Oestrogen or Progesterone for vaginal dryness? Which!?

[boddi]

Hi.  I've anecdotally heard that progesterone helps post-op vaginal dryness.  That seems contradictory as I always thought progesterone was closer to testosterone than oestrogen.  Yet this one lady swears blind by progesterone.  She even says oestrogen creams didn't help her moistness.  I'm so confused, as a few postop women have told me oestrogen cream did help their vaginal dryness. 

  I'm thinking surely oestrogen would help more with vaginal dryness than progesterone but I have no direct experience of either   Does anyone: (a) have any experience/thoughts etc on progesterone aiding dryness?  and (b) have any experience (or knowledge) with oestrogen vaginal creams to help dryness?  There are several creams aimed at helping GGs with dryness but would/do they work in transwomen?  I am aware that we do not possess the same 'receptors' as a GG.  Any help greatly received.

[Doctorwho?]

I am aware that we do not possess the same 'receptors' as a GG.

Actually that is a myth right there... You do - but then some natal women don't! so if you are like one of the women that doesn't then just like a natal female then you won't... If you see what I mean?

There is no magic about female flesh - the human body is really economically designed even peritoneal enervation is largely wired the same between the sexes, with the same nerve going to the equivalent structure...

So it is with receptors - we all have all of them - (unless we randomly don't...) but that difference isn't sexually dimorphic - in fact it's one of the reasons why some women "develop" and others don't, or some men get very virilised and others don't. It's just down to genetic variation - how many of which receptors you get. I'm androgen insensitive. I'm XY, but I have very few receptors for T - and by luck shed loads for E... that just the random nature of the beast.

As far as receptors go you have them - but what may be different is the differentiated cell type that exists in you neovagina - which may not match the smooth muscle and gobbet cell combo found in the natal tube... Basically if you don't have the right cell type to express the mucus then no amount of endocrine stimulation can produce the right result.

Happily a lot of people find that some of their cells spontaneously mutate into the correct type - and the epidermis changes to epithelium...

Topical Oestrogen is what is normally prescribed for this. It generally works!

[Northern Jane]

I'd be "this one lady" she refers to and found estrogen alone had little effect but after adding progesterone the dryness problem disappeared. It may have a relation to being almost 40 years post-op or my own peculiar genetics.

[boddi]

Thank you for your help here, people.  Doctorwho: My original surgeon says we don't have the same receptors as natal women and he doesn't think topical E would help.  Any perceived moistness improvement is likely to be placeboic, he says.   I find it hard to disbelieve him, though, of course, docs can be wrong.   Re your comment '' differentiated cell type that exists in you neovagina'' etc: so you are saying trans women can have these ''right'' cells?  Or that they develop in time? Or both!?   I have read scientific papers both for and against our vaginas developing, in time, the same cell structure as natal vaginas.  It makes it so hard to know for sure.  Look at this link. http😕/www.ncbi.nlm.nih.gov/pubmed/19735277.  Apparently 4% of us were virtually indistinguishable.  But I wonder on the hows, whys, whats etc. I wonder what these 4% had in common.  One thing: is your reply based on experience, scientific, or otherwise?  Or are you just second-guessing?    And you say topical E generally works: for transwomen you mean?   So I should get  a wetter vagina constantly?  Or only for a little while after applying the cream? I wonder how long the effect lasts etc?   

[Doctorwho?]

My reply is based mainly on personal experience - but it has to be admitted that someone with androgen insensitivity may be physiologically different in some way...

Point about whether or not you have the receptors is moot in that you will IF you have the correct cell types. So the question of who is correct is not really at issue because it all depends on whether you have those cells or not... my point was more that estrogen receptor equipped tissue DOES exist in physiologically male people - otherwise HRT induced breast growth simply could not happen, and we would all need BA surgery. Now believe me when I say that BA is something I do NOT need. If anything I have needed a reduction for a LONG time, and I'm not joking.

I too have read the papers about cell plasticity and of course I tend towards believing it because I'm clearly in the 4% - I've been checked over had swabs etc...

