Dihydrotestosterone (DHT) is a metabolite of testosterone that’s recommended by some SRS surgeons to encourage genital growth in transgender men. DHT can be topically applied in a transdermal cream, but is not to be confused with testosterone cream or testogel/androgel. DHT is at least three times more potent as an androgenic compound and is therefore the preferred choice for FTM genital growth.
DHT plays a vital role in virilization. When a trans man injects testosterone, his body converts some of it into DHT. It influences facial and body hair growth, voice changes, sex drive, and growth of muscle and genital tissue. Unlike other androgens, DHT cannot be converted to estradiol, and it’s not anabolic, so it doesn’t build up in tissues, muscles and bones.
DHT for Dick Growth
For genital growth, a 10% DHT concentration, non-alcoholic cream is desired. A typical dosage is 20 mg administered three times a day, and it dispenses very easily when packaged in syringes (1 line = 1 dose). Simply rub the cream onto the glans, shaft and foreskin; it absorbs quickly. A minimum of three months of use is recommended.
Topical DHT shouldn’t drastically affect blood pressure or testosterone levels, but it’s a good idea to get regular blood work done while you’re using DHT, and to observe your moods and adjust your testosterone dosage as required.
Getting a Prescription for DHT
To get a prescription for DHT, ask your doctor or endocrinologist for “10% Dihydrotestosterone cream.” If they grant your request, take the prescription to a compounding pharmacy. Be sure to specify that the cream should not contain any alcohol.
In North America, DHT has been available to compounding pharmacies through the PCCA. In July 2009, the PCCA announced that they were out of stock and that the manufacturer had ceased production of DHT. This was reportedly the only source of DHT available to Canadian pharmacies. It’s unknown if there are other sources available or not in the United States. It may be difficult to get a prescription for DHT filled in North America at this time.
Buying DHT Online
You can buy a 2% DHT cream called Andractim online and without a prescription at buyandractim.com. However, this product is alcohol based (and may cause a temporary burning sensation). It’s also illegal to import DHT—a controlled substance—through an online “pharmacy.” Purchase at your own risk. If you do buy DHT online, check off “female” for gender on the order form, otherwise you’ll be required to purchase a prostate test kit.
Side Effects of DHT
Hair Loss
Despite being responsible for facial and body hair growth, one of the potential side effects of DHT is hair loss. DHT leaves a waxy substance at the root of hair follicles on the scalp that can inhibit hair growth. One possible solution is saw palmetto berry extract tincture, a natural herb that’s been shown to block DHT. The tincture can be mixed with water and topically applied to the scalp to prevent that build up in the hair follicle roots. Dosage is 30-60 drops daily. A one month supply of saw palmetto tincture costs about $25 USD.
Secondary Exposure
Like Androgel, DHT cream presents a risk for transference and requires diligence to prevent accidental secondary exposure to sexual partners, children, and pets. Washing well an hour after application reduces—but does not eliminate—chance of exposure. The only safe form of protection is zero exposure. Since DHT is applied daily, avoiding all direct contact to the genitals throughout the period of usage is recommended.
DHT Research
While there aren’t any clinical studies about DHT use in transgender men, we can look to related studies for some guidance, particularly with regard to safety.
Transdermal dihydrotestosterone therapy and its effects on patients with microphallus.
All patients demonstrated growth of the penis during treatment. The mean increase rate (153%) in the first 4 weeks of treatment was higher than that (118%) of the second 4 weeks… In conclusion, transdermal dihydrotestosterone therapy is an effective and relatively safe modality in the treatment of microphallus.
We conclude that 3 months treatment with transdermal dihydrotestosterone gel demonstrates expected androgenic effects, short-term safety, and limited improvement in lower limb muscle strength but no change in physical functioning or cognitive function.
…percutaneous DHT administration is a relatively safe modality of androgen replacement therapy as far as atherogenicity is concerned.
Absorption of dihydrotestosterone (DHT) after its intramuscular administration.
…suitable for long-term substitution therapy.
DHT offers trans men the potential for genital growth that exceeds the promises of testosterone therapy alone. While dedicated research is lacking, related studies and anecdotal accounts suggest that DHT is a safe and promising treatment.
October 10th, 2009 at 6:45 am
Thanks for taking the time to write, test and report your experience.
