lucky in that my symptoms were minimal for quite some time... and I experienced benefits for the first 5 years after menstruation ceased. However not all effects have symptoms, so perhaps if I'd had more bothersome symptoms I would have addressed things sooner, which would probably be more beneficial overall. More on that later.
My hot flashes were not bothersome and were more like an interesting occasional adventure. It was so odd how other people could feel the heat coming off my body when I had them, but they didn't last long so it wasn't a bother. The night sweats were more bothersome. Still, I could deal with it, as while it would wake me, I could still go back to sleep easily. I joked about my experience being 'covers on, covers off' using motions like the 'wax on, wax off' scene from "The Karate Kid" movie as the motions really did match, lol. My LDL and total cholesterol were higher than the reference ranges, which was very odd because I wasn't consuming things known to have cholesterol (as I was literally only eating fresh uncooked whole: fruits, greens, other veggies, and minimal nuts and seeds). My healthcare providers were not concerned about it though as my HDL and triglycerides were great and I had no CV risk factors.
I loved not having to think about whether I would get pregnant or not with intercourse, and felt so free in that way. Also, it seems my hormonal balance for the 5 years after menstruation ceased helped my libido immensely as practically anything would turn me on, and quickies were an easy reality for me like never before, in multiples for the first time in my life too. So, yeah, I thought I'd won the lottery for a while there.
Gradually after those 5 golden years though things caught up and while dryness wasn't the issue for me (even though I was a bit drier), atrophy (i.e. lack of tissue elasticity) did become an issue as did urinary urgency resulting in not always getting the pants off in time. My skin overall had gotten much drier too. I thought it was maybe due to having alkaline water to shower in rather than the more neutral to acidic water I'd had before, but now I know that wasn't it.
Also, my electrolyte balances were affected and I needed much more sodium than I used to, but it took me a while to connect it all (several hyponatremic trips to the ER and a stay at a rural hospital that nearly killed me due to mismanaging it with too large of sodium level swings).
I had some risk factors for osteoporosis so I asked to get a DeXA to get a baseline on my bone density 5 years after menstruation ceased, only to be surprised to find my bone density well into the osteoporosis range. That's a story of its own, but is the main reason I think if I'd had more symptoms sooner I may have done HRT earlier and perhaps been able to start building bone sooner (HRT helps prevent bone loss). I don't know if I actually lost bone during those 5 years (statistically I did), but I'm fairly certain I never reached what is considered peak bone mass as I was always small boned. Still, I may not have done HRT back then partly due to not wanting to have any prescriptions, but also due to:
I had an autoimmune condition that was managed without meds via the raw v*gan diet I had been following, but it wasn't getting rid of it altogether. It also made getting HRT questionable (some thought fine, most thought no), so I never considered it, until... About 9 years after my last menstruation I got some functional labs and worked with a functional medicine person who helped me figure out where I wasn't absorbing things, etc. After about a year this resulted in my autoimmune bloodwork showing normal (without it). So the autoimmune issue was moot, and I had the other issues building, so I considered HRT. My bone density hadn't gotten any worse, and perhaps a bit better (I'd been working hard on it via LIFTMOR protocols and similar), but I had a lot of density to build to get out of osteoporosis levels even.
I started HRT (transdermal estradiol and oral micronized progesterone) a couple weeks before the 10th anniversary of my last bleed. It has helped with the atrophy (along with a dialator), and the urgency (most of the time--levels still rise and fall between doses), and my sleep which by the time I'd started with it was not so great. My LDL and total cholesterol went down into the reference range too. "I" was less dry, but my skin overall still dry. By the time I started HRT I had HSDD and the HRT did not help with that, so after a few years I started transdermal testosterone as well. This helped my skin not be so dry-finally! Occasionally it has helped me feel like those golden 5 years postbleed, but the HSDD has still remained to a lesser degree than before the testosterone. We're still working on getting the correct dosage level for it though, as it's kind of a Goldilocks kind of thing: doesn't work if too little or too much either.
I have had a lot more trouble with the HRT than I did those first 5 years though, as I have skin allergies to adhesives and most everything, yet transdermal estradiol is the best method for me theoretically, especially given the autoimmune history. I started with estradiol patches which were a total no-go for my skin, then I switched to a different brand which my skin tolerated surprising well enough for about a year. After that year though, I could no longer find any undamaged skin to put them on (I get a rash, blisters, etc. and the oozing wounds take weeks to heal). My body was rejecting it in other ways too, and I was getting visual migraines (no headache, but did have the sensory sensitivity wooziness, etc in addition to the visuals).
My electrolytes were out of whack again too, which after some intense blood testing in relation to my doses I figured were due to the hormonal swings. My medical provider thought that using a gel daily would help me have less intense swings, and that worked. The gel has been okay with my skin too.
In the US even though testosterone is a primary therapy for HSDD, it is not FDA approved for women, so considered off-label. This means that insurance doesn't cover it and the usual way to get it for women is via a compounding pharmacy, or try to microdose men's testosterone therapy which is FDA approved for men, only. The thing was, I had trouble finding a compounding cream or gel base that my skin would tolerate for testosterone, but eventually I found a men's gel that had similar inactive ingredients to the estradiol gel (which I microdose to women's levels) and that has been tolerated well by my skin, thank goodness. The longevity and non-removability of pellets was just too scary given my skin and hormonal swing issues. Oral was too risky too, so if the mens gel didn't work I'd be looking at injections, which I'd rather skip. Testosterone can also help build muscle and bone, so that's a bonus too. If it doesn't end up helping my HSDD, I'm thinking I may keep taking it if I can--for the skin, muscle, and bone benefits, but it's yet to see. Sometimes I wonder if I'd have been better off just skipping the hormone therapies, but then I remember how things were getting before I started. There were other things happening too that I haven't mentioned (like having the only panic attack I've ever had). It has been challenging to get the HRT and testosterone that will work for me, but overall they are helping me in tangibly measurable ways. I have built more bone with just the HRT, and haven't tested since I started the testosterone.