The primary cause of ED in trans women is the during gender-affirming hormone therapy (GAHT).
Sexual health changes are a common part of the medical transition process. For many, these changes are expected or even desired to reduce gender dysphoria, while for others, they are unwanted side effects that can be managed with medical support. Causes of Erectile Dysfunction in Trans Women shemale impotence
Research indicates that sexual dysfunction is common but varies significantly between individuals. Estrogen HRT and Sexual Function - FOLX HEALTH The primary cause of ED in trans women
: Reduced frequency of erections (including the loss of "nocturnal erections") can lead to the shrinkage of erectile tissue over months or years. Causes of Erectile Dysfunction in Trans Women Research
: GAHT typically involves estrogen and anti-androgens (testosterone blockers) like spironolactone or cyproterone acetate. Testosterone is the primary driver of spontaneous and maintained erections; when it is lowered to the female range, the physical ability to achieve an erection often decreases or stops entirely.
: Estrogen can change genital sensations, sometimes making the experience of an erection feel uncomfortable or different than before. Frequency and Impact