So it seems I’ve stumbled upon one of the downsides of transitioning. I’d heard that HRT changes the environment around your junk and becomes basically like a cis woman’s labia, but I hadn’t really thought through the implications until recently. It seems I developed a yeast infection on the glans of my penis, and it’s been just the worst. Initially I wasn’t sure what it was (I got tested for STIs like the week before so I knew it wasn’t that), it was just kind of redder than usual, but then it got worse and started to be really itchy. Well I itched it, big mistake by the way, which coupled with more sensitive skin meant I formed some friction injuries which I don’t think helped much. Thankfully I have some experience with ringworm from a brief and ill-fated attempt at wrestling in the distant past, so I got right on it and started anti-fungal cream once I recognized the characteristic overwhelming itchiness and slow weeping of clear fluid of a fungal infection.
I did some researching and it turns out this is just a thing all women have to deal with at one time or another. I’ve been doing my best to keep it dry and applying the anti-fungal cream twice a day. Do y’all have any advice to reduce the chances of this happening again? I know regular cleaning, keeping the area dry, but I also found someone suggest maybe eating a lot of sugar can make it worse, which to be honest I’ve been doing lately… I’m also just generally curious about other people’s experience.
Update:
I realized the initial infection was my fault. I sat playing games without moving with a warm cat on my lap for several hours straight over the course of several days. It had never been a problem before but here I am lol.
For posterity, see my treatment plan below. This seems to be working for me, so maybe it can help someone else too.
My current treatment is to do the following procedure twice a day at least, once when I get up in the morning and once before I go to bed. If I end up taking a shower during the day, or get really sweaty, or disrupt the area for some other reason, I will do an additional application just to make sure there is always an anti-fungal agent on there.
- Clean the glans, either by just running lukewarm water over it to get the old cream off or washing it very gently with some fluconazole shampoo I have (I assume an extra anti-fungal agent couldn’t hurt). I’m really just trying to get the majority of the old cream off so I can apply new stuff.
- Dry the area thoroughly and very gently, dabbing/pressing the area and avoiding rubbing as much as possible
- Apply tolnaftate 1% liquid (it was made for treating the nails so has much better penetration than the creams) to the infected areas and a little around it. I usually do a couple coats to make sure I really get it on there. This may sting a lot if there are abrasions, but since mine have healed it only really stings if some gets in the urethra.
- Wait for the tolnaftate solution to dry. It usually takes less than a minute.
- Apply clotrimazole 1% cream over the infected areas and a bit around. At this point I’m doing this step mainly to get the itching relief (which the tolnaftate liquid doesn’t seem to provide) and I assume it doesn’t hurt to hit the fungus with a second chemical.
- Wait for the clotrimazole cream to dry before getting on with my day. This usually takes a little longer, like 5 minutes or so, but I find it important to keep the cream from getting wiped off on my clothes or something. Once it dries it leaves a thin clear/whiteish layer on the skin which I find will usually stay until I reapply, and has a slightly leathery texture that provides some protection against abrasions/chaffing.
definitely never had that happen, but I would also push back that all women experience infections on occasion (let alone that we can extrapolate this to pre-op trans women).
The mechanism for
UTIsyeast infections in cis women is mostly through the vaginal canal and the microbiome getting disrupted and a fungus overwhelming the lactobacillus and getting established; this is absent / not relevant in the case of a scrotum, though obviously fungal infections of any skin is possible, and cis men do get fungal infections on the glans of their penis (this is called balanitis thrush).Why women get yeast infections vary from woman to woman and a lot of it comes down to hygiene and practices, e.g. penetrative sex is much more likely to disrupt a vaginal microbiome than someone who is asexual or celibate.
Are you taping or tucking with materials that don’t breathe well? I would make sure to wear cotton underwear (not polyester), or just not wear underwear a lot of the time.
It sounds like you already know to wash the area well when you shower (ideally once a day), and allow it to dry well.
You might visit a doctor and have them take a look. I had what I thought was a fungal infection on my hand and a doctor even looked at it and prescribed an anti-fungal cream, but when I followed up with a dermatologist who specializes, she confirmed it was never a fungal infection and I just had eczema. Doctors can be helpful when trying to figure out the causes, and recommend the best way to prevent future issues.
