Dilation school

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Ok, girls take out a pen and paper and be sure to jot down notes. Test to follow.

So, I spent a delightful morning at the Gyno docs while she taught he how I might get myself out of my pruned up Vagina problem. You see, I have been a bad little girl and stopped dilating about 2 years ago, and now I don't think a rabbit could do me.

So, I got acquainted with the stirrup table and was so small that they couldn't even get a small speculum in. So, if you can picture Two interns and a doctor mulling over the problem. They finally digitally dilated me, and I must say that even in the Doctor's office I can now see how having a loving partner rod me out gently could get to be most agreeable. Sigh...

So, moving right along, she did prescribe some Estrogen creme to um soften things up and then a gradual proceedure to open my love pot back up in 6 to 12 weeks. Wow.

So, the question begs, will the Estrogen creme in my vagina get absorbed into my bawdy? In the past I have demonstrated a propensity to go barking mad if I take too much Estrogen. Will that happen with the creme?

She did say that if I get a partner, he is going to need to be very patient, gentle and loving. Wow, whoda thought?

More on the 6:00 AM News.

Gwendolyn

Comments

Does dancing and dinner count?

I don't know if he's gonna be a partner but he's taking me do dances and dinner at least once a week. :)

Gwendolyn

typical early dating for people of our faith...

If you want him to eventually be, I'll bet he's already got his head there. Well, part of it anyways... With some men you sometimes need to make hints VERY strong.

Wishing you happy dating,

Abigail Drew.

Abigail Drew.

Estrogen Absorption

littlerocksilver's picture

Yes, it will be absorbed. You might want to talk to the doctors about balancing the cream with what you are currently taking.

Portia

Portia

Actually...

S.L.Hawke's picture

I have been prescribed vaginal estrogen creams before on several occasions... [as this is a public forum, don't ask]... and they are really just a topical ointment rather than an HRT replacement. Yes, in theory, you are right that it is absorbed... they do add a tiny bit to the total amount of estrogen in your body... but it is negligible. Personally, I could never "feel" the slightest difference. The whole point of this method of medication administration is to increase the estrogen levels *locally* in the vaginal tissues, *without* it increasing the levels significantly to the rest of the body...

As a matter of fact, I still have a couple unused tubes of the stuff around here somewhere, and a prescription for more -- I never bothered to use it all up, as it never seemed to have much of an effect on me...

What this medication is intended to do is directly stimulate the estrogen receptors in the surface it is applied to -- namely, the skin lining the vaginal wall. The purpose is to increase the self-lubrication and the elasticity of the skin... and it possibly does that, slightly. Shrug. In many ways the "neo-vagina" of a TS is quite similar to that of a "natal female". In a very few minor ways, the lining of the vagina is (microscopically) not quite the same -- the cellular structure is not quite identical. Close... but just dissimilar enough that I suspect that the benefits of the estrogen cream are overrated, for this particular application.

Shrug. It is useful for natal's, which is why it is a standard recommendation from gynaecologists when faced with this sort of problem. Among natal's, "atrophic vaginitis" [defined on Wikipedia as "an inflammation of the vagina (and the outer urinary tract) due to the thinning and shrinking of the tissues, as well as decreased lubrication"] is probably the closest "normal" medical condition to what Gwen has... and for atrophic vaginitis estrogen creams are definitely appropriate -- the condition is caused by low estrogen levels (usually due to menopause), and directly applying estrogen specifically to those tissues is the best preliminary medical treatment. For TS, where the problem actually has a slightly different medical cause? "Your mileage may vary." Worth trying, and it won't harm anything to take it -- but don't expect miracles...

That said, the stuff is, by itself, a decent lubricant... and *may* be able to stimulate at least a little natural lubrication even in those TS who are not lucky enough to "normally" self lubricate after surgery... so it will make things at least a bit "slipperier". Which is definitely to the good, given what Gwen has written about her problem, and the challenges she faces in re-starting dilation. But it will be that recommended "gradual procedure" (almost certainly a dilation program, probably the "Ingram" technique using professional medical dilators of increasing length and diameter) which will be the actual "cure" -- the estrogen is just a tool to make that a tiny bit easier.

By the way, Gwen... depending on how much experience with TS your gyno has, be careful with that "gradual procedure" -- natal vaginal tissue is significantly more "stretchy" than TS vaginal tissue... and the estrogen therapy may also have less of an effect than they are expecting. Which is to say, be careful not to overdo things, trying to progress too far, too soon. Uncomfortable is fine -- even "intensely" uncomfortable. Sharp pain is not. Smirk. "When in doubt, pull it out!" [Which is not to say give up... just make haste more slowly...]

