madman
Super Moderator
Testosterone Therapy in Adolescent Boys: The Need for a Structured Approach
Abstract
Background: In adolescents, testosterone may have several effects including promotion of secondary sexual characteristics and pubertal growth, attainment of optimal muscle mass and peak bone mass, optimization of the metabolic profile, and psychosocial maturation and well-being.
Summary: Testosterone therapy is a cornerstone of the management of hypogonadism in boys. Since the initial report of the chemical synthesis of testosterone, several formulations have continued to develop, and although many of these have been used in boys, none of them have been studied in detail in this age group. Given the wide ranging effects of testosterone, the level of evidence for their effects in boys and the heterogeneity of conditions that lead to early-onset hypogonadism, a standardized protocol for monitoring testosterone replacement in this age group is needed.
Key Messages: In this review, we focus on the perceived benefits of androgen replacement in boys affected by pubertal delay and highlight the need to improve the health monitoring of boys who receive androgen replacement therapy, proposing different approaches based on the underlying pathophysiology.
Conclusion
Adolescence represents a crucial period in human life history, the transition between childhood and emerging adulthood, characterized by multiple challenges and developments in the physical and social domains. Testosterone therapy in adolescent boys is primarily aimed at increasing linear growth and pubertal progression, but may also have a positive effect on bone mineral content, muscle function, metabolic profile, and psychological well-being. Therapy should limit the long-term consequences of early-onset hypogonadism and the psychosocial distress of pubertal delay that may affect teenage behavior, lasting into emerging adulthood. Hypogonadal adolescent males may start on testosterone therapy for several conditions; some may only require testosterone therapy temporarily, while others may need lifetime therapy and the monitoring of therapy will, therefore, depend on the underlying condition. Thus, not only is there a need for clear guidance on how to investigate adolescent males with delayed puberty but there is also a need to have a clear protocol for monitoring boys receiving testosterone therapy, especially in those who may have permanent hypogonadism.
Abstract
Background: In adolescents, testosterone may have several effects including promotion of secondary sexual characteristics and pubertal growth, attainment of optimal muscle mass and peak bone mass, optimization of the metabolic profile, and psychosocial maturation and well-being.
Summary: Testosterone therapy is a cornerstone of the management of hypogonadism in boys. Since the initial report of the chemical synthesis of testosterone, several formulations have continued to develop, and although many of these have been used in boys, none of them have been studied in detail in this age group. Given the wide ranging effects of testosterone, the level of evidence for their effects in boys and the heterogeneity of conditions that lead to early-onset hypogonadism, a standardized protocol for monitoring testosterone replacement in this age group is needed.
Key Messages: In this review, we focus on the perceived benefits of androgen replacement in boys affected by pubertal delay and highlight the need to improve the health monitoring of boys who receive androgen replacement therapy, proposing different approaches based on the underlying pathophysiology.
Conclusion
Adolescence represents a crucial period in human life history, the transition between childhood and emerging adulthood, characterized by multiple challenges and developments in the physical and social domains. Testosterone therapy in adolescent boys is primarily aimed at increasing linear growth and pubertal progression, but may also have a positive effect on bone mineral content, muscle function, metabolic profile, and psychological well-being. Therapy should limit the long-term consequences of early-onset hypogonadism and the psychosocial distress of pubertal delay that may affect teenage behavior, lasting into emerging adulthood. Hypogonadal adolescent males may start on testosterone therapy for several conditions; some may only require testosterone therapy temporarily, while others may need lifetime therapy and the monitoring of therapy will, therefore, depend on the underlying condition. Thus, not only is there a need for clear guidance on how to investigate adolescent males with delayed puberty but there is also a need to have a clear protocol for monitoring boys receiving testosterone therapy, especially in those who may have permanent hypogonadism.
