Advice on PE for Trans Woman

Welcome to the community, sister. By the way, quite an amusing moniker you picked out for yourself. Love it.

AccidentalSixtyNINE said:

I'm a trans woman who has been on a stable dose of non-cyclical monotherapy testosterone (0.4 nmol/L) since I was 20. I've always had a mild form of erectile dysfunction, characterized by reduced erectile strength, but I could still get erections and until recently I was a top in bed.

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Just to verify, when did you start developing a mild form of ED? Before 20? After 20 when you started the testosterone? Is the testosterone doses used to control ED? We're trying to do a pathway diagnosis.

AccidentalSixtyNINE said:

I'm interested in exploring options for penis enlargement, and I'd love to hear your opinions on various methods. I've been reading through some of the posts on this forum and I'm curious about using pumps, topical creams, supplements, exercises, and pumping routines.

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PE is primarily mechanical approach, be using the hands, pumps, or devices, while relying on the body's resilent staging growth to further develop the penile tissues through stressor factors. Topical cream, supplements, injections, and pharma meds are used to boost the recovery rate of the penile tissues or the developmental states. There's no miracle penis growth formula. Just recovery to optimize growth rates.

Until we can figure out the ED issues, PE routines should be revisit in a bit. We need to maximize the blood flow, erection quality, and determine the recovery levels at this moment in time.

AccidentalSixtyNINE said:

I came across a post from a user who shared their 6-month PE routine and results, and I was impressed by their progress. I also saw a post about personal coaching services, but I'm not sure if I can afford it.

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Our person coach, @huge-girth, keeps hounding you daily to ensure you have what you need and do what you need to do to succeed. However, if you want general approaches, routines, exercises, and a routine analysis, we're here to assist. You can build a personal log page that you can dump all your questions, build your exercises, and keep a progress report of yourself, and we can do deeper dives on what you did, how you progress, and examine your routines on a daily basis.


You can read through some of the personal logs here. Quite a few brothers provide daily routines and observable gains in their logs.

AccidentalSixtyNINE said:

As someone who is new to PE, I'm not sure where to start. I'm looking for advice on how to get started with free methods, and I'd appreciate any guidance on exercises, stretches, and routines that I can try.

Specifically, I'm interested in learning more about:

• Penis pumps: What are the best pumps on the market right now for daily pumping maybe while at the home office?
• Topical creams: Have any of you had success with creams or gels that claim to promote growth? Potentially even interested in topical testosterone. AA potentially involved if so.
• Supplements: Which supplements that you've found to be helpful in promoting growth or improving erectile function?
• Exercises: Which exercises or stretches that can help improve erectile function or promote growth?
• Pumping routines: What are some effective pumping routines that you've found?

I'd also appreciate any advice on how to track progress and measure results.

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First thing first. What is your primary focus for the gains? Length? Girth? Both? If you focus on one, it's faster. If you focus on both, it's slower, but balanced.

Read the SRT (now a clickable word) for length and try to digest a bit of info at a time. Read the 5x5x3 (now clickable) for girth. Both will provide sufficient info to get you thinking on specific budget to set a side, be a "free" or "extremely limited budget" approach, or "go for broke". Just let us know what you like to do. You can start on the PE journey using the extremely low budget or free to try using your own hands, simply to get a feel for what is needed.

Whatever you chose, let us know. We'll tailor the routines for you in your personal log. We can even turn this post into your log starter if you like.

oldandlively said:

Just to verify, when did you start developing a mild form of ED? Before 20? After 20 when you started the testosterone? Is the testosterone doses used to control ED? We're trying to do a pathway diagnosis.

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Before 20. Tbh I've had a mild form of it my whole life. It could be pelvic floor nerve related as I've got a bit of nerve damage from childhood injuries. I'm not taking testosterone. But I'm not taking an anti androgen(testosterone blocker) so my pituitary gland is still producing some testosterone as I want to maintain penile sexual function.

oldandlively said:

PE is primarily mechanical approach, be using the hands, pumps, or devices, while relying on the body's resilent staging growth to further develop the penile tissues through stressor factors. Topical cream, supplements, injections, and pharma meds are used to boost the recovery rate of the penile tissues or the developmental states. There's no miracle penis growth formula. Just recovery to optimize growth rates.