Just my two cents worth... probably not worth even that much. [Rolling eyes].

Grin. Well, Gwen? Did I pass the test? Huh? Huh? Did I? Did I? Do I get a star sticker, pretty please?

[Giggle. Okay, when I start getting silly like this, it is obviously way passed time I go to bed... where my husband is probably getting impatient anyway. Good night, all. Sweet dreams...]

You get an A with a star!

Yes, your comments show an "in depth" understanding of the nature of the problem. :) And made one of the questions I was going to ask the Doctor unnecessary. Thank you.

Much peace

Gwendolyn

Self lubricating!

Angharad's picture

Unless the vagina is constructed from intestinal tissue it won't secret more than a little sweat and sebacious fluid, which certainly wouldn't lubricate anything. Natural vaginas are lined with mucous membrane which do produce secretions capable of lubricating sexual intercourse, sadly vaginas constructed of mainly skin from recycled scrotal/penile skin, do not.

Angharad

Actually...

Some males penile skin excretes a sort of lubrication along the shaft and particularly concentrated just before the glans, under the foreskin for uncircumcised males. On a circumcised male, these excretions tend to dry up too fast to be very noticeable, unless they are particularly... powerful, in which case you may notice a sort of itchy sticky dampness in your underclothes along with any erection... On an uncircumcised male, well, it stays sealed in the foreskin until intercourse, at which point, how exactly do you tell the male fluids from the female fluids anyways?

Now, if a male with a particularly powerful pre-sexual lubrication is an MtF transsexual and these systems are not damaged during the surgery, it is POSSIBLE, that their neo-vagina will be able to self lubricate.

Slim chances, no one ought count on or expect to be so gifted, but, it is anatomically possible.

Abigail Drew.

The Mechanics of 'Getting Wet', redux.

S.L.Hawke's picture

SNOOZE ALERT WARNING: The following non-fiction article is rather lengthy... and probably extremely boring in places -- reader descretion is advised. [At the least, go get a BIG cup of coffee to help keep you awake through this... LOL.].

More seriously... the following medical article contains (non-sexual) references and discussions about the functions of various parts of the human genitals -- please consider this article as restricted "adult" material...

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Smile. I used to write sometimes "highly technical" medical articles for "another forum" for many years... and while I am trying to consciously refrain from writing that sort of thing anymore, I do still have a personal archive of all the articles that I have written... and I suppose it won't hurt me to dig up some of that old stuff, relevant to your comment. The following are quotes of myself, from assorted things I wrote about 6 years ago. Sorry if it is a bit heavy on "jargon" -- I had just taken a refresher course of medical training about that time. Some of the jargon words are defined later on, so maybe scan ahead if you are not sure what something means...

As I have married since writing that earlier piece, I will just add that I am heterosexually "active" now... and have been for going on five years now... and only very rarely have I needed to use artificial lubricants while with him.

"Your mileage may vary..."

To give context to the following... the thread it was written in reply to had previously had someone asking about self lubrication. I don't want to quote exactly what someone else posted to a private forum... but a comment had been made about the Cowper's Gland, and asking if the 'slippery liquid' they had observed might be from there, and speculating if the Cowper's glands might be acting as a functional version of the Bartholin's glands "with slightly different plumbing".

Part of my reply was as follows:

To answer your question, [name deleted], Cowper's glands are just distal to the prostate... meaning they are connected to the urethra just a little further along (closer to the surface). And yes, [another name deleted], Cowper's glands are homologous to Bartholin's glands... and the tissue functions in almost identical fashion. Other than the fluid being discharged via the urethra, rather than through their own ducts a little lower down and to each side of the vaginal opening. But given how close the urethra is to the vaginal opening, the functional result is identical.

If anyone is curious, I wrote about this stuff a couple years back, on a previous incarnation of [site name deleted]. As the original articles are no longer available to link to, I will append them as "spoilers" to this note -- just click on the titles below to expand out the articles, if you want. [Edit: Spoilers replaced with simple block quotes below]. But fair warning... they are rather loaded with medical terminology. The [edit: third quote] contains a complete list of homologous genital tissues listed on the end, for those who may be curious...

