Maintaining erections and healthy penile tissue: topical testosterone

Tags:

• Feminizing HRT
• Androgens

Feminizing HRT will most likely cause a decrease - if not loss - of erections, and primarily spontaneous erections. If this comes with joy and helps with genetital dysphoria for many, some might want to prevent this phenomenon, for different results: desire to maintain sexual practices that requests erections, or avoiding as much as possible penile tissue atrophy.

Indeed, spontaneous erections are a way for the body to keep the penile skin and inner tissue elastic and resilient to friction and minor wounds. With the disappearance of androgen impregnation in these tissues, you might experience pain during erections, and more fragile skin. As described here, the scrotal method of applying gel seems to increase this phenomenon.

A solution to help with penile tissue atrophy and maintaining erections is application of topical testosterone, as a gel. This way, the low levels of testosterone will limit its action to the penile/scrotal zone, and the general systemic levels won’t raise significantly. Once again, this method has been particularly experimented by american doctor Will Powers, but many trans women in the world use it. This is his own description:

“This cream is applied topically to the penis/scrotum once a week at bedtime in AMAB people experiencing erectile dysfunction, painful erections, tissue atrophy (shrinkage and thinning of the skin). It is used with an escalating frequency approaching SRS for optimal tissue health. Post SRS it can be used weekly during a dilation session (by coating the dilator) and sometimes can help achieve additional depth due to increasing tissue elasticity.” “This can be done without increasing systemic levels or causing re-masculinization if you use my compounded formulation, which is 1 gram of compounded 0.5% topical testosterone topically to the penis and scrotum once weekly. It tends to raise T levels about 10-20ng/dl with weekly administration.”

If you manage to have it prescribed, you will most likely need to get the medication compounded for you, as the weakest gel available in Sweden has a 1.62% concentration, when what Dr Powers suggests is a 0.25% to 0.5 % concentration (2.5 mg to 5mg/g).