Answering a question I got on Reddit a little while ago: “How long should you wait after applying estrogen cream to have sex with your cis male partner? Or would the cream not affect them?”
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Content Warning!
Reproductive organs and genitals will be mentioned by name, for the sake of accuracy. I will always correct exclusionary and cisnormative language where possible, and I’ll do my best to avoid potentially dysphoria-inducing imagery without a warning. Primary sources tend to be cisnormative – please keep that in mind when clicking any links!
Topical Estrogens Are Systemically Weak
Topical estrogens are systemically weak – that is, they only mildly increase serum estrogen (the estrogen in your blood and body overall). A person who regularly applies topical estrogen to the vagina/vulva is unlikely to experience a significant increase in their estrogen levels. The majority of a topical estrogen will instead be absorbed by the vulva, vagina, urinary tract, bladder, cervix, and uterus. Another word for “topical” estrogen is “local” estrogen. While very helpful for treating atrophy, topical low dose estrogen doesn’t tend to affect the rest of your body very much.
Published data indicate that low-dose vaginal estrogens minimally increase plasma estradiol and clearly not to levels observed with oral or transdermal estrogen products. Use of vaginal estrogens has increased since publication of the results from the Women’s Health Initiative (WHI), presumably from concerns about the adverse effects of increased systemic estrogen levels. Notably, local administration of vaginal estrogens minimizes systemic estrogen exposure, compared with that of oral or transdermal estrogens. (Source)
Will a Sex Partner Absorb Estrogen During PIV?
Despite this systemic absorption being quite minimal, estrogen is very stigmatized among men. It’s something we worry about. Speaking as a guy who went through the wrong puberty the first time, estrogen can be some scary stuff. So is there any evidence that a cis male partner might absorb estrogen cream after having PIV sex with a partner who uses the cream? Unfortunately, yes.
But again, it’s minimal. Even if your partner does absorb some low dose topical estrogen, it likely won’t be enough for them to notice any feminizing effects. Let’s put it another way: if a trans woman attempted to feminize her body by having PIV sex with people who’ve recently used estrogen cream, she would likely be very disappointed with the outcome. (Though I like joking about my force-feminizing bussy).
[Partners with penises] absorb vaginal estradiol during intercourse, whereas intercourse reduces estradiol absorption in [partners with vaginas]. Although serum estradiol levels were only mildly elevated in [partners with penises], it is possible that long-term exposure could cause feminizing changes. In [partners with vaginas], estradiol levels were markedly reduced by intercourse. (Source)
What should I do about it?
The typical recommendation for folks who use estrogen cream is to wait 8-12 hours after application to have PIV sex to avoid exposing your partner to estrogen. As far as I’ve found, there are no studies determining how long you must wait to prevent exposure. The 8-12 hours is only an estimate. But it doesn’t hurt to double check with a doctor or pharmacist.
Another important takeaway from the above study is that having sex soon after application can reduce the amount of estrogen that you absorb. So for the sake of effectiveness, it’s a good idea to wait a few hours.
Absorbing estrogen through the penis is a concern with estrogen cream and suppositories, but not with vaginal rings such as Estring or Nuvaring. You may leave the ring in the vagina during PIV sex. If you or your partner are worried about estrogen exposure via sex, an estrogen ring may be a better option for you. Also it’s probably a good idea to let your partner know. A condom would be a good preventative measure.
