If you’re a trans man and have a vulva and vagina, it may feel complicated or you may even feel disconnected from these parts of your body. Everyone’s experience with their anatomy is different, and there’s no ‘right’ way to feel about it.

Understanding the vulva and vagina can help you take care of your body, even if these terms don’t fully feel like they align with who you are.

Anatomical terminology

Here at My Vagina, we understand that some the anatomical terminology used may make some people uncomfortable due to this potential disconnection. Just to warn you, out of necessity, we use standard medical anatomical terminology. 

What is the vulva?

The vulva is the external part of the anatomy that includes the labia (the “lips”), the clitoris, and the openings for the vagina and urethra (where you pee). The vulva can look different for everyone—different shapes, sizes, and colors are all normal.

What is the vagina?

The vagina is the internal passageway that connects the vulva to the uterus. It plays a role in things like menstruation, childbirth, and sexual activity, depending on your body and choices.

Anatomy

Understanding female anatomy

Here we take a closer look at what the female reproductive system looks like.

Understanding the pelvic floor

The pelvic floor is critical for supporting pelvic organs, keeping us going to the toilet effectively, and enjoying sex.

The vulva and vagina through ages and changes

An overview of how your vulva and vagina changes throughout your life, from being a newborn to old age.

Supporting your body on T

For trans men, navigating care for these parts of the body might feel challenging. Hormone therapy (HT), like testosterone, can cause some changes, such as thinning of the vaginal walls or changes in natural lubrication.

These changes are normal and can be managed with the help of a healthcare provider and useful natural tools such as My Vagina’s unique natural vaginal support, EstroBoost or Fennelope. Both are easy to use and are drug-free, to be used as often or as little as you need them. 

Both EstroBoost and Fennelope contain phytoestrogens (weak plant estrogens) to support local oestrogenic effect in the vagina, without affecting systemic estrogen levels.

EstroBoost vs Fennelope: what’s the difference? 

If you’re experiencing odour or unusual discharge, EstroBoost contains some pomegranate oil, which has the extra advantage of being phytoestrogenic and a little antimicrobial.

Fennelope is a straight up soothing, phytoestrogenic application. Both are 100% natural oil-based treatments used deep vaginally while you sleep. 

EstroBoost and Fennelope are both very soothing, and support strengthening and thickening of vaginal epithelial cells. This effect increases the performance of the cells, reducing uncomfortable symptoms of low estrogen in vaginal tissue. 

Probiotic support

Probiotics designed to support the vaginal environment can be very useful, particularly when combined with EstroBoost or Fennelope, to support protective lactobacilli populations.

V-Spot is a direct vaginal probiotic, not need to take any pills, just use vaginally as needed to support healthy flora.

Do not use the oil-based EstroBoost or Fennelope at the exact same time as the probiotics; use the probiotics at the opposite end of the day or on different days. 

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Getting support if things don’t feel right

It’s important to check in with your body and seek medical advice if something doesn’t feel right, like unusual pain, discomfort, or changes in discharge.

Taking care of your body doesn’t make you any less of a man—it’s an act of self-care and health. If the language or feelings around these parts of your body feel uncomfortable, you’re not alone.

Many trans and nonbinary people share these experiences, and there are supportive resources and professionals who can help you navigate them. Your body is yours to care for in a way that feels best for you, and My Vagina is here to help you. 

How My Vagina can help

We understand the nuances of hormone therapy and its impact on the vaginal microbiome and body. 

Our practitioners are highly skilled and are very comfortable treating trans men. Book a consultation in our specialist clinic

The impact of T on the vulva and vagina

If you’re a trans man taking testosterone (T) as part of gender-affirming hormone therapy, you might notice changes to your vulva and vagina.

These changes are a normal part of how T works in the body, but they can sometimes cause new challenges. Knowing what to expect can help you take care of your health and feel more in control of your body.

Treating vaginal dryness, irritation and atrophy

One common effect of testosterone is vaginal atrophy (sometimes called genital atrophy or atrophic vaginitis). This happens because T reduces estrogen levels in the body, which can cause the vaginal walls to become thinner, drier, and more prone to irritation.

This might lead to discomfort, itching, or even pain during activities like sex, using tampons, or exercise.

