All of the above. But the worst thing now, after several years of HRT is the vaginal and clitoral atrophy and itching down below. I’ve recently requested topical oestrogen cream as that seemed to help, but for some reason they stopped prescribing it for me and kept sending pessaries instead.
It got to a point where my clitoris had all but disappeared and if I tried to orgasm it was a painful ache instead of pleasure. I’d had similar when B12 deficient but even taking B12 supplements didn’t help this time. Once I added testosterone into my HRT my orgasms became stronger again, and not painful.
My clitoris has definitely plumped up a bit and the surrounding tissues feel less fragile, although I’m still prone to UTIs and soreness. Daily application of oestrogen cream, coconut oil and Vagisil lidocaine cream help temporarily.
But TBH one of my least favourite parts about it all is the feeling that I’m no longer naturally womanly. Knowing that I need all these creams and potions to remain functional, especially as DP is younger (and male) so I feel very unsexy even talking about it. I left my XP because he was so gobsmackingly misogynistic about menopause that it gave me the rage. So I try to give the benefit of the doubt and talk about it with current DP assuming he won’t use it against me in an argument or think less of me.
But he seems to think its all about sex, like why do I need to try and remain young? Why not let my body age naturally? Having to explain vaginal/clitoral atrophy, paper thin vulval tissue, UTIs, clotted periods, urinary incontinence and all the MH symptoms mentioned by PPs to a man you want to fancy you is the pits.