So last June I went to Montreal for zero-depth vaginoplasty with Brussard. It's almost a year into recovering and I'm still struggling with many things.

1. My trans clinic recommended me to go off of progesterone a few months after surgery due to cancer concerns. I took the recommendation, since cancer is a bit of concern because of family history. However, from that point my sex drive slowly tanked and I became severely depressed. A few weeks ago I decided to go back on to it, and luckily, my sex drive came back and I'm feeling less depressed.

Struggling with this because, well, I don't want to get breast cancer... but I also seemingly can't live without being on prog. Does anyone know exactly how seriously I should be concerned with this?

2. The surgical site is still quite sensitive and gets irritated a lot. I am putting on a vaginal moisturizer daily to combat it, as well as trying to remember to spray down the region with water after peeing when I can. Does anyone have any other recommendations for dealing with this? Will it get better with time?

3. Dealing with discrepancies between what my trans clinic states are good estrogen and testosterone levels and what I have seen on the internet. 
My levels are:
581 pmol/L estrogen
<0.4 nmol/L testosterone
From what I have seen thats too high for e and too low of t, but my clinic says that they are right where I want them to be.

4. Has anyone else who's had this done had a lot of difficulties getting back into sex the same way as before? Its almost been a year and I am still having a hard time reaching completion, with it happening with a partner only 5 times since I started having sex again. Everything feels different, and I am struggling with figuring out what works and what doesn't. How do I go about re-learning my body?

Hello Riley,

I'm Lori Dee. Welcome to Susan's Place!

I see that you have just registered as a new member, and this is your first post.

We strive to make this a safe place to find information and share your thoughts and comments. No matter who you are, you are always welcome at Susan's Place.

The questions you are asking are best answered by medical professionals, not strangers on a website forum. No one here knows anything about your medical history, and we can't examine you to make appropriate recommendations. It would be illegal for us to try. Seriously, if you are having post-op issues, I would suggest you talk to your doctor or the surgeon to get their opinion.

We would like to get to know you. Once you feel comfortable here, please feel free to stop by the Introductions Forum, introduce yourself and tell us something about you.

When you click on the HOME button, you will see a page that lists all of the various sub-forums by category and topic. Each sub-forum has a description of what that forum is about, as well as any guidelines for posting.

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Once again, welcome to Susan's Place!

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@RileyQuinn32
@Sarah B
@Northern Star Girl

Riley, As Lori said, medical concerns are best handled by a doctor. It does help you to educate yourself as much as you can. Look for information on the risks of medroxyprogesterone vs bio identical progesterone. You will find that many texts only list the risk factors for the older medroxy medication, and that the risk factors for bio identical are much lower (actually similar to cis women).

Your hormone levels are very individual depending on your biology and what you hope to achieve, but the levels you posted are not unusual in trans HRT. Again, there is some misinformation, not only on the web, but in the texts many doctors use, mostly originating from an outdated report called the Women's Health Initiative. This report used synthetic hormones to establish risk levels, and it not applicable to the bio identical hormones in common use nowadays.

To kick you off, here is a paper from the University of California San Francisco on Feminising Hormones. It is over a decade old but has good information regarding risk factors. https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy

Post surgery recovery can take more than a year, and may be benefited by specialist care. There is another member here from Canada who has experience in this and I hope she chimes in.

Hugs,

Allie

Quote from: RileyQuinn32 on April 30, 2025, 01:50:43 PM2. The surgical site is still quite sensitive and gets irritated a lot. I am putting on a vaginal moisturizer daily to combat it, as well as trying to remember to spray down the region with water after peeing when I can. Does anyone have any other recommendations for dealing with this? Will it get better with time?

Hi, Riley.  Welcome!  Sorry to hear that you are experiencing ongoing problems.

I, too, had zero-depth vaginoplasty with Dr. Brassard.  I had a lot of pain and pressure at the site for a couple of years afterwards.  I finally heard about pelvic floor physiotherapy, and found a practitioner with experience helping trans women.  The massage and exercises, both in the office and at home, following her instructions, helped a lot.  My doctor also prescribed anti-inflammatory medication that helped a bit.  I attribute most of the improvement to the pelvic floor exercises.

The pain gradually improved from continuous to intermittent, and eventually it (mostly) went away.  While it was intermittent, I noticed that it seemed to increase monthly.  Being a math and statistics nerd, I started keeping track.  Would you believe it came on a 26-day cycle, regular as clockwork?  Not that this has any significance, and it may be totally irrelevant to you, but I thought it was fascinating.  Anecdotally, quite a few trans women on this and similar forums report various peri-monthly symptoms.

Nowadays, I only notice pain and pressure occasionally.  The quality of the pain is relevant.  If it is skin pain, I know to apply an anti-fungal cream.  If it is deeper tissue pressure, I do some massage in the area.

Sorry, I can't help with the sexual issues.  I am mostly asexual.  My sex drive was never strong, and it seems totally absent since I started HRT.