If you experience these symptoms, options like EstroBoost, Fennelope, vaginal moisturisers or lubricants can help. Low-dose estrogen creams (used locally, not systemically) may be prescribed by a doctor without affecting your overall testosterone levels.

Understanding vaginal pH and infections

Another issue can be changes in the pH balance of the vagina. Testosterone can alter the natural bacteria in the vagina, sometimes making infections like bacterial vaginosis (BV) or yeast infections more common.

Symptoms like unusual discharge, itching, or a strong odor could indicate an infection. If this happens, it’s important to see a healthcare provider for treatment, as infections are usually easy to manage with the right treatment.

If you suspect an infection, seeing a doctor for a test is usually the first port of call. However if you want to do an at-home comprehensive vaginal microbiome test first, you can send the results to our support team and we can recommend the next best steps for you, all free of charge. 

Clitoral growth

Some trans men on T also report increased sensitivity or growth of the clitoris (sometimes called bottom growth), which can be a positive or neutral experience for many but might cause discomfort for some.

Staying informed and communicating openly with a trans-competent healthcare provider can help you navigate these changes.

Getting the right support

Remember, these effects don’t change who you are or your identity as a man. Taking care of your vulva and vagina is just a part of maintaining your overall health, and you deserve respectful, affirming care.

If you feel uncomfortable discussing these issues, seek out LGBTQIA+-friendly providers who understand your needs and can help you feel supported, such as the My Vagina clinic

Vaginal dryness, irritation and atrophy on high dose T therapy

Learn why testosterone therapy can cause vaginal dryness, irritation, and atrophy in trans men, and discover effective tips and treatments.

Understanding ‘bottom growth’ in trans men on T

Everything you need to know about clitoral growth (bottom growth) on testosterone: what to expect, sensitivity, sexual pleasure, and embracing this change with confidence.

Navigating pleasure and sex on high dose T therapy

Explore how testosterone affects clitoral growth, libido, vaginal health, and sexual pleasure for trans men, with tips.

T and sexual pleasure

For trans men taking testosterone (T) as part of gender-affirming hormone therapy, changes to the body can affect sexual pleasure, masturbation, and sex in different ways.

These changes are natural as your body adapts to T, but they may bring up new challenges or adjustments. Knowing what to expect can help you explore what feels good and take care of your sexual health.

Navigating clitoral growth and extra sensitivity

Clitoral growth (bottom growth) can make the clitoris larger and more sensitive, which can increase pleasure during masturbation or sex, but for some, it might take time to get used to the new sensations.

Experimenting with touch, pressure, or different positions can help you discover what feels best. If the increased sensitivity feels uncomfortable, using lubrication or gentle techniques may help.

Managing dryness and irritation

Vaginal atrophy makes the vaginal walls thinner, drier, and less elastic which can sometimes lead to discomfort or pain during penetration or friction-based activities.

Using a water-based or silicone-based lubricant can reduce dryness and make things more comfortable.

If discomfort persists, try Fennelope – use one pessary deep vaginally at night for two weeks, then as needed. Talking to a healthcare provider about options like vaginal moisturisers or low-dose estrogen creams (applied locally) can help without affecting your overall hormone therapy.

Understanding odours and infections

For some, changes in the pH balance of the vagina due to T can increase the risk of infections like bacterial vaginosis (BV) or aerobic vaginitis (AV), which may cause irritation or impact pleasure. Odours can be embarrassing and deter intimacy. 

Keeping an eye on symptoms like unusual discharge or itching and seeking treatment promptly can prevent these issues from interfering with your sexual health.

T’s impact on libido

Lastly, it’s normal for testosterone to affect your libido, or desire for sex. Many people notice an increase in sex drive on T, but others may find it fluctuates or changes.

Your relationship with your body and how you experience pleasure might also evolve. It’s important to explore what feels right for you and communicate with partners if you’re engaging in sex.

Remember, there’s no right or wrong way to experience pleasure—your journey is unique.

If you encounter challenges or have questions, reaching out to an LGBTQIA+-friendly healthcare provider or sexual health expert can help you navigate these experiences.

Your sexual health and pleasure matter, and you deserve support that respects your identity and your body.

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