a trans kid binding
All Prism Blog Posts, Self Care for Trans Health

Androgel: Info for Trans Men

Androgel can be used to initiate or maintain the development of male secondary sex characteristics, as well as virilization (clitoral enlargement) and cessation of menstrual periods.

Though testosterone levels return to baseline 48-72 hours after last dose, most changes (such as cessation of the menstrual period and muscle/fat redistribution) reverse if Androgel treatment is stopped; however, voice changes, facial and body hair, genital growth, and male-pattern baldness persist.

Showering 2-6 hours post-dose decreases testosterone by 13%; using lotion on the application site 1 hour after increases testosterone 14%.

Excess testosterone is converted to DHT (which causes male pattern baldness) and estradiol (a form of estrogen), and can therefore cause adverse effects. This makes finding the appropriate dose and getting hormones checked regularly very important.

It is important to apply gel only to the area of your shoulders that can be covered by a t-shirt, since skin-to-skin contact within 2 hours of application can significantly increase testosterone levels in others (research shows a 280% increase in cis women with skin-to-skin contact vs. only 6% if covered with a t-shirt). Also, remember to wash your hands right away afterwards to prevent transmission as well!

You may experience an increase in urinary disorders or other side effects. It is important to continue to perform regular self chest exams to check for lumps if you still have breast tissue (including tissue near the armpits which often is not removed during top surgery). You should also get your blood pressure, red blood cell counts (to monitor for blood clots), cholesterol and T4 levels checked regularly to monitor for these side effects.

Full Review of Research Follows:

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a woman with long beautiful hair
All Prism Blog Posts, Menopause and Andropause, Self Care for Trans Health

How Does Saw Palmetto Decrease Baldness?

Normally, hair follicles remain active for up to a decade, producing a long strand of 10 year old hair. In alopecia, however, follicles stop producing hair before the hair is long enough to even emerge from the skin. Male pattern baldness, or Androgenic Alopecia, is both genetically determined and influenced by hormones.

Genetics cause some people’s hair follicles to be more susceptible to DHT (dihidrotestosterone), which changes the growth phase of hair follicles. This gene can be present in any sex, but is only expressed when DHT, a form of testosterone, is present. Hence the name “male-pattern” baldness. This is the reason why many trans men develop this pattern of baldness while on T, and why this process of balding stops in most trans women once they start taking anti-androgens (like spironolactone).

Though we cannot change the gene, we can prevent testosterone from converting to DHT to stop this balding process. Testosterone converts to DHT via the enzyme 5-alpha-reductase. Research has shown that saw palmetto inhibits 5-alpha-reductase, preventing this pattern of baldness.

Saw palmetto is very effective for hair growthSaw palmetto together with the supplement beta-sitosterol has been shown to have a 60% effectiveness rate for hair loss reversal. In my experience this does not increase facial hair growth, however studies have shown inconclusive results about its effect on overall testosterone levels. It likely blocks aromatase, an enzyme which converts testosterone to estradiol, a major hormone involved in breast development. If you’re concerned about saw palmetto supplements increasing your testosterone levels, a good alternative is to use it topically. It has been used topically with similar effectiveness.

Saw palmetto also prevents the accumulation of DHT in the prostate, lowering the risk of prostate cancer. It acts on estrogen and progesterone receptors to lower the risk of breast cancer. It’s helpful for colds and coughs, sore throats, asthma, chronic bronchitis, chronic pelvic pain syndrome, and migraine headaches. It is also a diuretic (makes you pee more), a sedative, and an aphrodisiac, so be cautious if those are effect you do not want.

DO NOT take saw palmetto with spironolactone because they are both diuretics and could significantly lower your blood pressure or cause dehydration. People with bleeding disorders or who are taking anticoagulant or antiplatelet medications (“blood-thinners”) such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix) should avoid taking saw palmetto unless under medical supervision. It should also be avoided at least two weeks before or after surgery. Saw palmetto may interact with other medicines, including anti-inflammatory drugs, blood pressure medications, birth control pills and antibiotics.

Another great herb for hair loss is Shou Wu. Shou Wu Pian (aka Fu Ti) is an ancient Chinese herb that increases hair growth. It is generally used for scalp hair growth, but in my experience it increases mustache growth as well. If increased facial hair would be a problem for you, you may not want to take this formula. It’s also important not to take this formula if you are already taking synthetic hormones or other medications as it can increase the strain on your liver.

More hair loss prevention
Massage daily with Rosemary hair oil
Topical borage seed oil works like Propecia to block androgen receptors in hair follicles
Teas of silica rich herbs like horsetail, oats, or nettles
Nourish your kidneys with asparagus, artichoke, celery, aduki beans, parsley
Using a plum blossom needle to stimulate hair growth.

Finally, to support your overall constitution and get treatments tailored specficially to your goals, come in for a treatment!

Where to find:

Shou Wu Pian (aka Fu Ti)

Saw Palmetto with Beta-Sitosterol

Topical Saw Palmetto

Read more

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.

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A nonbinary queer person with a face mask for hormonal testosterone acne
All Prism Blog Posts, Endometriosis, Menopause and Andropause, Self Care for Trans Health

Can Vitamins Treat Hormonal Acne?

Vitamin B5 supplementation can reduce acne caused by testosterone!

