Supplements for surgical recovery, as included in Prism Integrative Acupuncture's post-surgical recovery toolkit
All Prism Blog Posts, Self Care for Trans Health, Surgical Recovery & Scars

Best Supplements and Herbs for Surgical Recovery

What Herbs and Supplements Help with Gender Affirming Surgery Preparation and Healing?

When preparing for your gender-affirming surgery, there are many natural remedies and supplements to speed healing and make your recovery more comfortable. Knowing what to take, and when to take it is important. Always check with your doctor and/or surgeon before taking any supplements or herbs.

Things to Avoid: 

When preparing for gender-affirming surgeries, there are certain herbs and supplements that should be avoided in the days leading up. While each individual is unique, I tend to err on the side of caution, recommending stopping all herbs and supplements seven days before surgery. Do not take any supplements that your surgeon does not approve. 

  1. Avoid vitamin E, fish oil, omegas, ginkgo, and garlic at least seven days before surgery, as these can act as potential blood thinners.
  2. Avoid St. John’s wort, feverfew, bai shao, devil’s claw, dan shen, ginger, dong quai/dang gui/angelica, goldenseal, saw palmetto, reishi, echinacea, ephedra/ma huang, kava, ginseng, licorice, and valerian at least seven days before surgery, as these can either potentially cause excess bleeding or interfere with anesthesia.
  3. Avoid green tea and chili peppers at least 24 hours before surgery, or longer if your surgeon advises. 
  4. Avoid teas that contain herbs like hibiscus or mulberry leaf, which may lower blood pressure or blood sugar, at least seven days before surgery.

Supplements for Pre-Op: 

Leading up to your surgery, treat your body to supplements and herbs that will lead to faster healing overtime. Taking care of your body before gender-affirming surgery is key to a positive recovery. These supplements can help get you there.

    1. Vitamin D: Having your vitamin D and iron levels tested during your pre-op blood work can give you more information on whether or not you should supplement with the two. If you do decide to supplement with vitamin D, take 2000-5000 IU per day with food if not included in your multivitamin.
    2. Zinc: Taking 30-50mg of zinc per day with food for four to six weeks leading up to your surgery can speed healing post-op.


  • One month before your surgery, begin to take:


    1. A multivitamin with 25-50mg of B vitamin complex to boost immunity and reduce stress on your nervous system.
    2. 50mg of CoQ10 a day to reduce the stress of surgery on the heart and improve recovery.
    3. 500-1000mg of vitamin C a day to aid with wound healing.
    4. Milk thistle to detox the liver to prepare for successful anesthesia.
  1. Probiotic: Two weeks before surgery, begin taking a probiotic blend with acidophilus and bifida to reduce the risk of post-surgical infection.

Supplements for Right After Surgery: 

Help your body heal as fast as possible with these three herbs and supplements, taken right after surgery if your surgeon allows, or as soon as you get home.

  1. Dramamine Natural: Dramamine Natural is just super concentrated ginger, which studies show can be just as effective as metoclopramide, a common anti-nausea drug, at reducing nausea.
  2. Vitamin C: Take 500mg of vitamin C to help flush out the anesthesia and encourage collagen growth and repair. 
  3. Tea: Make a nourishing post-surgery tea of nettles, oatstraw, horsetail (equal parts), and rosehips (pinch); full of nourishing vitamins and minerals that speed healing.

Supplements for Post-Op: 

Check with your surgeon about when to begin taking supplements after surgery. Some surgeons will recommend waiting a few days before restarting supplements and herbs. This supplement plan should last for one month post-surgery, unless otherwise noted. After your supplement plan, return to your regular supplements and herbs as recommended by your healthcare providers. Don’t take anything that interferes with your regular medications and don’t stop taking your regularly prescribed medications around surgery unless your surgeon directs you to do so.

