do you need to take stuff for vaginal atrophy if you don't use your vagina for sexual intercourse? or if you don't have sex at all?
sorry if this question has an obvious answer, the sources about vaginal atrophy i personally have seen never mentioned it.
Lee says:
I'm not surprised you've never seen this mentioned-- unfortunately, there isn't enough open discussion of this type of thing in the trans community.
I think that's partially due to a lack of institutional knowledge; there aren't many studies on these issues so doctors/providers aren't able to tell you the average percentage of people who experience mild/moderate/severe atrophy per time spent taking testosterone.
When there's no Official Statistic saying "only 5% of people have severe atrophy within the first year of taking T, but 95% of people have X, Y, and Z symptom of severe atrophy after 15 years on T," (that is an example!) it can be hard to provide guidance about how often these things occur because the community-level knowledge is mostly based on personal anecdotes and word-of-mouth.
The general stigma around discussing sex and sexuality in relationship with trans bodies makes it even more difficult for people to bring up the topic because it seems some people worry that they will be invalidated by others in the community if they assert their identity as a trans man, for example, while also saying they like to be vaginally penetrated.
The final barrier in having these discussions besides the straight-up issue of lack of knowledge is people's (understandable) reluctance to talk about parts of their bodies that may make them feel dysphoric.
In my opinion, that's the hardest barrier to overcome. Encouraging more research into how testosterone changes the body (for example, how much clitoral growth is average) and addressing the way toxic masculinity and transphobia intertwine to create self-policing/gatekeeping and stigma within the community are both things that people can campaign to do, but it's hard to try and make people discuss something that is deeply uncomfortable for them to acknowledge because of dysphoria, and it's important to respect people's boundaries on that.
But it's still an important issue, and I'm a big proponent of being open about health issues that affect people who have medically transitioned, so as y'all know, I've been on T myself for close to 5 years now and I have been prescribed localized estrogen for atrophy that affects my sex life, but I haven't had any issues with atrophy in my day-to-day life.
I've been lucky enough to have open and frank conversations with several folks who have been on T for more years than I have, and the majority of folks I've talked to have had similar experiences to my own, but there is some variation.
Some people do end up experiencing symptoms of vaginal atrophy like dryness, itching, and UTIs that bother them on a daily basis and they find it helpful to take localized estrogen to treat those symptoms even though they aren't having sex that involves being vaginally penetrated.
Other folks find that the atrophy they're experiencing is less severe, and they only have discomfort when they are penetrated vaginally, so they wouldn't necessarily need localized estrogen if they chose to not have that type of sex and would rather explore other sexual acts instead of taking localized estrogen.
And there are some folks who don't feel like they have an issue with atrophy even after years on T, or have such minor atrophy that using plenty of lube during sex resolves the issue, so they don't need localized estrogen at all.
There are also some situations where a person with atrophy may want to take localized estrogen, like in preparation for a vaginally-assisted surgery. For example, some hysterectomy techniques are vaginally assisted, and recovery time may be quicker if the vaginal tissue is more robust and not atrophied.
So not everyone needs to take stuff for vaginal atrophy if they don't use their vagina for sexual intercourse, but it will depend on the individual in question as there are certain situations (like severe atrophy or pre-op surgery prep) where it might be recommend.
Or if you stop taking testosterone while you're younger (aka pre-menopause) and still have your ovaries (aka haven't had an oophorectomy), then atrophy shouldn't be a major problem for you because it is a reversible testosterone change and should eventually revert back after you stop taking T.
But atrophy does occur to even cisgender non-intersex women with ovaries once they've gone through menopause, so you'll likely end up with some level of atrophy at some point in your life anyway. It just tends to be more severe for trans people on testosterone because our T levels are higher and our E levels are lower than the average post-menopausal woman.
Of course if you've had a vaginectomy as part of your bottom surgery, you obviously don't have vaginal atrophy issues anymore due to not having a vagina.
Followers, if you've used topical/localized estrogen for vaginal atrophy, feel free to weigh in about your experiences and what symptoms prompted you to try it!