Click to expand...

Yup and so I'd basically like to try everything. Indeed I might also try topical testosterone which would have a strong effect on me as high estrogen actually changes the skin of the penis (smell, dryness, tissue flexibility) basically making it less muscular. This is semi well recorded in trans women. What supplements would be beneficial here? Currently taking MSM, vit d3, vit c, magnesium pills, magnesium glycinate, creatine 3x the usual dose, fish oil 1000u omega 3, calcium, Phosphatidyl Serine & Phosphatidyl Choline and probably some more.
I'm aware zinc, biotin and pygeum africanum have been suggested prior.
Also considering anabolic non masculinzing steroids like nandolone as an alternative to testosterone.

oldandlively said:

Until we can figure out the ED issues, PE routines should be revisit in a bit. We need to maximize the blood flow, erection quality, and determine the recovery levels at this moment in time.

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Feel free to ask anything btw.

oldandlively said:

First thing first. What is your primary focus for the gains? Length? Girth? Both? If you focus on one, it's faster. If you focus on both, it's slower, but balanced.

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Both.

oldandlively said:

Read the SRT (now a clickable word) for length and try to digest a bit of info at a time. Read the 5x5x3 (now clickable) for girth. Both will provide sufficient info to get you thinking on specific budget to set a side, be a "free" or "extremely limited budget" approach, or "go for broke". Just let us know what you like to do. You can start on the PE journey using the extremely low budget or free to try using your own hands, simply to get a feel for what is needed.

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Thanks <3 and thanks for referring to me as sister hard to find community these days.

AccidentalSixtyNINE said:

Before 20. Tbh I've had a mild form of it my whole life. It could be pelvic floor nerve related as I've got a bit of nerve damage from childhood injuries. I'm not taking testosterone. But I'm not taking an anti androgen(testosterone blocker) so my pituitary gland is still producing some testosterone as I want to maintain penile sexual function.

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Got it. I was about to chime in that it went counterintuitive to use a non-cyclical monotherapy testosterone while using an anti-androgen. Two of us were scratching our heads on that small bit of info.

Let's take some scenarios into the whole picture. Let's say, while being young and crazy, you hurt yourself through the "I'm invincible" phase, either on a bicycle or a hard impact in the groin. Happens all the time. Let's say there's a nerve compression in the pelvic region causing a partial ED. However, don't just stop at the pelvic floor region. There may be nerve compression in the lower lumbar region, which is a hidden monster in the sciatic pathway. Just something to be aware of. When possible, make sure both areas are evaluated. A simple one is an ultrasound. Secondary one is MRI. It may not sound unimportant now, but as you get older, it's a whole different world of nightmares.

AccidentalSixtyNINE said:

Yup and so I'd basically like to try everything. Indeed I might also try topical testosterone which would have a strong effect on me as high estrogen actually changes the skin of the penis (smell, dryness, tissue flexibility) basically making it less muscular. This is semi well recorded in trans women.

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Yes, early phases of transwomen (between 15 and 25) do have conflicting developmental signals and residual biological effects over the latter phases (between 26 and 31). For those who are in their late years (after 32), nothing much changes in the areas you described. Before your testosterone peak phases in the early 20s (around 21 to 24), higher doses of estrogen being introduced, the body goes through a reprogramming phase, and biochemical triggers are formed. Think of these triggers are on-off triggers. The moment a high level of cortisol kicks in, your body triggers a shutdown of testosterone production to favor maintenance of estrogen levels, causing noticeable EQ level. But, something else may also occur. Triggers tend to work in two or more. One trigger is not enough to cause a sudden fall in EQ.