November 2nd, 2009 at 11:32 am
Hi,
I wonder there other testosterone cream in USA? I understand about DHT is difficult approve by USA. I am appreciate how you explain about testosterone. I send link to my doctor if he read and understand it but problem he see that DHT can’t be in USA. I wonder what other can use? I am trying to find other one. thank
November 2nd, 2009 at 12:58 pm
Thanks for putting this information together. Since my spouse is a transwoman, and drug transfer would be most unwelcome for her, it’s not a viable option for me. With topical T, you can put a bandage over the skin to prevent transfer, but . . . it would be taking safe sex to an extreme to spend three months with a bandage over my junk. Still, I’m glad you wrote this blog article, to help guys make informed choices and know about their options.
November 2nd, 2009 at 3:57 pm
@Austin Yes, you can easily get plain testosterone cream compounded. It may have some effect, but it’s not as effective as DHT in this regard.
@gabriel Everyone’s different, but I quite easily managed 3 months of no genital contact w/ sex to avoid transference, and it was worth it given the growth I experienced.
November 2nd, 2009 at 7:02 pm
Joshua,
Please tell us what growth (length and girth) you experienced? Did you administer typical dosage of 20 mg three times a day? If you are in USA, could you recommend a doctor and/or pharmacy? Thank you.
November 3rd, 2009 at 8:45 am
Fred, I haven’t done my official final measurement, but I achieved about 1/2″ to 3/4″ of extra length. Not sure I got much extra girth though. It might not sound like much, but it could mean the difference between clearing my fly or not post-op, so I’m pleased. Yes, I used 20mg of 10% DHT three times a day.
I’m not in the US. I obtained a prescription from my primary care provider here in Canada, and had it filled at a compounding pharmacy, with DHT sourced from the PCCA. If I do have a metoidioplasty with urethroplasty, I will do two more 3-month DHT treatments: 1 pre-op and 1 post-op, both in conjunction with pumping. Of course, this assumes that DHT will once again be manufactured and available in North America.
November 5th, 2009 at 10:21 pm
Hey Joshua
I got the andractim gel online and found that if I use lidocaine ointment before I apply the gel it doesn’t sting at all. My question is, should I use it more than 3 times a day because it’s only 2.5%?
November 6th, 2009 at 10:17 am
Lidocaine is a great idea! Someone on YouTube suggested Orajel. (Note: Anbesol has alcohol in it, apparently Orajel does not.) However, Orajel is not intended for genital use, while lidocaine is, so again, great idea Key!
Given that the Andractrim is only 2.5% concentration, yes you could use more safely. Rather than increasing frequency (I found 3x day inconvenient enough!) I would increase dosage.
It would be great if you could report back with your own anecdotal experience with DHT!
November 8th, 2009 at 9:58 am
Thanks for the info Joshua. I will definately report back. I started about 3 days ago and I forgot to measure first but i’m gonna go ahead and do that now. I’ll report back in about a month.
November 8th, 2009 at 12:59 pm
This is great and incredibly interesting to me. I have had significant growth from my T shots alone so hopefully I’ll be able to acquire this prescription (I live in the states).
Thanks, again for posting this, Joshua.
December 5th, 2009 at 11:47 am
Hey Joshua –
I am desperate to get hold of some DHT, however I live in the UK and it is not available here.
Do you think there is any way to circumvent the prescription process to allow someone to purchase and post this to me?
Thanks!
Ben
December 6th, 2009 at 9:40 am
Ben, you can order Andractim (DHT gel w/alcohol) online. See the link above. (Note that it may be illegal to do so in the UK.)
December 10th, 2009 at 5:31 am
I’m a guy who’s cock stopped working and shrunk after using a drug for hairloss, will DHT cream work for me? (Just to clarify I’m not a transguy but your experience and expertise of DHT gel is invaluable. Thanks.)
December 20th, 2009 at 9:04 pm
Hey Bonzo, sorry for the delay. Honestly, I don’t know. If the hair loss treatment was designed to block DHT, and now you’re off that treatment, topically supplementing DHT may help reverse the effects. DHT gel has been shown to alleviate finasteride-induced gynomastia, so there’s a chance it could help. I bet there are plenty of men who are considering this or have done it, so keep looking for those accounts for more anecdonal info.