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Another part of my reply, which was a quote of an even earlier article I had written:

As an aside with regards to another thread I glanced at a few weeks back... the mechanics of "getting wet" is more than just sweat. :-)

Those readers who are still pre-op (and those post-ops with access to a partner's body) may note that the skin of the genitals is not quite like the rest of the external skin. Up to day 49 of pregnancy, there is no difference between male and female babies' genitals -- the same tissue that forms the lining of a GG's labia and vagina forms the males external genitals. Although the skin does develop some extra layers of "keratinized cells" (dead cells filled with a waxy substance called keratin that provides some protection and waterproofing to the outer skin), it remains thinner than elsewhere on the body, and has a higher percentage of a particular type of sudoriferous ("sweat") gland known as "apocrine glands". What most people think of as "sweat glands" are "eccrine glands", rather than apocrine glands... the apocrine glands produce a "sweat" that is a viscous substance rich in proteins and fatty acids... rather than the mostly water with a few electrolytes that is the "sweat" on other parts of the body. This is why the pores look different on the male genitals, than the pores elsewhere on the body... and why it burns so much if you accidentally get depilatory cream on the genitals while "shaving" the legs as a pre-op -- the skin is thinner, with less protection and bigger pores.

The squamous epithelial tissue that would have lined your vagina, had things been different, migrates during foetal development to form the extension of the urethra along the underside of the penis. (The male urethra is much longer than the female one, with the distal portions lined with squamous epithelial tissue).

After SRS, when those tissues are inside, some conversion of tissues *may* occur. The genital "external skin", which always had fewer layers of keratinized cells, and less keratin in those cells, may lose even more of the keratin production -- becoming similar to the unkeratinized lining of the mouth. This happens simply because there is no longer a need for protection from moisture loss (the skin is moist most of the time anyway), and there is no exposure to UV light to stimulate the keratinocytes that produce the keratin in surface skin. As such, this lower keratin level means that moisture can seep through the skin easily when the tissues in that area become engorged with fluid -- as they do, when we become aroused. Mixing with the proteins and fatty oils of the apocrine glands, the result of this moisture is not dissimilar to the secretions of a GG's vagina... especially since the vagina soon becomes populated with the same balance of natural flora that produces a GG's distinctive "odour".

Depending on the surgeon you see, the extra urethral tissue (which you may recall is unkeratinized squamous epithelial cells -- the same as a GG's vaginal lining) is recycled to be used as "skin" for one or more areas of the neo-vagina. Some use it for labium minora construction, others for other areas... regardless, it is often used somewhere, and retains its mucous secretory functions -- adding to the moisture level of the whole area.

Also adding to this normal moisture, the prostate gland is left intact -- and retains its ability to produce prostatic fluid. There is no longer any testicles to add sperm to that fluid, but the fluid itself is still available -- and can leak out of the urethra as "pre-cum", just as before SRS. The difference being, of course, that now the urethra opening is right above the vagina, inside the labial folds... so that pre-cum adds to the lubrication of the area.

"Sweat"? Not exactly... ;-).

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Another reply to someone else in the same thread, who had made an erroneous statement regarding Cowper's glands that I felt needed correcting...

Cowper's glands [bulbourethral glands] actually are present in male's, and are located just distal to the prostate gland along the urethra. Because of male anatomy, these glands are located inside the body, with their discharge ducts leading into the urethra on biological males. However, they are homologous to Bartholin's glands in females, which are the glands that secrete mucus to provide lubrication -- especially during sexual arousal. The Bartholin's glands might seen dissimilar in that they have their discharge ducts externally, inside the labium minora, with one on each side of the vaginal opening... but that is purely a cosmetic difference. The Cowper's glands are [like the prostate gland] left intact during SRS, and while their discharge may appear through the urethra rather than through their own, external ducts... the result is the same.

Much of the taste and smell of the vulva is partially [as {name deleted} indicated] based on dietary factors... but some of it is caused by the balance of natural flora that grow on the skin of the vulva. [Everyone has a mix of bacteria and fungi growing there -- and it is not a problem, as the body is designed to work with those normal flora present. So long as the balance is normal, anyway... when the balance tips in either direction, you end up with unpleasantness such as yeast infections...]. While initially not present right after surgery, within a few months of SRS these normal flora colonize the neo-vagina... and things end up tasting and smelling pretty much like any other woman's vagina.

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Another quoted passage, this time originally written to someone else entirely different in a thread about "Female ejaculation"...

The short version of an answer to your question about female ejaculation is... "yes, there *can* be ejaculate, though not all post ops will experience this". And of those who do, it will not be actual "semen", which is fluid containing sperm. The testicles are removed during GRS, so there are no more sperm -- but the majority of the fluid in male ejaculate is not from the testicles, coming [feeble pun, I know...] instead from other glands along the urethra. Those other glands are still present, post op.

This is not that atypical of female anatomy in general, by the way. Which leads me to the long version of my answer -- feel free to stop reading any time now...

Many of the structures that are present in males are also present in females... though some of them are slightly modified during development. These are known as homologous organs, and there are several of them that are relevant to your question...