AccidentalSixtyNINE said:

What supplements would be beneficial here? Currently taking MSM, vit d3, vit c, magnesium pills, magnesium glycinate, creatine 3x the usual dose, fish oil 1000u omega 3, calcium, Phosphatidyl Serine & Phosphatidyl Choline and probably some more.
I'm aware zinc, biotin and pygeum africanum have been suggested prior.
Also considering anabolic non masculinzing steroids like nandolone as an alternative to testosterone.

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That's an interesting approach in supplements. Do you mind providing your thinking process in taking those specific combination. I believe I know, and my colleagues are thinking the same. But we want to verify.

AccidentalSixtyNINE said:

Thanks <3 and thanks for referring to me as sister hard to find community these days.

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In the community, there are many walks of life. We cannot be judgmental based on our biased thinking. We all have our beliefs, but at the end of the day, each person has preferences we have to respect. You are welcome and have a safe harbor here in this community. This community is about providing validated data and research information, not judgments.

oldandlively said:

Let's take some scenarios into the whole picture. Let's say, while being young and crazy, you hurt yourself through the "I'm invincible" phase, either on a bicycle or a hard impact in the groin. Happens all the time. Let's say there's a nerve compression in the pelvic region causing a partial ED. However, don't just stop at the pelvic floor region. There may be nerve compression in the lower lumbar region, which is a hidden monster in the sciatic pathway. Just something to be aware of. When possible, make sure both areas are evaluated. A simple one is an ultrasound. Secondary one is MRI. It may not sound unimportant now, but as you get older, it's a whole different world of nightmares.

Click to expand...

nail on the head there. i have a bit of a spinal deformity confirmed via xray which leads to sciatica. think my asshole parents dropped me off a building when i was a baby.

oldandlively said:

That's an interesting approach in supplements. Do you mind providing your thinking process in taking those specific combination. I believe I know, and my colleagues are thinking the same. But we want to verify.

Click to expand...

I'm on a few breast growth forums for cis women and they do pay alot of attention to mtf breast growth too. First off I'll just say that Ashwagandha, and Pueraria Mirifica(Maca root). The first one would increase testosterone and I am trying to avoid systematic increases in that. Investigating if local increases might be be efficacious. The second has much more estrogenic activity than standard estrogen so it would basically cause my levels to shoot up and this would be counterproductive as it doesnt do anything other than just contribute to cortisol and all sorts of other blood issues.

Methylsulfonylmethane is basically like what creatine is to atp, it's a building block for collagen and tissue health in general. Given I'm growing I might aswell be on it.

Vitamin D3 theres a correlation with low vit d and small breast sizes in cis women but I believe this is systematic and everyone should get their vit d3 to good levels as its a precursor to all sorts of bodily hormones and stuff

Vitamin C supports collagen systhesis.

Magnesium supports hormonal regulation and it is also required for nerve growth. I grew up malnourished so I've always had low magnesium. Some believe it also helps with adhd, some correlation has been found.

Creatine is just great it allows one to have more energy when muscles are under strain and work. People talk about progressive overload in the gym and this is basically a 25% boost to how many reps you can do.

Omega-3 is important for reducing cardiovascular strain. Given I'm working on breast health and gaining weight in general, my blood lipid levels are gonna look scary at times because it's always bulking season for me. Cardiovacular strain is a very very important factor to manage if you don't want to die when you're 60.

Calcium is a primary building block for bones and also nerve cells.

Phosphatidyl Serine & Choline HRT lowers these ones in trans women aswell as trans men for some reason. Not sure why. But I've checked my bloods and I was low on both. Especially Choline. You'd think I'd just need to increase my salt intake but it didn't help. Choline is the building block for neurotransmitters, imagine the electricity in nerve cells that makes it work. Phosphatidyl Serine is the precursor for the phosphate part of ATP and bones.


There are a few links between ADHD, being transgender, adrenal issues and other things. I keep taking my health seriously and noticing things are not as they seem and my blood work always looks bizare in some way. I've spoken to endocrinologists, urologists, all sorts really. I've realized the only person who can take my health seriously and look at it wholistically is myself.

We have to zoom out and in to get the macro and micro perspectives on your approach. We like to do cloud-based doodling just to map things out, and at times, we like to do tic-tac-toe as well, the moment we see a pattern emerge. A literal tic-tac-toe doodle of patterns.