    1. Herbs for constipation: If you’re dealing with constipation, senna, aloe, and burdock are all gentle herbal supplements for post-op. You can take them with your surgeon prescribed stool softeners.
    2. Fennel: Drink fennel tea for gas pains.
    3. Vitamin C: Take 300mg-1g of vitamin C per day to help with wound healing. Vitamin C is required by the body to make collagen, the connective tissue in the skin that helps healing and prevents blistering. It also helps to strengthen the immune system and fight off infection. A good way to get vitamin C is through rose hips and camu camu berries. You can stop taking this after two weeks, unless it’s already part of your regular supplement regimen.
    4. Selenium: Eat a brazil nut everyday to give your body selenium, which is necessary for healing.
    5. Bromelain: Take bromelain for inflammation and bruising. It boosts the immune system to reduce pain, bruising, tenderness. Bromelain should be taken in doses of 1000-1500mg three times a day on an empty stomach, which is necessary. You can stop taking this after two weeks.
    6. Quercetin: Another anti-inflammatory supplement is quercetin, which can be taken in 1000mg doses up to two-three times daily to reduce swelling and reduce the tendency to develop hypertrophic scars.
    7. Willow: valerian, kava, and poppy teas can help ease pain, although they shouldn’t be combined with pain medication.
    8. Tea: Make a post-surgery tea of burdock (to aid with constipation, skin healing, lymph circulation, and liver detox), red root and cleavers (to help with lymph circulation, skin healing, and swelling), horsetail (silica for skin healing), gotu kola (for circulation), nettles, and echinacea. 


  • CoQ10: 100-200mg, aids in rebuilding cell walls and protects the skeletal muscles in the body.
  • B6: 250mg two times a day to reduce swelling (or use a multivitamin). This can be stopped one week post-surgery, unless it’s already part of your regular supplement regimen.
  • Milk thistle: to detox anesthesia from the liver; do not take at the same time as other medications or herbs.


  1. Zinc: 30-50mg per day for wound healing. You can stop taking this after two weeks.
  2. Probiotic: with acidophilus and bifida to reduce the risk of post-surgical infection.
  3. Omega 3s: 2000-3000mg of omega 3, like fish oil, per day to reduce inflammation and improve circulation. This should be lowered to 500-1000 mg per day after two weeks.
  4. Arnica: 30C of homeopathic arnica five times a day to reduce pain, bruising, and swelling.
  5. Vitamin D: 2000-5000 IU of vitamin D per day with food.
  6. Healing skin salve: Make a healing skin salve to use after stitches are gone of aloe, calendula, comfrey, plantain leaf, selfheal, yarrow, rosemary, and sage

Remember: If you can’t eat, drink, and/or urinate, or have a fever, chills, an infection, trouble breathing, unusual bleeding, redness, feel unwell, or have a hot feeling in the surgical site, call your doctor or go to the emergency room. Ask your surgeon what signs you should look for regarding post-surgical complications.

Get acupuncture home visits in Berkeley, Oakland, and the greater Bay Area to improve your recovery:

This information is for educational purposes only, please consult a healthcare provider before exercising and always follow your surgeon’s advice.

All Prism Blog Posts, Self Care for Trans Health, Surgical Recovery & Scars

Can You Exercise After Gender Affirming Surgeries?

Exercise can be a great way to increase energy, keep your body strong, and help clear your mind. Treating your body kindly with modified exercise before and after surgery is especially imperative to assist in the healing process. However, it’s important to know how much and what type is okay. Today, we’re breaking down what types of exercise you can incorporate into your recovery routine and how they can help your body feel its best after gender affirming surgery.

Remember that this is just a guide. Only YOU know your body and your limits. While there may be movements that are uncomfortable after surgery, never do anything that causes you pain or causes you to bleed. Know your body’s limits and be sure to take care of it.


Prior to your surgery, it’s best to make time for daily exercise. While each person is unique, take time to discover what exercises feel good and prepare your body best for surgery. Since you likely won’t be able to be active for some time after surgery, it’s important to get your exercise in and make it count.

