remainder being identifiable later during the process of pubertal induction through failure to normalise testicular volume with testosterone therapy ( 1 ). Given the aforementioned factors, the diagnostic evaluation and management of pubertal delay should
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Agnieszka Pazderska, Yaasir Mamoojee, Satish Artham, Margaret Miller, Stephen G Ball, Tim Cheetham, and Richard Quinton
Hans Valdemar López Krabbe, Jørgen Holm Petersen, Louise Laub Asserhøj, Trine Holm Johannsen, Peter Christiansen, Rikke Beck Jensen, Line Hartvig Cleemann, Casper P. Hagen, Lærke Priskorn, Niels Jørgensen, Katharina M Main, Anders Juul, and Lise Aksglaede
Adult patients with Klinefelter syndrome (KS) are characterized by a highly variable phenotype including tall stature, obesity and hypergonadotropic hypogonadism as well as an increased risk of developing insulin resistance, metabolic syndrome, and osteoporosis. Most adults need testosterone replacement therapy (TRT), whereas the use of TRT during puberty has been debated. In this retrospective, observational study reproductive hormones and whole-body dual-energy X-ray absorptiometry (DXA) derived body composition and bone mineral content were standardized to age-related standard deviation scores (SDS) in 62 patients with KS aged 5.9 to 20.6 years. Serum concentrations of total testosterone and inhibin B were low, whereas LH and FSH were high in patients before TRT. Despite normal body mass index (BMI), body fat% and ratio between android fat% and gynoid fat% were significantly higher in the entire group irrespective of treatment status. In patients evaluated before and during TRT a tendency towards a more beneficial body composition with a significant reduction in ratio between android fat% and gynoid fat% during TRT was found. Bone mineral content (BMC) did not differ from the reference, but BMC corrected for bone area was significantly lower when compared to the reference. This study confirms that patients with KS have an unfavorable body composition and an impaired bone mineral status already during childhood and adolescence. Systematic studies are needed to evaluate whether TRT during puberty will improve these parameters.
Angelica Lindén Hirschberg
estradiol, progesterone and testosterone, as well as subsequent anovulation and amenorrhea ( 3 ). Several mechanisms underlie such inhibition of the HPG axis ( Fig. 1 ), including exercise-induced activation of the hypothalamic-pituitary-adrenal axis and a
Mikkel Andreassen, Anders Juul, Ulla Feldt-Rasmussen, and Niels Jørgensen
testosterone secretion. FSH primarily stimulates Sertoli cells adjacent to germ cells within the seminiferous tubules. Intratesticular testosterone stimulated by LH, and stimulation of Sertoli cells by FSH seems both important for induction of spermatogenesis
Sidsel Mathiesen, Kaspar Sørensen, Marianne Ifversen, Casper P Hagen, Jørgen Holm Petersen, Anders Juul, and Klaus Müller
due to increasing survival rates and longer follow-up time ( 1 ). HSCT interferes with the male reproductive axis, potentially causing testosterone deficiency and impaired spermatogenesis due to the detrimental effects of high-dose chemotherapy and
Johanna Christina Penell, Mark M Kushnir, Lars Lind, Jonatan Bergquist, Jonas Bergquist, P Monica Lind, and Tord Naessen
testosterone concentrations in older men have been associated with reduced all-cause mortality and higher dihydrotestosterone (DHT) with reduced ischemic heart disease mortality ( 11 ). Estrone is the most prevalent estrogen in menopause and has less intra- and
Maki Igarashi, Tadayuki Ayabe, Kiwako Yamamoto-Hanada, Keiko Matsubara, Hatoko Sasaki, Mayako Saito-Abe, Miori Sato, Nathan Mise, Akihiko Ikegami, Masayuki Shimono, Reiko Suga, Shouichi Ohga, Masafumi Sanefuji, Masako Oda, Hiroshi Mitsubuchi, Takehiro Michikawa, Shin Yamazaki, Shoji Nakayama, Yukihiro Ohya, and Maki Fukami
). Subsequently, an increase in circulating gonadal steroids (‘gonadarche’) takes place in a sex-specific manner. In girls, blood levels of estradiol (E 2 ) start to increase around 8 years of age, while in boys, testosterone levels typically increase at 9 years
Shanlee M Davis, Rhianna Urban, Angelo D’Alessandro, Julie A Reisz, Christine L Chan, Megan Kelsey, Susan Howell, Nicole Tartaglia, Philip Zeitler, and Peter Baker II
hypogonadism, a nearly universal finding in adult men with KS, has been implicated as the underlying pathologic mechanism leading to this increased risk ( 2 ). As an anabolic steroid, testosterone has effects on body composition and mitochondrial metabolism
Jennifer K Y Ko, Thomas F J King, Louise Williams, Sarah M Creighton, and Gerard S Conway
use of testosterone, which in this situation is used as a prohormone providing oestradiol via aromatisation. As women with CAIS do not have a uterus, progesterone is not required. Based on our clinical experience, interest in the use of testosterone
Eleftherios E Deiktakis, Eleftheria Ieronymaki, Peter Zarén, Agnes Hagsund, Elin Wirestrand, Johan Malm, Christos Tsatsanis, Ilpo T Huhtaniemi, Aleksander Giwercman, and Yvonne Lundberg Giwercman
Introduction For decades, gonadotropin-releasing hormone (GnRH) agonists have formed the mainstay hormonal treatment of prostate cancer ( 1 ). While they generate suppression of testosterone due to persistent suppression of luteinizing hormone