In a previous article, I have talked about Cowper's glands [bulbourethral glands], and their homologous function to Bartholin's glands in females (which secrete mucus to provide lubrication during sex...), as well as mentioning that the prostate gland is left intact during GRS. While both of those glands are relevant to lubrication *during* intercourse, it is more the later that is relevant to your question about post op ejaculation.

Semen is made up of two parts: a cellular part composed mostly of spermatozoa from the testicles, and a noncellular part known as seminal plasma. This seminal fluid is mostly saline [salt water], but also contains proteins, enzymes, fructose sugars, vitamin C, flavins, phosphorylcholine and prostaglandins... which are mostly there to help nourish the sperm. All those other things in the seminal fluid result in it being the "slimy liquid" [name deleted] referred to -- but it definitely is *not* urine. It is not quite the same chemical balance as you would find in a normal women's secretions, but it is quite similar. Which is not surprising, considering where it comes from...

About 70% of this seminal plasma comes from the seminal vesicles [which drain through the prostate gland], and a third from the prostate gland itself. The prostate gland [the lesser vestibular or periurethral gland] is homologous to the Skene's gland in female anatomy, which is also known as the Gräfenberg spot, commonly called the "G-spot". Not all women have Skene's glands, but in the ones who do... it is believed that this is the source of female ejaculation.