  1. Foam rolling: You can buy these in most stores or online and they can be used to help sore or tight muscles. Use a foam roller daily the week before surgery (or earlier than that) to soothe any tight muscles. Do what feels right for your body, but refer to this article for five beginner-friendly positions. 
  2. Core exercises: Core work can help your posture and strengthen your core. Here are some core moves to incorporate into your exercises before your surgery. 
  3. Stretching: Stretching isn’t just for before or after a workout. Stretching can help with tight muscles, improve flexibility, release tension, and more. Find a stretching routine that works for you
  4. Pelvic floor exercises: Prior to bottom surgery–like vaginoplasty, metoidioplasty, or phalloplasty–pelvic floor exercises can be extremely helpful in preparing the body. One exercise we recommend involves imagining you’re picking up a marble or closing a drawstring purse with your perineum. Pick it up, hold for a moment, then let it go. This exercise can both strengthen and relax your pelvic floor muscles prior to surgery. If you have any pre-existing pain or issues with urination, contact a pelvic physical therapist to discuss what’s best for your body. 


After your surgery, you may notice your body feels and moves differently. It’s important to be sure to balance out your healing with both rest and movement to help your body in its recovery. Take each move slowly, paying attention to how your body is feeling.

  1. Slow walks: Unless you’re on bed rest (which may be the case for bottom surgery), try going for a slow walk around the block the day after surgery. If you’re on bed rest, start this the day you’re off bed rest. Bring a buddy with you to keep you company and assist you if needed. Rather than going for longer walks, go for shorter walks more often. A good rule of thumb is to aim for three one-block walks every day in the first week, then increase to a few blocks at a time if you’re up to it. Many doctors recommend you keep your walks short, around less than 15 minutes until two or more weeks post-op. 
  2. Ankle exercises: Start with pointing and flexing your toes 20 times every two hours. Then, make circles with your ankles 10 times in each direction to promote circulation and prevent deep vein thrombosis. This is recommended to be done every two hours while lying in bed. Ankle pumps are simply moving your ankle up and down. To do ankle pumps, plantarflex one foot as if pressing down on an imaginary gas pedal. Then, dorsiflex your feet by pulling your toes up toward your shins as if letting off the gas. Repeat with the other foot and alternate sides for 20 repetitions. This is great when you’re on bed rest, such as after phalloplasty, metoidioplasty, or vaginoplasty.
  3. Deep breathing: Not necessarily an exercise, but a great way to check in with yourself and your body. If at any point you need to relax, breathe through discomfort, or put your mind at ease, practice deep breathing through your nose. Let your belly and chest expand all the way from the tops of your shoulders to your pelvic floor, and sideways to expand your ribs. Feel the air fill your lungs and exhale slowly through the mouth. Do this however often you’d like, with a recommendation of two or more minutes, two or more times per day. Yes, this exercise is ok to do after top surgery (mastectomy, chest masculinization, or breast augmentation); you may feel some discomfort but should not feel pain.
  4. Shoulder rolls: With a surgeon’s consent, stand or sit comfortably with your arms relaxed at your sides. In a circular motion, bring your shoulders forward, up, backward, and down. Try to make the circle as large as you can and move both of your shoulders at the same time, doing this 10 times. If you have tightness across your incision or chest, start with smaller circles and increase the size as the tightness decreases. After your series of 10, switch directions and do 10 shoulder rolls in the backward direction. Bring your shoulders backward, up, forward, and down. You may find that the backward direction is a little tighter across your chest than the forward direction. Rest assured knowing that this will get better with practice.
  5. “Chicken wings:” Also called shoulder wings, these are done by placing your hands on your chest or collarbone, wherever is most comfortable. Raise your elbows upwards out to the side, limiting your range of motion as instructed by your healthcare team. Slowly lower your elbows. Do this 10 times, imitating a chicken wing, and then slowly lower your hands back down to your lap. If you feel discomfort while doing this exercise, hold your position and do the deep breathing exercise above. If the discomfort doesn’t go away, don’t raise your elbows any higher. If the discomfort does go away, finish the exercise in a range of motion that’s comfortable for you.
  6. Arm side circles: With a surgeon’s consent, stand with your feet slightly apart to help you balance. Raise each arm, one at a time, out to the side as high as you can. Gently, start making slow, backward circles in the air with your arm. Be sure you’re moving your arm from your shoulder, not your elbow, and keep your elbow straight. Increase the size of the circles until they’re as large as you can comfortably make them, limiting your range of motion as instructed by your healthcare team. Be sure to complete at least 10 full backward circles. If you feel any aching or if your arm is tired, take a break. Continue doing the exercise when you feel better. Slowly lower your arm to your side to rest your arm for a moment. Repeat the exercise at your comfort level, this time making slow, forward circles instead. 
  7. Hand pumps: These can help reduce swelling in the chest and should be done three times a day. Open and close the fists ten times, holding for a few moments in between. 
  8. Other exercises: Three slightly more advanced poses to help with surgical recovery are “happy baby pose,” “child’s pose,” and side bends. You can use a pillow under your knees in child’s pose if it’s uncomfortable. Wait to start these until you have surgeon approval as they require a little more range of motion. 

