I am a pre op m to f and have been taking finasteride and spironolactone. No estradiol due to a prior DVT. My doctor says it is way too risky to resume estrogens. I have tried to masturbate a few times but am unable to achieve an erection as well as ejaculate even when using vibrators or any other toys I can think of. Is this what can expect to happen post op? I don't have a problem with the fact that it won't become erect, but the lack of an orgasm is bothering me. Any feedback?

Quote from: Ejo on April 27, 2017, 04:53:07 PM
I am a pre op m to f and have been taking finasteride and spironolactone. No estradiol due to a prior DVT. My doctor says it is way too risky to resume estrogens. I have tried to masturbate a few times but am unable to achieve an erection as well as ejaculate even when using vibrators or any other toys I can think of. Is this what can expect to happen post op? I don't have a problem with the fact that it won't become erect, but the lack of an orgasm is bothering me. Any feedback?

Maybe your response has changed? Have you been taking your time? I know my response is slowly changing. Each time I have to exercise it, things are slightly different. My response seems to be not so focussed on one particular area like male orgasms...I know its changing slowly so will be interested to see where it ends up. Maybe things are changing for you? Try relaxing and with no expectations...try "getting in the mood" more so than you were. I know I need to have my mind set right and be way more aroused than I what I used to have to be.

Liz

Once you get rid of testosterone, things work differently. First you have to get yourself turned on. You do it by thinking about a lover massaging your body or thinking dirty thoughts. If done right, you will feel a warm glow all over your body. After that, sex play below the belt should work. This is how a CIS woman has enjoyable sex and without it, there is no joy and it might even be painful.

Quote from: Ejo on April 27, 2017, 04:53:07 PM
I am a pre op m to f and have been taking finasteride and spironolactone. No estradiol due to a prior DVT. My doctor says it is way too risky to resume estrogens. I have tried to masturbate a few times but am unable to achieve an erection as well as ejaculate even when using vibrators or any other toys I can think of. Is this what can expect to happen post op? I don't have a problem with the fact that it won't become erect, but the lack of an orgasm is bothering me. Any feedback?

Re DVT: what if you went on blood thinners and had a greenfield filter put in?


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Quote from: Dena on April 27, 2017, 05:27:15 PM
Once you get rid of testosterone, things work differently. First you have to get yourself turned on. You do it by thinking about a lover massaging your body or thinking dirty thoughts. If done right, you will feel a warm glow all over your body. After that, sex play below the belt should work. This is how a CIS woman has enjoyable sex and without it, there is no joy and it might even be painful.

↖ This, totally! Sometimes it happens out of the blue... At other times it happens as I see or think about something sensual... I feel that warmth filling my entire body, a sense of "floating", my nipples become erect... And apparently my look changes because my wife can tell when Sarah is excited... No more spontaneous erections about 2 weeks after starting meds, but when I'm turned on, I do have erections (albeit not as hard and persistent) and I do ejaculate (although it's just a transparent liquid, egg white-like). And I definitely have an orgasm, but in some way it's a little different than before... I enjoy it more!😋 I hope I'll be able to find my "sweet spot" after SRS.

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Quote from: Ejo on April 27, 2017, 04:53:07 PM
I am a pre op m to f and have been taking finasteride and spironolactone. No estradiol due to a prior DVT. My doctor says it is way too risky to resume estrogens. I have tried to masturbate a few times but am unable to achieve an erection as well as ejaculate even when using vibrators or any other toys I can think of. Is this what can expect to happen post op? I don't have a problem with the fact that it won't become erect, but the lack of an orgasm is bothering me. Any feedback?

First, as others have said, I would try to enter the right mindset... Sexual arousal in a woman seems to originate a little differently than in a man. I found that imagery and imagination play a much bigger role than physical stimulation.

Now, my opinion as a physician (nota bene: it's the opinion of YOUR doctor that counts, not mine - he knows you, I don't)... If the more conservative methods don't work, you may try Viagra or another drug from the same family (after consulting your doc, of course). A third option would be to take an estrogen AND an anticoagulant medication (blood thinner), although this carries its own set of risks (such as bleeding, which could sometimes be fatal, even with the new generation of oral anticoagulants [NOACs]). Someone has suggested an inferior vena cava filter (Greenfield); albeit possible, this would be a very last and questionable resort because you'd still have to take the oral anticoagulant in order to prevent DVTs (the filter only protects you from massive pulmonary embolisms, not from DVTs associated with the use of estrogen) and it carries its own share of significant risks, which would add to the risks of chronic anticoagulation.

Bottom line: insist very, very, (very!) much on the more "conservative", preferably non-pharmacological and non-invasive methods. To be clear: insist VERY MUCH! And don't rush it. With patience and the right mindset, you'll have a good chance of having erections again, but above all JOY. 😊

Good luck! Hugs, Sarah


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  On the few times I have played to conclusion since on HRT I've thought it slightly painful and unsatisfying. I am more intrigued with it's efforts to hide from me. It's funny. It used to be my friend but now is afraid I might do it in.

OFF WITH HIS HEAD! 

Hugs,
    Laura or Jeanette

I am sure it will come with time. And I am not sure I would be of any help because in the beginning I did not get erections. So I asked my doc for viagra. Used it once. But since then. I have been being aggravated by waking up with erections again. And now I get them throughout the day. It's kind of aggravating. But since I do like making love to my wife it is something I can live with. But really would not mind if I never got them again. As far as an orgasm goes, it takes a while but I get there. Nothing comes out. But I do orgasm. As far as I go. I could not imagine how I would orgasm without an erection.