December 22nd, 2009 at 1:51 pm
Hello Joshua.I would like to know if I use DHT cream only my genital parts it will be possible to growth hair in my face and my voice could be changed.Thanks.
December 22nd, 2009 at 2:04 pm
Max, some of the DHT that’s topically applied will be absorbed into your system, so yes there’s a good chance that using DHT for genital growth will produce other masculinizing effects.
I don’t recommend using DHT to acheive other masculinizing effects as there’s supposed to be a specific ratio of DHT to T in your system, so one probably wouldn’t want to be on it for long periods of time. It’s a good idea to get DHT levels checked in addition to T levels when using DHT.
January 3rd, 2010 at 1:58 pm
Hi,Joshua.Thanks for answer.I don’t started my transition yet.However, I’m 40 years old and I have many questions about the process…Thanks again.Happy new year!
January 5th, 2010 at 3:31 pm
hey bro,
funny thing i thought I’d share. I googled metoidioplasty, and your pic comes up!!!
January 10th, 2010 at 4:34 pm
Ha, look at my mug smiling back in the search results! I suppose it’s the meta/phallo survey, my meta surgeons blog post series and the meta content here that’s dropped my Gravatar into the results. Ethan’s photo used to be there. His site is an awesome resource for metoidioplasty.
January 30th, 2010 at 1:19 am
Hello Joshua, and thanks for this great article. There are a few questions I’d like to ask you about DHT:
– Can DHT be taken only untill the penis has achieved a comfortable length, or must I take it for the rest of my life to maintain the size? I really hope that I can just take it untill I am satisfied, and then go off it with confidence that my penis won’t start to shrink back.
– Did you experience any hair loss? Can hair loss be estimated based on genetics? If you did experience hair loss, did you do anything to counter it?
– How long had you been on T before trying DHT? And how old were you when you started DHT? Are you still applying DHT?
– This one is really important. If my penis has stopped growing from the T, and I start to apply DHT, will it start to grow again?
– Lastly, does age effect hair loss probability? For example, if I apply DHT for a set number of months and I am 17 years old, will I be less likely to experience hair loss than if I were applying DHT as a 30 year old?
Sorry for the multitude of questions. Don’t feel obliged to answer every single one, they are probably better suited for my endocrinologist, I just have a lot of trouble asking them. If you do happen to answer my questions, then hats off to you, you’re a life saver.
January 31st, 2010 at 6:52 pm
Hey MC, I’m happy to answer your questions. Some endos wouldn’t be able to answer these anyway…
You do not need to take DHT for life. I haven’t come across any information that suggests that growth achieved with DHT goes away after treatment has stopped. (It has not in my case.) I wouldn’t take DHT for periods longer than 3 months anyway, for several reasons including…
Yes, I experienced hair loss. I noticed it quite immediately. I started using the topical saw palmetto and that stopped the hair loss. However, I didn’t continue the saw palmetto after I was done the DHT, and I wish I had because the hair loss picked up again at that point and lasted a few more months. In the future, I will use the saw palmetto for an additional 3 months after finishing the DHT. I don’t think age is much of a factor with DHT related hair loss. Lastly, DHT is one aspect of hair loss, while genetics is another.
I started using DHT when I was about 14 months on T, at age 35. I wouldn’t recommend using it until hormone levels are balanced (ie, after 1 year of T.)
No, I’m not using it now. I used it for 3 months, and will use it again twice more, pre-op and post-op (if I op!)
It’s possible that you will experience growth with DHT despite the fact that you’ve stopped growing from T. I say it’s “possible” not because of this fact, only because some of this is genetics too: not everyone experiences measurable growth from DHT. Also, I’ve heard plenty of guys say that they had growth spurts 3, 4, even 5 years after starting T, long past when it seemed like growth had stopped.
Hope that helps!
January 31st, 2010 at 11:43 pm
Yes, it does help. Thanks a ton for all the information, I copied and pasted it into a word document to save and reference in the future.
Cheers!
February 27th, 2010 at 6:58 pm
Hi Joshua,
This site that u mentioned to buy andractin is trustfull?
Thaks,
Cilene.
February 27th, 2010 at 7:03 pm
Cilene, lots of guys have ordered from buyandractim.com and had no problems. I sent them several emails with questions about ordering and they never replied to any of them. That was a turn off for me.
February 28th, 2010 at 1:05 pm
Ok thank u for the information.