
Idk about testosterone but I know there’s localized estrogen that doesn’t raise whole-body levels and just works in the area it’s applied - there may be something like that. Separately there are tons of meds out there for ED, some of which also prevent atrophy while on E w/out reducing the efficacy of E
What I have heard is there are meds that people take (literally viagra - phosphodiesterase-5 drugs) before going to sleep that essentially cause enough blood flow in the area to do "maintenance boners" that otherwise don't happen on estrogen, and this effectively reduces/eliminates atrophy. It seems to be a very recent development that it’s prescribed for this purpose
basically the meds are vasodilators (make your veins widen). the reason T makes it big in the first place is because it also acts as a vasodilator. so if you remove T and add a vasodilator, you get rid of all of T’s other effects and still have sexual function. atrophy over time is due to your veins shrinking because they aren’t “stretched” open wide as often. so keep em “stretched” = no atrophy. def not an expert so maybe someone can fact check me here, but that’s my 2 cents