If you can’t see a doctor and you are confident it’s a fungal infection like thrush, I would personally probably buy an anti-fungal ointment over the counter and apply it to the skin (maybe after some research on the best ointment, drug, dose, etc. that is safe for genitals, since that is a sensitive area).
I would not say this is probably not a side effect of taking estrogen.
UTI is different from a yeast infection
omg, you’re totally right 😱 I misread OP’s description as being burning around the opening of the urinary tract, and thought it was a UTI
upon re-reading it sounds more like she’s describing a fungal infection on the skin of the glans (“thrush”) …
either way my general point still stands, generally a “yeast infection” for cis women indicates a yeast infection in their vaginal canal, not their clitoral glans (though it does look like a fungal infection on the outer labia is possible!)
Either way, if OP is right it’s a fungal infection, it should be treatable through anti-fungal ointments (many are available over the counter if you can’t afford to see a doctor), and the infection isn’t caused by estrogen (cis men get these kinds of infections on their penises, too).
Yeah I think it is thrush. I’ve never had it before so was kind of surprised when it happened. I haven’t really changed anything about my hygiene or clothing, and I read somewhere that estrogen makes the genital area more moist. I don’t think getting thrush is a direct side effect of estrogen, more that the increased moisture makes it more likely. So combined with perhaps suboptimal hygiene practices or clothing which were fine before, the increased moisture pushes the environment over the edge to fungal infection territory.
oh interesting, I hadn’t heard that estrogen increases moisture in the genital region (other than like the way vaginal dryness can occur without estrogen, like in trans men or menopausal women) - do you think it’s like the way estrogen makes the skin softer, that has to do with skin moisture or something?
But yeah, that makes sense that moisture and the right kinds of clothes could create an environment where fungus could get into the skin 😱 luckily it’s hopefully not too big of a deal to treat - I would be really interested to hear what ends up working, it’s great you raised this and to have these kinds of experiences discussed - you never know who else might be going through the same thing and would benefit from what you’re sharing here
I really hope it’s easy to get taken care of and it’s not too unpleasant, ugh
I don’t think it’s exactly related to how it makes the skin softer, because from what I’ve heard estrogen can also make your skin drier. The way I heard it, estrogen changes the secretions in the genital region to be similar to a cis woman, but since we have a penis and testicles initially, rather than a vagina/vulva/clitoris, the expression of the changes in secretions is somewhat different. I definitely noticed a change, especially during sex stuff. Like within a week of starting estrogen I noticed that I actually produced a larger volume of both precum and ejaculate than before, and it became clear and didn’t coagulate anymore like it used to. Since then the volume of precum hasn’t really gone down, but the volume of ejaculate has. I wish it would stop completely like some people get, but I’ve been lucky in other ways so I’ll take it. Those are just a couple examples, but I have also noticed my junk is generally more moist than it used to be.
After thinking about it for a while I do think I know why I got it. So I have AuDHD and sometimes I like to hyperfocus on a videogame for hours on end. I also have a cat who likes to sit on my lap. There were a few times over the past month where I got really into a game, and sat there for several hours with my cat on my lap the whole time, not really moving. When I finally got up to go to the bathroom I noticed the glans was kind of white in a spot, sort of like your fingers get when they’re in water too long… So yeah I think that was just sitting motionless for hours with a warm cat on my lap making me slightly sweaty and blocking airflow.
As for what I did to treat it, I initially tried a clotrimazole topical cream. It didn’t seem to work very well because the cream is kind of dry, so it didn’t really penetrate into the skin the way you’d want. The one I got was made for athletes foot though so that’s probably why. It did relieve the itching immediately, which made it much easier to leave it alone and let the little abrasions heal. After about a week of that it seemed things were getting worse or staying the same, so I switched to a tolnaftate liquid. This one is pretty interesting because it’s a liquid and was designed for fungal infections of the nails, so it needs to penetrate much deeper than the creams can. It comes with a little brush applicator, kind of like a nail polish brush, so you just paint it on the infected areas. The downside is that it doesn’t really help the itching, and it stings like fucking crazy if there are any abrasions in the area. I tried that by itself for a couple days and it seemed like it was getting better, but it became very itchy again so I ended up causing new abrasions that made it too painful to apply. I switched back to the cream for a bit, which didn’t really change anything, then switched to applying both.
