notes

20200718144852-feminizing_hormone_therapy.org

@@ -20,7 +20,11 @@ experienced during HRT is due to lowered interest and atrophy ([[file:CBettocchi
 
 Distress due to lowered sexual interest meets the critera for hypoactive sexual
 desire disorder. Maintenance of erectile function may benefit from low-dose
-testosterone or PDE5 inhibitors ([[file:MatsHolmberg1970.org][Holmberg et al., 2018]]).
+testosterone or erectile dysfunction medications ([[file:MatsHolmberg1970.org][Holmberg et al., 2018]]).
+Alternatively, consider consulting with your doctor about reducing or halting
+androgen blocking medication. While ED meds may help, it's worth noting that
+erections with them may not feel the same as you're used to ([[file:trans_women_and_viagra_trans_tool_shed.org][Trans Women and
+Viagra – Trans Tool Shed]]).
 
 * Is Progesterone an important addition to a feminizing HRT regimen?
 The addition of progesterone may yield improved feminization and breast

trans_women_and_viagra_trans_tool_shed.org

@@ -0,0 +1,43 @@
+#+title: Trans Women and Viagra – Trans Tool Shed
+#+roam_key: https://transtoolshed.com/blogs/news/trans-women-and-viagra
+
+https://transtoolshed.com/blogs/news/trans-women-and-viagra
+
+#+begin_quote
+For lots of trans women, including adult performers, those doing sex work, or
+anyone simply looking to use their trans girl cock, erectile dysfunction
+medications such as Viagra, Cialis and Levitra can be essential. Prescription ED
+medications work by blocking phosphodiesterase type-5 (PDE-5), an enzyme that
+promotes the breakdown of cyclic guanosine monophosphate (cGMP), which regulates
+blood flow. This relaxes blood vessels in the body, including in the penis,
+which makes erections easier to achieve and maintain. These medications do not
+interact with or alter the effects of hormone replacement therapies (HRT) and
+work the same way in both trans women and cisgender men, but with some added
+considerations for trans ladies.
+
+Trans women who are on HRT and have taken ED medications have reported that
+erections “feel different” than the erections they had prior to HRT. Erections
+may not be as firm as they were before hormone replacement therapy, but still
+firmer and longer-lasting than without ED medications. Estrogen also tends to
+make penile skin thinner and more sensitive, which may make erections feel more
+painful.
+
+Lower testosterone levels typically decrease many trans women’s libidos. Since
+ED medications still require you be aroused in order to work, some may discover
+that Viagra, Cialis, or Levitra are not exactly the “magic pill” they were
+hoping for. ED medications won’t necessarily make sex “feel” more pleasurable,
+but if your aim is penetrating your partner, the confidence of knowing you can
+may improve your enjoyment.
+
+There are of course other methods you can try to help achieve an erection. Some
+folks use injectables called prostaglandins such as Caverject or Trimix. These
+injections also increase blood flow to the genitals and are prescription-based,
+but unlike pills, they can provide erections whether or not the user is aroused.
+Cock rings are a great way to help maintain an erection by restricting the flow
+of blood out of the penis. There are also lubes or arousal gels, such as Max
+Arousal Gel, Intimate Earth Intense Clitoral Gel or others, that open the blood
+vessels to the genitals making erections easier. Another option to consider may
+be reducing or going off any androgen-blocking medications that you might be
+taking, unless doing so would be dysphoria-inducing. Be sure to consult with
+your medical provider before deciding to alter your hormones.
+#+end_quote