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I took my time, and yes I was able to orgasm without an erection after quite a while of trying (WHAT A RELIEF)!. I hope it gets easier with time. I don't care if I never have another erection. My sex life with my wife is non existent anyways because she is not attracted to me as a female. So far she's been hanging around but how long that will last only she knows... Thanks for everyone's input.

You are depleting your body of T and not replacing it with E.

Anti androgens can kill sex drive and can possibly even mute erogenous sensation.

This is not a good way to stay healthy in the long run.

Yeah arousal for me is much different than before. I need to think of a person romantically and do manual stimulation to get there. Estrogen is a key part of that too so yeah i'd see by asking doctors including a second opinion, if different drugs or a blood filter might help you.

Sometimes now my orgasms are longer, way longer and whole body orgasms (albeit maybe a bit less intense than before) or sometimes they are less intense and quicker but still be nice. The amount of ejaculate i experience is less and less, sometimes the lubrication phase itself it "wetter" than the results of an orgasm.

Quote from: Ejo on April 27, 2017, 04:53:07 PM
I am a pre op m to f and have been taking finasteride and spironolactone. No estradiol due to a prior DVT. My doctor says it is way too risky to resume estrogens.

Then you need to find a new doctor, quickly. A prior DVT isn't a good reason not to take estrogen. Non-oral bio-identical estrogen (i.e. estradiol) in physiological concentrations or even somewhat higher has been shown to be safe in several studies, on men of an advanced age (many patches at a time, DVT risk actually found to lessen, not increase), in transgendered women, even with a presdisposition to clots (activated protein C resistance or protein C deficiency), in ciswomen, etc. I, myself can attest to this as my clotting times have not budged despite my high levels of estradiol (up to 4,000 pg/ml) on injectable estradiol.

Taking an anti-androgen alone without any E to compensate for the loss of T can result in ageing a lot quicker, feeling fatigued and having no/low sex drive, depression/anxiety, hot flashes, osteoporosis, memory deficits, poor feminization, etc. Your overall health may also be compromised.

Do premenopausal ciswomen who have DVT need to have a full oophorectomy (removal of both ovaries) because the estrogen in their bodies is a danger to their health and increases the risk of DVT? No. So, if you are taking the same identical estrogen and in the same manner (i.e. directly delivered to your blood), the same should logically apply to you.

p.s.: I can PM you those studies if you want and you can show your doctor.

QuoteI have tried to masturbate a few times but am unable to achieve an erection as well as ejaculate even when using vibrators or any other toys I can think of. Is this what can expect to happen post op? I don't have a problem with the fact that it won't become erect, but the lack of an orgasm is bothering me. Any feedback?

This may be due to low sex hormones. I am post-op and have amazing orgasms, where I ejaculate and it dribbles out of my vagina. Progesterone helps, I think.

Quote from: Sarah.VanDistel on April 28, 2017, 01:31:48 AM
First, as others have said, I would try to enter the right mindset... Sexual arousal in a woman seems to originate a little differently than in a man. I found that imagery and imagination play a much bigger role than physical stimulation.

Now, my opinion as a physician (nota bene: it's the opinion of YOUR doctor that counts, not mine - he knows you, I don't)... If the more conservative methods don't work, you may try Viagra or another drug from the same family (after consulting your doc, of course). A third option would be to take an estrogen AND an anticoagulant medication (blood thinner), although this carries its own set of risks (such as bleeding, which could sometimes be fatal, even with the new generation of oral anticoagulants [NOACs]). Someone has suggested an inferior vena cava filter (Greenfield); albeit possible, this would be a very last and questionable resort because you'd still have to take the oral anticoagulant in order to prevent DVTs (the filter only protects you from massive pulmonary embolisms, not from DVTs associated with the use of estrogen) and it carries its own share of significant risks, which would add to the risks of chronic anticoagulation.

Bottom line: insist very, very, (very!) much on the more "conservative", preferably non-pharmacological and non-invasive methods. To be clear: insist VERY MUCH! And don't rush it. With patience and the right mindset, you'll have a good chance of having erections again, but above all JOY. [emoji4]

Good luck! Hugs, Sarah


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With my DVTs, Coumadin was prophylactic, but my vascular doctor at the time thought a filter instead of Coumadin was better choice because of my age at the time. I've had the filter for 18 years. When I go on planes or trips where I am sitting for a long time, I take aspirin. The only side effect I've had is post phlebetic leg syndrome so I wear a compression stocking every day.


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Quote from: Gertrude on April 29, 2017, 03:57:29 PM
With my DVTs, Coumadin was prophylactic, but my vascular doctor at the time thought a filter instead of Coumadin was better choice because of my age at the time. I've had the filter for 18 years. When I go on planes or trips where I am sitting for a long time, I take aspirin. The only side effect I've had is post phlebetic leg syndrome so I wear a compression stocking every day.


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An IVC filter is indeed a good option if the patient is considered high risk for pulmonary embolisms and for some reason can't (or won't) take an oral anticoagulant. Anyways, I'm glad that OP reached encouraging results without extras meds, etc.

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