AccidentalSixtyNINE said:

nail on the head there. i have a bit of a spinal deformity confirmed via xray which leads to sciatica. think my asshole parents dropped me off a building when i was a baby.

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For spinal deformity, the best way to correct this is to look for a good chiropractor who can perform a bone corrective procedure. Deformity doesn't require a surgical procedure with frames and correction rods. Funny enough, competent chiropractors can do the mild corrections without having to resort to invasive surgeries. We don't want to sponsor specific professionals, but if you use YouTube quite a bit, two specific competent chiropractors actually perform spinal correction to alleviate mild spinal stenosis for your sciatic region. Something to consider. What you can't correct in the past doesn't mean you can't correct it going forward.

AccidentalSixtyNINE said:

I'm on a few breast growth forums for cis women and they do pay alot of attention to mtf breast growth too. First off I'll just say that Ashwagandha, and Pueraria Mirifica(Maca root). The first one would increase testosterone and I am trying to avoid systematic increases in that. Investigating if local increases might be be efficacious. The second has much more estrogenic activity than standard estrogen so it would basically cause my levels to shoot up and this would be counterproductive as it doesnt do anything other than just contribute to cortisol and all sorts of other blood issues.

Methylsulfonylmethane is basically like what creatine is to atp, it's a building block for collagen and tissue health in general. Given I'm growing I might aswell be on it.

Click to expand...

This is what we're expecting. Just be careful where you're sourcing your MSM, the type of MSM, and daily dosing. Remember, MSM does have side effects when taken in the long term.

AccidentalSixtyNINE said:

Vitamin D3 theres a correlation with low vit d and small breast sizes in cis women but I believe this is systematic and everyone should get their vit d3 to good levels as its a precursor to all sorts of bodily hormones and stuff

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Be very careful when taking D3 with specific doses. If you're being suggested to take between 3,000 and 5,000 IUs for a long period of time to sustain a biochemical balance with the other supplements, your cardiovascular system will also take a hit. Research carefully.

AccidentalSixtyNINE said:

Vitamin C supports collagen systhesis.

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Vit C is a great supplement to support a wellness balance across the board. But make sure to do an absorption balance sheet for Vit C with other interactive supplements, medication, and dietary intakes. Yes, excess Vit C is expelled by the system, but overworking your adrenal system, pancreas, and kidneys is not a good idea.

AccidentalSixtyNINE said:

Magnesium supports hormonal regulation and it is also required for nerve growth. I grew up malnourished so I've always had low magnesium. Some believe it also helps with adhd, some correlation has been found.

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We wholeheartedly encourage magnesium supplements. Most don't take this. A good absorption form of magnesium is a great thing. But also worry about the iodine level as well. They work in tandem. One without the other is like gasoline with minimal air for ignition and combustion.

AccidentalSixtyNINE said:

Creatine is just great it allows one to have more energy when muscles are under strain and work. People talk about progressive overload in the gym and this is basically a 25% boost to how many reps you can do.

Click to expand...

Creatine is a good supplement to use daily. But, don't just think one directionality. HMB, L-citrulline, and creatine can assist each other to initiate and sustain gynecomastia. We see quite a few odd results from the three together at high doses in the males that don't perform strain muscle development but only sustaining muscle losses.

AccidentalSixtyNINE said:

Omega-3 is important for reducing cardiovascular strain. Given I'm working on breast health and gaining weight in general, my blood lipid levels are gonna look scary at times because it's always bulking season for me. Cardiovacular strain is a very very important factor to manage if you don't want to die when you're 60.

Click to expand...

Just make sure to understand the various omega-3 sourcing you're using. Not all omega-3 supplements and the extracted sources are equal. Again, perform a balancing sheet when using omega-3 with other supplements. Magnesium and D3 are great. Iodine is critical.

AccidentalSixtyNINE said:

Calcium is a primary building block for bones and also nerve cells.

Click to expand...