Now whether that is down to innate difference - luck - or something different that I did by way of self experiment, I can't say for sure. All I can say is that 30 years on my internals are as close as makes no difference to the natal result.

[calico]

Now whether that is down to innate difference - luck - or something that I did - and believe me I tried many things which are not usually done, precisely because I wanted to find a way to induce that result... I can't say. All I can say is that 30 years on my internals are as close as makes no difference to the natal result.

for curiosity and conversations sake and without crossing the border of the rules and of course if it does not bother you what many things that are not usually done?

I believe I am one of the few with the correct receptors as after about 4 months maybe a lil bit more things shifted so to speak and well everything is as it should be for a normal vagina.

[Zumbagirl]

I use summers eve personal moisturizer. I can buy it in the grocery store for less than $5 a bottle and the little bottle for me lasts about 6 months. It works great for those hot summer months when I am outside a lot. No prescription no doctor no side effects to worry about. I tried estrogen cream but I prefer this approach much better.

[boddi]

Zumbagirl: thanks.  But does Summer's Eve help you to be moist or even wet not just at times that you apply it?  Is it enough to have sex without lube?  I tried properly 'playing' recently for the first time since post-op.  And I noticed, at best, a tiny increase in moistness. And that was after 1.5 hours!    Calico: you believe you are one of this minority.  You say things shifted and everything is as it should be for a normal vagina.  Could you please elaborate?  Thanks.

[Doctorwho?]

Sadly I think I will have to adopt caution at this point. My experiments on myself were done a very long time ago, but I am now subject to the rules of professional medical ethics, and I can't in all good conscience cross that line.

As a student, while I may from time to time, share my understanding and personal experiences in a general way, I would be crossing many many lines if I were to give anything which could be mistaken for medical advice or shared details about unproven personal experiments. I don't want to get struck off before I start, so if you will forgive me I will hold my tongue.

[calico]

Sadly I think I will have to adopt caution at this point. My experiments on myself were done a very long time ago, but I am now subject to the rules of professional medical ethics, and I can't in all good conscience cross that line.

As a student, while I may from time to time, share my understanding and personal experiences in a general way, I would be crossing many many lines if I were to give anything which could be mistaken for medical advice or shared details about unproven personal experiments. I don't want to get struck off before I start, so if you will forgive me I will hold my tongue.

I understand and as noted was just a curiosity.

Zumbagirl: thanks.  But does Summer's Eve help you to be moist or even wet not just at times that you apply it?  Is it enough to have sex without lube?  I tried properly 'playing' recently for the first time since post-op.  And I noticed, at best, a tiny increase in moistness. And that was after 1.5 hours!    Calico: you believe you are one of this minority.  You say things shifted and everything is as it should be for a normal vagina.  Could you please elaborate?  Thanks.

I'll do my best to explain my experience while it obviously cant be assumed for everyone but somewhere round 4 or so month I started retaining/producing my own moisture to finally at this point I use a pantyliner daily. When aroused I have enough that ..well that I don't need any help from ky to get the party started. Also a couple months back I had some sort of skin/shedding I want to say with just a minor pinkish liquid and maybe a little blood on my pad. Which prompted me to go see a gyno to make sure nothing was wrong. Her explanation was it was likely just some dead skin as nothing was out of the norm and that everything was as it should be for a normal healthy and sexually active vagina. Imo it was as the a article you posted suggested nothing strange has happened since but considering everything the body can be a very amazing machine.

[Jenna Marie]

I'm going to recommend Vagisil lube again - it's not intended to be absorbed, but it's not as "leaky" as KY and similar lubes, so it basically is designed to stay in place and keep things moist. It also doesn't rely on estrogen receptors or whatever in the vagina, because it's a purely physical product, no hormones. It works beautifully for me; not enough moisture that I need to wear a pad or worry about it, but just enough that I'm not occasionally uncomfortably dry day to day. I use it for dilations, which at this point is about every other day but was 3X a day back when I started with it.

(This is, of course, a recommendation for daily moisturizing rather than for sexual intercourse - although I'm sure it'd work fine for that too, I self-lubricate enough when aroused that I haven't tried.)