Congenital hypogonadotropic hypogonadism and micropenis: Effect of testosterone treatment on adult penile size—Why sex reversal is not indicated

Bin-Abbas, Bassam; Conte, Felix A.; Grumbach, Melvin M.; Kaplan, Selna L.

doi:10.1016/s0022-3476(99)70244-1

Cited by 185 publications

(120 citation statements)

References 26 publications

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“…[166][167][168] Micropenis should be treated early using short-term, low-dose testos terone (dihydrotestosterone or testosterone esters) to induce penile growth (Table 4). 86,169 Importantly, as the duration of treatment is brief, no major concerns regarding virilization or the development of secondary sexual characteristics exist; however, erections might be observed. Gonadotropins (LH and FSH) have been used to treat patients with micropenis and evidence of absent minipuberty.…”

Section: During Infancy and Childhoodmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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| Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), which is the master hormone regulating the reproductive axis. CHH is clinically and genetically heterogeneous, with >25 different causal genes identified to date. Clinically, the disorder is characterized by an absence of puberty and infertility. The association of CHH with a defective sense of smell (anosmia or hyposmia), which is found in ~50% of patients with CHH is termed Kallmann syndrome and results from incomplete embryonic migration of GnRHsynthesizing neurons. CHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. A timely diagnosis and treatment to induce puberty can be beneficial for sexual, bone and metabolic health, and might help minimize some of the psychological effects of CHH. In most cases, fertility can be induced using specialized treatment regimens and several predictors of outcome have been identified. Patients typically require lifelong treatment, yet ~10-20% of patients exhibit a spontaneous recovery of reproductive function. This Consensus Statement summarizes approaches for the diagnosis and treatment of CHH and discusses important unanswered questions in the field.

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Section: During Infancy and Childhoodmentioning

confidence: 99%

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

et al. 2015

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“…Studies on subjects with micropenis demonstrated an inarguable establishment of male role by all patients, as well as the establishment of a successful sexual relationship [104,149,172]. In fact, it should be taken into account that testosterone therapy in micropenis caused by fetal testosterone deficiency results in a functionally adequate penis, even if penile length usually remains significantly shorter than the reference values for young adults [104,[173][174][175].…”

Section: Isolated Micropenismentioning

confidence: 97%

“…In children with micropenis at preschool age, a further short course of 25-50 mg IM testosterone enanthate for 3 months can be used [91]. This is particularly the case when children experience social anxiety or difficulties in urinating while standing, or if there are concerns regarding adequate penile length for penetrative sexual intercourse in adulthood [104].…”

Section: Dsd With Male Gender Assignment and Identitymentioning

confidence: 99%

“…In fact, it should be taken into account that testosterone therapy in micropenis caused by fetal testosterone deficiency results in a functionally adequate penis, even if penile length usually remains significantly shorter than the reference values for young adults [104,[173][174][175]. Available data suggest that there is no clinical [104], physiologic [176], or psychological [177,178] basis for considering gender reversal in infants with micropenis and they should therefore be raised as males.…”

Section: Isolated Micropenismentioning

confidence: 99%

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Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma

Fisher

Ristori

Fanni

et al. 2016

J Endocrinol Invest

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“…2 The clinical management of micropenis includes testosterone treatment to induce a functionally adequate penile size. 3 The results of testosterone treatment are controversial, with disagreement about capacity of this form of treatment to induce an adequate adult penis. 3 As a consequence, some clinicians recommend sex reversal of affected male infants particularly where a small penis fails to achieve 2 cm of stretched length 1 month after intramuscular testosterone treatment.…”

Section: Introductionmentioning

confidence: 99%

Effect of penile size on nocturnal erections: evaluation with NPTR testing with men having micropenis

et al. 2005

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There has been conflicting opinions in the literature regarding sexual function in hypogonadal men with micropenis. In this study we aimed to evaluate erectile function in hypogonadal men with micropenis by nocturnal penile tumescence and rigidity testing (NPTR) and compared the results with young potent normal penile sized men. A total of 15 men (ages 17-30 y) defined having a micropenis with a stretched penile length of less than 9.3 cm were constituted the study group. Mean stretched penile length was 6.871.6 cm (range 3.6-7.8 cm). Karyotype analysis showed 46XY in all cases. Control group included 22 potent and normal penile sized men (23-29 y). All subjects completed three sessions of consecutive nights using the RigiScan Plus device. Comparison of the results of NPTR of control group with study group revealed that number and duration of erectile episodes (Po0.001), duration of tip rigidity 460% (Po0.01), TAU tip and TAU base (P ¼ 0.001), and RAU base (P ¼ 0.01) were found to be significantly lower in men with micropenis. In conclusion, our study showed that men with micropenis are associated with decreased nocturnal erectile activity.

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Congenital hypogonadotropic hypogonadism and micropenis: Effect of testosterone treatment on adult penile size—Why sex reversal is not indicated

Cited by 185 publications

References 26 publications

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

European Consensus Statement on congenital hypogonadotropic hypogonadism—pathogenesis, diagnosis and treatment

Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma

Effect of penile size on nocturnal erections: evaluation with NPTR testing with men having micropenis

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