Make sure calcium is a high absorbing kind. Do limit the total doses at one time, and break the loading between morning and night instead.

AccidentalSixtyNINE said:

Phosphatidyl Serine & Choline HRT lowers these ones in trans women aswell as trans men for some reason. Not sure why. But I've checked my bloods and I was low on both. Especially Choline. You'd think I'd just need to increase my salt intake but it didn't help. Choline is the building block for neurotransmitters, imagine the electricity in nerve cells that makes it work. Phosphatidyl Serine is the precursor for the phosphate part of ATP and bones.

Click to expand...

This is quite a sore subject discussed by may professional across the fields. Since you're on a research frenzy, I'll leave it here for you to continue your research. Just say that no one is right, and no one is wrong. It's still an investigative audit trail.

AccidentalSixtyNINE said:

There are a few links between ADHD, being transgender, adrenal issues and other things. I keep taking my health seriously and noticing things are not as they seem and my blood work always looks bizare in some way. I've spoken to endocrinologists, urologists, all sorts really. I've realized the only person who can take my health seriously and look at it wholistically is myself.

Click to expand...

Yes, you are your own person who needs to take care of your needs. Keep at it. If you don't, no one will do the work for you. Understand your body, the biological needs, and the nutrition it requires to keep it a healthy functional biomachine.

Let's circle back around and start discussing in terms of biological functions and deficiencies. So far, we know that:

Possible sciatic compression, a factor for mild to moderate ED.
Possible pelvic floor impacting blood flow delivery, a factor for mild ED.
Possible conflicts of natural androgens and adaptogens from supplements.

Any boosting of supplements containing testosterone to excite the male libido is excluded.
Requirements in getting your blood flow are needed without conflicting with the existing supplement loading.
An adaptive routine is required to expand the tunica, which is needed using moderate tissue stressing, for both length and girth. However, the girth must undergo a transitional period of low-pressure pumping before moderate and high-pressure pumping.

So, the options are:

You can pursue both length, which is simple adoptive stretches that we already have. You can use the SRT (a clickable acronym now) newbie routine to get into the PE journey. In about a month or two, you can switch to various exercises to refocus on the stress loading on the tunica tissues to increase the stress loads for further tunica development. Read carefully the bundled BTC (behind/between the cheek) exercises. The "bundled" or "bundling" portion is the contortional/twisting of the penile shaft to stress the tissues laterally, and pulling longitudinally with less effort. This is doing PE in a smarter way. Read through other brothers' routines to get the logistics of what they're doing.


For girth, you can progress from low pressures to get the blood to flow into the penis and establish rigidity, and new tissue formation for expansion. A simple modular pump like the Bathmate is a great on-the-go device to get the blood to flow. There are negative sides to the BathMate since it can cause your scrotum to get sucked into the cylinder. For long term usages, the MityVac or similar system is great for starters and long-term penile girth development. Cylinders can be changed to meet the growth and needs during girth development. The downside is it's a large system. Low pressure pumping is between -5inHg and -6inHg. Moderate starts around -6inHg to -7inHg. Low pumping allows blood to expand and build penile tissue ridigity over time. It can be as short as 3 months, and it can be as long as 9 months.

The other thing to comprehend is the recoined method of angiogenesis, or angion development. It's another way in saying, "Make your blood vessel develop faster and provide more blood into the penile body, creating stronger rigidity. We simply use jelqing methods. There are many approach to this. The only problem is, a semi-erected state is required. If you can maintain a good semi-flaccid and semi-erect state at around 70%, it will not work well.

Let's stop here. Too much info overload in one sitting is not a good thing. Ask questions if you need to.

oldandlively said:

For spinal deformity, the best way to correct this is to look for a good chiropractor who can perform a bone corrective procedure. Deformity doesn't require a surgical procedure with frames and correction rods. Funny enough, competent chiropractors can do the mild corrections without having to resort to invasive surgeries. We don't want to sponsor specific professionals, but if you use YouTube quite a bit, two specific competent chiropractors actually perform spinal correction to alleviate mild spinal stenosis for your sciatic region. Something to consider. What you can't correct in the past doesn't mean you can't correct it going forward.

