Management of hypogonadism from birth to adolescence

Best Pract Res Clin Endocrinol Metab. 2018 Aug;32(4):355-372. doi: 10.1016/j.beem.2018.05.011. Epub 2018 Jun 6.

Abstract

Management of patients with hypogonadism is dependent on the underlying cause. Whilst functional hypogonadism presenting as delayed puberty in adolescence is relatively common, permanent hypogonadism presenting in infancy or adolescence is unusual. The main differential diagnoses of delayed puberty include self-limited delayed puberty (DP), idiopathic hypogonadotropic hypogonadism (IHH) and hypergonadotropic hypogonadism. Treatment of self-limited DP involves expectant observation or short courses of low dose sex steroid supplementation. More complex and involved management is required in permanent hypogonadism to achieve both development of secondary sexual characteristics and to maximize the potential for fertility. This review will cover the options for management involving sex steroid or gonadotropin therapy, with discussion of benefits, limitations and specific considerations of the different treatment options.

Keywords: estradiol; gonadotropin therapy; hypogonadism; puberty; rFSH; testosterone.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Gonadal Steroid Hormones / therapeutic use
  • Gonadotropins / therapeutic use
  • Humans
  • Hypogonadism / diagnosis*
  • Hypogonadism / drug therapy
  • Male
  • Puberty, Delayed / diagnosis*
  • Puberty, Delayed / drug therapy

Substances

  • Gonadal Steroid Hormones
  • Gonadotropins