Remember: If you can’t eat, drink, and/or urinate, or have a fever, chills, an infection, trouble breathing, unusual bleeding, redness, feel unwell, or have a hot feeling in the surgical site, call your doctor or go to the emergency room. Ask your surgeon what signs you should look for regarding post-surgical complications.

Get acupuncture home visits in Berkeley, Oakland, and the greater Bay Area to improve your recovery:

This information is for educational purposes only, please consult a healthcare provider before exercising and always follow your surgeon’s advice.

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All Prism Blog Posts, Endometriosis, LGBT Inclusion For Providers, Menopause and Andropause, Self Care for Trans Health, Surgical Recovery & Scars

Treating Post-Surgical Constipation

photo credit: Practical Cures on flickr CC

Constipation is extremely common post-surgery, especially in combination with constipating pain killers, less physical activity, and irregular fluid and food intake. Often a bowel movement is required before a hospital will let a patient go home, so encouraging this process is especially beneficial to get you home sooner.


Acupuncture is extremely useful for alleviating postoperative constipation. Studies have shown that patients receiving regular acupuncture post-surgery actually perform better (have more frequent, easier,  less painful, more complete bowel movements) than those taking laxatives or stool softeners.

Points on your arms, legs, and abdomen are most frequently chosen for this purpose, especially points on either side of your navel and points on the stomach and large intestine ‘meridians’ (lines along the body in Chinese Medicine, sort of like dermatomes).


Several of these points can also be used at home as acupressure points for constipation. Press each point lightly (no more than an inch deep for abdominal points, about the pressure of holding hands for arm and leg points) for about 30 seconds at a time:


Belly massage is also helpful. You can find a Chi-Nei-Tsang practitioner near you, or watch this video demo to perform a similar belly massage yourself. You can also refer to the illustrated steps available here. There are many methods of breathing exercises for constipation as well that massage your belly from the inside!


Acupuncture can be complemented with some herbs that stimulate bowel motility like:


Hydration is key. Drink plenty of water and incorporate more warm foods and beverages to wake up your digestive system gently. Try ginger tea, hot water with lemon, and bone broth. If you urinate more frequently than every 2 hours you may be drinking too much or too fast. If you urinate less frequently than every 5 hours you are dehydrated!

Eat warm, easy-to-digest foods like rice porridge, oatmeal, and mashed sweet potato or yams. When you’re ready, try lamb or vegetable and mushroom soup. Give your family and friends recipes to make for you during your recovery, such as: Magical Mineral Broth, Congee, and Almond flour ginger cookies.

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

Contact us to see if your insurance covers services at our office!

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For more herbal estrogens, ideas, and resources see my previous posts: Feminizing Herbs and “The Basics.”

Further study:

  Acupuncture at ST25 and BL25   Acupuncture at LI11 and ST37   Acupuncture at ST25, BL25, LI11 and ST37   Medicine:oral use of mosapride citrate: 4-week oral use, 5mg, three times daily 0.5 hour before meal   Total
SBMs [1]
[units: times per week]
Mean (Standard Deviation)
  2.7  (1.9)   2.5  (1.7)   2.9  (2.0)   2.9  (2.8)   2.8  (2.1)
Bristol scale [2]
[units: units on a scale]
Mean (Standard Deviation)
  2.8  (1.3)   2.9  (1.4)   3.0  (1.5)   2.7  (1.4)   2.9  (1.8)
Degree of straining during defecation [3]
[units: participants]
0   5   8   9   5   27
1   63   60   68   59   250
2   68   69   58   72   267
3   30   35   28   31   124
no defecation   2   0   2   3   7