Click to expand...

yup I've seen all of them. Happy with my current ortho team and physio team.

oldandlively said:

This is what we're expecting. Just be careful where you're sourcing your MSM, the type of MSM, and daily dosing. Remember, MSM does have side effects when taken in the long term.

Click to expand...

Yup aware and I'll be getting bloods to monitor in a few weeks will titrate accordingly.

oldandlively said:

Creatine is a good supplement to use daily. But, don't just think one directionality. HMB, L-citrulline, and creatine can assist each other to initiate and sustain gynecomastia. We see quite a few odd results from the three together at high doses in the males that don't perform strain muscle development but only sustaining muscle losses.

Click to expand...

Not sure where you're getting gynomastia from.

oldandlively said:

Just make sure to understand the various omega-3 sourcing you're using. Not all omega-3 supplements and the extracted sources are equal. Again, perform a balancing sheet when using omega-3 with other supplements. Magnesium and D3 are great. Iodine is critical.

Click to expand...

I'm stopping mine its got all sorts of other rubbish in it. I'll go find some more pure stuff that doesnt double dose my vit c.

oldandlively said:

This is quite a sore subject discussed by may professional across the fields. Since you're on a research frenzy, I'll leave it here for you to continue your research. Just say that no one is right, and no one is wrong. It's still an investigative audit trail.

Click to expand...

This is also being investigated by a breast growth forum so I may update you once thats been concluded.

current plan is lots of stretching. gonna try and get a bathmate or equiv and last question


Any creams I should consider for topical use? doesnt have to be medicated. intention is just for lube or to stop the skin from tearing. using coconut oil rn for all activity.

AccidentalSixtyNINE said:

Any creams I should consider for topical use? doesnt have to be medicated. intention is just for lube or to stop the skin from tearing. using coconut oil rn for all activity.

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A simple daily 0.5% hydrocortisone is more than enough. It acts as a barrier to moisture loss and skin recovery, while still allowing natural healing factors to dictate your healing capacity rather than medicated, forced healing.

oldandlively said:

A simple daily 0.5% hydrocortisone is more than enough. It acts as a barrier to moisture loss and skin recovery, while still allowing natural healing factors to dictate your healing capacity rather than medicated, forced healing.

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Hydrocoritsone thins skin. Muscosal genital skin is already thinned by E, so much that when I'm greasing the pole it can hurt at times in ways it didn't used to. I would not suggest hydrocortisone for this purpose E or otherwise. Interestingly it's the same exact gene thats triggered by both. REDD1. Muscosal skin is also a good vector for systematic absorption and my cortisol levels are high enough. Considering pioglitazone as metabolically cortisol is dominant compared to estradiol. viseral vs gynoid adipose tissue distrobution is another pharmacological pain in my asshole. But worried about fluid retention as my renal and cardiovascular system are fucking mid asf already.

AccidentalSixtyNINE said:

Hydrocoritsone thins skin. Muscosal genital skin is already thinned by E, so much that when I'm greasing the pole it can hurt at times in ways it didn't used to. I would not suggest hydrocortisone for this purpose E or otherwise. Interestingly it's the same exact gene thats triggered by both. REDD1. Muscosal skin is also a good vector for systematic absorption and my cortisol levels are high enough. Considering pioglitazone as metabolically cortisol is dominant compared to estradiol. viseral vs gynoid adipose tissue distrobution is another pharmacological pain in my asshole. But worried about fluid retention as my renal and cardiovascular system are fucking mid asf already.

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If you worry about hydrocortisone at lowered concentration, or in general, the lube you're looking for is liquid Vit E. But Vit E has already thinned out the genital skin; you're really greasing the pole with limited options. If you're using olive oil and coconut oil, think about the concentrated vitamins in both of them. Thicker carrier agents like jojoba, shea butter, avocado, argan, just to name a few, may offer relief in a different method, or greasing the skin, so to speak, without the absorption rate you're looking for and the concerns of synthetics and E you're trying to stray away from.