My current treatment is to do the following procedure twice a day at least, once when I get up in the morning and once before I got to bed. If I end up taking a shower during the day, or get really sweaty, or disrupt the area for some other reason, I will do an additional application just to make sure there is always an anti-fungal agent on there.
- Clean the glans, either by just running lukewarm water over it to get the old cream off or washing it very gently with some fluconazole shampoo I have (an extra anti-fungal agent couldn’t hurt). I’m really just trying to get the majority of the old cream off so I can apply new stuff.
- Dry the area thoroughly and very gently, dabbing/pressing the area and avoiding rubbing as much as possible
- Apply the tolnaftate 1% liquid to the infected areas and a little around it. I usually do a couple coats to make sure I really get it on there. Now that the abrasions have healed it only really stings if any gets in the urethra.
- Wait for the tolnaftate solution to dry. It usually takes less than a minute.
- Apply the clotrimazole 1% cream over the infected areas and a bit around. At this point I’m doing this step mainly to get the itching relief and I assume it doesn’t hurt to hit the fungus with a second chemical.
- Wait for the clotrimazole cream to dry before getting on with my day. This usually takes a little longer, like 5 minutes or so, but I find it important to keep the cream from getting wiped off on my clothes or something. Once it dries it leaves a thin clear/whiteish layer on the skin which I find will usually stay until I reapply, and has a slightly leathery texture that provides some protection against abrasions/chaffing.
I’ve been doing this procedure for the past few days and I’ve seen by far the best progress of anything else I’ve tried. It’s only been about 3 days and I’m already seeing major improvement, with the infected areas much less red and finally starting to shrink.
I think a lot of “scrotum-havers” use talcum powder to keep their genitals dry, you could try that out? I think it’s more common for like athletes. I think it’s not uncommon to apply talcum after toweling down after a shower, for example.
And yeah, my understanding is like you that estrogen generally makes skin more dry and require more moisturizer.
An animal like a cat can also be a vector for a fungal skin infection - cats and dogs can either have the fungal spores on them, or they can have a fungal infection on their skin as well. It depends on the species of fungus, not all of them easily transfer from the animal to humans, but it can happen. Might be worth inspecting the cat for any fungal skin infections.
In terms of discharge - yes, estrogen definitely results in changes to discharge. To be honest, I only ever noticed this during sex or arousal. Mostly I noticed my precum became very copious and thinner, and I basically stopped ejaculating. Pre-op, I don’t think this ever impacted the moisture of my genitals, it seemed unchanged to me. Post-op it’s really hard to tell, but I don’t think my vagina is wet from anything like regular discharge through my urethra, I think it’s mostly excess lube from my vaginal canal (except during sex, when I’m aroused I become very gushy and wet, which is clearly pre-cum like before). Yay for the Cowper’s gland!
I hope your rash clears up, that sounds no fun. I have no idea if those drugs are safe to use together or the way you’re using them, I would be careful and do thorough research from good sources - even better if you can see a doctor (even a walk-in clinic). Hopefully it doesn’t last much longer 🤞
who is asexual
Asexuals can and do have sex. We just don’t experience sexual attraction (at least not all the time depending where on the spectrum an ace person is), that’s what it means.
Some asexuals don’t have sex, but not all of us experience sex repulsion, or are okay with it for other reasons.
Yes, I had it too. I got it under control with an anti-fungal cream and gentle cleaning. It still took a while before it was entirely gone though, partially because I did not get the “gentle” part of the cleaning right at first.
I tried just a cream for a while but I didn’t see much effect. It made it stop itching but didn’t seem to knock back the infection itself. Might be that the one I got is too dry to really penetrate into the skin of the glans. I added my current procedure to the post if you’re curious. I’m getting much better results with that than just the clotrimazole cream.
Thanks, but fortunately it is gone for now. A change in my HRT also seems to have had a positive effect, besides the cream and proper care.
I know regular cleaning…
But also, you can’t be too aggressive, or else you’ll irritate it which can then contribute to the infection.
I did have problems around the 6 month mark. After a couple courses of clotrimazole, I think my microbiome adjusted and I learned to be gentler with the foreskin
Yeah I was a little aggressive with washing early in the infection. Wishing I had a foreskin to be gentle with though :'(