B5, also known as pantothenic acid, limits oil production in the sebaceous glands of the skin, a common cause of acne. Testosterone causes these glands to produce more oil, so vitamin B5 reverses this process, without counteracting any of the other desirable effects of T.

Doses of 500mg up to 5 g a day were used in the study, however 5mg is the standard recommended dose. It’s safer to start with a smaller dose and work your way up; I wouldn’t recommend going higher than 1g a day without working with a healthcare provider. Also, be cautious with any supplements if you are using oral testosterone, as it can be very hard on the liver.

B5 can also help lower cholesterol, which can be important with long-term testosterone use. It also helps speed wound healing and can be helpful for rheumatoid arthritis.

B5 is available in the diet, though it is often lost in processing, so fresh foods have significantly higher amounts than processed foods. The best sources are brewer’s yeast, wheat germ, corn, cauliflower, kale, broccoli, tomatoes, avocado, egg yolks, beef (especially organ meats), poultry, milk, legumes, peanuts, sunflower seeds, whole-grains, lobster, and salmon. Soybeans and sweet potatoes also contain large amounts, but be cautious with them as they have an estrogenic effect.

B5 is a water soluble vitamin, so it’s not stored in your body if you take too much (unlike vitamin D), but it does need to be filtered out by your body to get rid of it, which can stress your liver and kidneys. Overdose on B5 can cause diarrhea, an increased risk of bleeding, and a deficiency of other B vitamins, especially B1/thiamin. For this last reason, you may consider taking a B complex rather than just B5.

B5 can interfere with tetracycline (an antibiotic) function, so don’t take them at the same time. It can also increase the effects of certain alzheimer’s medications so should be used with caution if taking Donepezil, Memantine hydrochloride, Galantamine, Rivastigime, or other Cholinesterase inhibitors.

One study noted that taking L-carnitine along with B5 supplementation allowed patients to take higher amounts, since L-carnitine aids in the breakdown and absorption of B5. The study recommended 250mg a day, though the standard dose is up to 3 g a day. It is important to note, however, that the addition of l-carnitine can actually cause smoother skin with smaller pores (the opposite of testosterone’s effects), and weight loss; so consider whether you want those effects before taking it. High doses can cause diarrhea, increased appetite, body odor, and rash. L-carnitine can also make thyroid hormone replacement less effective; it can be beneficial for those with hyperthyroidism, but detrimental to those with hypothyroidism. It can also increase the risk of seizures in people with epilepsy.


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!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.

a trans man and a trans woman cuddling
All Prism Blog Posts, Self Care for Trans Health

Herbs for Transitioning: The Basics

This is a follow-up post to “The Basics.” Also see the transmasculine post here, and the feminizing herbs post hereFor information on estrogen and progesterone supportive herbs, check out my follow-up article on Feminizing Herbs

For gender affirming transition, herbs can be used alone to create very mild ‘energetic’ effects or to support the body to counteract any side effects of synthetic hormones. Note: Most herbs are unlikely to have a significant effect without any other transition methods. If you are looking for physical effects, prescription hormones are the safest way to make that happen. The dosages you would need to take of herbs in order to get a physical effect can be dangerous.

DO NOT take herbs without consulting with an herbalist to ensure they are safe for you. DO NOT combine herbs with your medications without discussing with a healthcare provider.

The Basics:

It’s first important to take care of your body with proper nutrition so that you can handle the changes  and stress that will accompany transitioning. All hormones are made of fat, so it’s important to eat good fats (raw oils & omega 3s especially) to help your body form and transform those hormones, and also to coat your nerve cells (their myelin sheaths are also made of fat) to help you cope with stress and stay emotionally healthy. Fats form the boundaries of our cells–they keep out and let in what we want to–we need good fats in our bodies to have good boundaries physically and emotionally!

We ALL have the same hormones, just in different amounts and we USE different amounts of them too. Furthermore, we can change how our bodies use the hormones we already have. Every body makes progesterone from cholesterol, and that progesterone can turn into estrogen OR testosterone. The estrogen and testosterone in our bodies can also convert back and forth (estrogen to testosterone and vice versa). This is the reason you want to get your hormone dosages right: if you take too much, your body is just going to convert it into another hormone to maintain balance in your system. This could actually counter the desired effects of the hormone you are taking: too much estrogen in your system and your body will start converting it to testosterone, counteracting the changes you want to make.

Coming up with a plan for your body:

There are many different options for transitioning, even when just using synthetic hormones. Progesterone itself helps to build tissue and can often be useful for developing breasts (taken externally) or muscle tissue (taken internally). Aromatase is what turns testosterone into estrogen, so you can take extra aromatase instead of (or in addition to) taking estrogen. Likewise, you can take aromatase inhibitor to prevent that testosterone from turning into estrogen, instead of taking testosterone. There are many options for prescription hormones; it’s important to talk to your doctor about what will work best for your body.
For most people, herbs aren’t going to change your hormones drastically alone, so you might choose to start out taking synthetic hormones and, once you’ve achieved the effect you want, use herbs to lower your dose of synthetic hormones or switch to herbs entirely. Herbs can maintain the hormone levels and characteristics you’ve built up with synthetic hormones. This is a good alternative to the sometimes health damaging side effects of long-term synthetic hormone use.

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

References include:

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!

Join the Prism Family! Subscribe to our newsletter and get $30 off your first visit.