Okay, so we’re going to be talking about genitals in this article and about transdermal use of testosterone. We’ll have some anatomical terms sprinkled here and there.
What’s transdermal? Why not topical?
Topical substances lie on top of the skin, or are only very shallowly absorbed into the skin. If the substance can be absorbed into the tissues and bloodstream past the skin layers, it’s transdermal.
But, on our genitals?
Yep. Genital skin is thin, and the tissues just under genital skin have lots of blood vessels and hormone receptors, so, theoretically, we can specifically apply testosterone (or estrogen, but we’ll talk about that in another article) to target those tissues.
But why?
If you’re taking estrogen, with or without an anti-androgen:
Overall, you might be interested in minimizing the amount of testosterone in your body or minimizing the effects of any testosterone in your body. This can mean fewer morning, spontaneous, or intentional erections. They might be softer and less full. Your libido may diminish or change. How much your experience of wanting and having erections changes can’t really be predicted.
This is great if you want these changes. But what if you want to keep having erections and want to preserve firmness? What if you want to have penetrative sex using your erection? Here’s where targeted application of testosterone comes into play (pun intended.) We also might recommend that if you want to keep having erections, you should keep having erections: masturbate! Also, directly applying testosterone to your genitals is an option.
How?
Not gel. Androgel, or other testosterone gels on the market contain alcohol. Alcohol on sensitive genital skin can hurt and dry out the skin. If this kind of sensory play is in your toy bag, awesome, but there are much more effective and much less expensive ways to get alcohol on your bits than prescription gel.
So…
Usually, we’re looking at compounded creams containing testosterone. They can be formulated to be skin-friendly (and allergen-friendly) and thick enough to stay right where you put them.
As we said above, we have to assume that some testosterone gets into your bloodstream. But, hopefully, it has found receptors in the local tissues first.
What if it does circulate all over the body?
- It’s gonna be a tiny amount of testosterone.
- It may not be strong enough in your bloodstream and other tissues to affect your other gender goals.
- If you are taking anti-androgens, they may prevent other tissues from utilizing any new testosterone in the bloodstream.
- We can adjust! Like so many other gender things, changes take time, and we have options to encourage or discourage some specific changes.
If you have a clitoris:
“Bottom growth” is a potential body change when you start taking testosterone. That means your clitoris might grow. You might start having (or have more noticeable) erections.
If one of your gender goals is bottom growth, but not other big changes, you can apply transdermal t on your genitals, and just your genitals. BIG NOTE: this won’t prevent other bodily changes, but it may concentrate them. The skin here is mucosal and has a robust blood supply. So absorption is high, but there’s a lot of blood vessels in those tissues, too.
Curious about testosterone in general? Check out our resources:
- What You Need To Know Before Starting Testosterone
- Testosterone: A Quick Crash Course in Gender Affirming Care
- Testosterone And You: Gettin’ Square, The QueerDoc Way
- Testosterone and Cardiovascular Disease Risk
If you’re otherwise taking T, adding in transdermal T
might supercharge bottom growth. Your provider may lower the dosage of your other form of T to maintain overall levels in your body.
So What’s the Scoop on Compounded Meds?
We’ve discussed things to know before using a compounded pharmacy before.
Things to be aware of:
- Compounded T is likely to be relatively expensive.
- It can be formulated to play well with your skin if you have allergies (depending on the allergen!)
- Most compounding pharmacies can make it: you don’t need a sterile compounding pharmacy, as it isn’t an injectable.
- How does it arrive? It might be packaged in a click tube for easier dosing and less mess:
- It’s kind of like a deodorant tube: turn the base dial for a click of product at the top. Each click is a measured amount.
TLDR:
- Transdermal testosterone can help maintain erections and encourage bottom growth (or discourage loss of length/girth and firmness.)
- DON’T use gel.
- Apply directly to the area you want to target.
IMPORTANT BITS ABOUT T APPLIED TO YOUR SKIN - If it’s on your skin, it might come off your skin with contact: clothes, hands, other genitals. Wash your hands after applying, wash the area you applied before contact with other people, and consider doing laundry separately.
- Compounded creams contain oils that could degrade latex and polyisoprene. If you’re in a situation where a latex condom or other barrier might be used, here’s another reason to wash carefully before contact.
- What’s a polyisoprene condom? These are brands like Skyn and Durex Real Feel.
If you’re a QueerDoc patient, and this intrigues you, ask us about it at your next visit! We’ll talk to you about risks and benefits and your goals and options in more detail.
Click-On with QueerDoc!