Not all women experience female ejaculation, and not all post ops do either. But of the post ops that *do* experience "G-spot" orgasms, the fluid that is expelled is chemically very similar to that of any other women who has a G-spot orgasm with ejaculation.

~~~~~~~~~~~~~~~~~~~~~~~

If you are curious, the following is a list of homologous structures in human genitalia:

Gonads: Testis = Ovary.

Mullerian duct: Appendix testis = Fallopian tubes; Prostatic utricle = Uterus.

Wolffian duct: Rete testis = Rete ovarii; Efferent ducts = Epoophoron; Epididymis = Gartner's duct; Vas deferens, Seminal vesicle = [no homologous structure]; Prostate = Skene's glands.

Urogenital sinus: Bladder = Bladder; urethra = urethra; [no homologous structure] = vagina; Bulbourethral gland = Bartholin's gland.

Genital swelling: Scrotum = Labia majora.

Urogenital folds: Distal urethra = Labia minora.

Genital tubercle: Penis = Clitoris.

Prepuce: Foreskin = Clitoral hood.

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Hi! Anyone still reading this thing? If so... and you are still more or less conscious... here is some more stuff, to help finish you off... ;-)

Another person had mentioned that they had heard that Schrang "and maybe others" were using some urethral lining "mucosal like tissue" to give parts of the vulva "a more natural mucosal appearance". The following is part of my reply to that. As an update since I am pretty sure Ménard is retired now, and I think Schrang may be as well... the techniques mentioned are still in use by other surgeons such as the new team at Montréal, and I believe Bowers as well... and probably many others...

Ménard uses the excess urethral tissue to form the labia minora... which by the way, makes that portion of the vulva completely hair free. [Edit: irrelevant section deleted]. Using urethral tissue does indeed give a more natural appearance to the inner labia, though at the cost that they are not as large as, for example, the ones Dr Bowers can make. While this tissue is somewhat mucosal in nature... and hence does produce some moisture... that is not the source of most of the natural lubrication I was talking about.

The prostate gland (which is homologous to the Skene's gland in women) and the Cowper's glands (also known as bulbourethral glands, which are homologous with Bartholin's glands), both secrete larger quantities of a mucus like fluid when aroused... and as this is discharged from the urethral orifice (within the labia minora just above the vaginal orifice, for any pre-ops reading this...), while most of the fluid ends up near or entering the vagina cavity, it also provides external moisture to the whole vulva -- at least, if you are upright and walking around, where the natural movement of the skin while walking tends to "spread" the moisture around.

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ZZZZZZZZZZzzzzzzzzzzzzz. Huh? Is it over? Finally? Whee...

Sorry about this article, folks. I will try harder not to post something like this again -- I probably should have stayed out of this thread entirely. Old habits die hard...

The prolonged use of oestrogen

Angharad's picture

reduces secretions from prostate and bulbourethral glands, also the secretions are external to the vagina and as such will not lubricate the vagina.

Angharad

care to indicate a source for these claims?

Everyone else (even in scientific circles) seem to think that if anything, the excretions increase from estrogen. Male excretion levels are lower, than female ones, and the difference isn't so much in the glands themselves as what operating system the glands are running, or, the hormonal balance.

Also, as to being "external", not so much, it's inside the labial folds, it's as good as internal. Besides, there's always the fact that the skin itself SOMETIMES will lose it's protective keratinization and become much more able to let fluids from nearby glands excrete into the entire canal...

I'm not saying it'll happen for everyone, or even for very many, but it is POSSIBLE, for SOME people, to have neo-vagina's that are naturally self-lubricating.

Some, very few, very lucky women.

Abigail Drew.

I agree...

S.L.Hawke's picture

...with what you are saying, Abigail.

Smile. I actually wrote another long article about the variability of effects on different individuals from long term oestrogen therapy... the resultant variability of atrophy of various glands (including the prostate and bulbourethral)... the relevance of different surgical techniques, and how those techniques have evolved over the last couple decades... the side effects of "old school" high dosage oestrogen regimens versus combined androgen blockers and lower dosage oestrogen regimens in more recent use... the interactions other HRT components such as the use of progesterones or testosterone supplements may have on this issue (many long term TS have very low testosterone levels, far below natal females -- which can have negative side effects on both the libido and various skin and reproductive gland secretions)... the mechanics of vaginal sex, and how that can spread "external" lubrications inwards from the labial folds...

Smile. Then it slowly dawned on me, as I was still typing merrily away, that I had already written a couple thousand words in reply to a single sentence from Angharad. Talk about severe overkill... LOL.

Short version: Angharad, it may surprise you to know that I also agree with you. I have no doubt that you are stating the facts as you know them, probably based on your own experience. Shrug. But while I can see how you might have reached the conclusions you have... I think you are looking too closely at a particular case history, and missing the big picture. Humans vary a lot, and there is always a range of results from any procedure or medication treatment. You are probably being entirely honest... and I can see how the result you are indicating could happen for some individuals... possibly even a majority of individuals... but all I am saying is, this is not the case for everyone -- and certainly not for myself.

"Your mileage may vary..."

No, thank you, really.

You backed me up with a much more scientific explanation of what I was saying. Thank you.

Also, call me a geek, but I found it all rather fascinating.

Abigail Drew.

About vaginal lubrication...

Please know that my participation in this discuss is offered in the meekest and gentlest of terms. I helped my X get through nursing training, and read a lot and is my sole claim to any expertise at all.

Mine was done in Bangkok, Thailand by a Dr Kamol and was a penile inversion. I'd had an external castration about 2 years before. I was told that at the time of the surgery, the Doctor would rerout the Vas Deferens into the aft end of my faux vagina to provide lubrication, and I seem to have a constant drip from there that stains. I have no idea what so ever if his statement was correct.

I love reading discussions like this because I learn so much. :)

Please, lets all be kind to one another.

Gwendolyn

Stretching

You don't hang around on the web for long without coming across pictures of people with greatly stretched piercings. It isn't uncommon for body modification aficionados to gradually increase the size of their piercings by inserting bigger and bigger pieces of jewelry.

This isn't a new practice, either. We've all seen pictures of tribal folk with huge lip disks.

We're talking about ordinary skin, not skin that was specifically designed to be stretchy.

I think the main difference is that the body mod folks are constantly wearing their jewelry, where a stent is only inserted for a half hour or so. Perhaps you can order something softer and more flexible from one of those online companies that ship their products in a plain brown wrapper. (Not that I would know anything about such businesses. [snicker])

If I'm wrong ignore my comment

I'm going to give you a cyber-smack, HOW COULD YOU STOP DILATING!?! iT COULD HAVE BECOME SERIOUS THAT YOU WOULD HAVE NEEDED ANOTHER SURGERY. I mean what would happen if you weren't able to rid yourself of urine because of this? You could have gotten sick.

Now on the other hand I don't know all medical details invoved here but you know people get concerned about silly girls like you.

Owee, I'll be good, Cliff!

Yes, I will freely admit that it was quite stupid. :(

Well, there was no danger of the Urinary tract becoming blocked, just the closing of the Vaginal opening is quite enough problem for me, thank you.

You see the urinary orifice exits the body above the vaginal opening, so if the vaginal opening becomes blocked, one can still pass urine. The anal opening is below and posterior of the vaginal opening. All three of these openings are in close proximity to each other and e coli germs are naturally resident in one's gastrointestinal tract, so that explains to me the high need for good hygiene in the female and even more so in the post operative MtF.

http://www.3dvulva.com/

In my search for a good female anatomy illustration, I also found a video showing MtF surgery. It is couched in relatively high medical terminology, so it may be somewhat difficult to follow, but is quite graphic.

http://www.youtube.com/watch?NR=1&feature=endscreen&v=Y1vKT4...

Enjoy.

Gwendolyn