
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