Constitutional Growth Delay Medication

Updated: Jan 08, 2019
  • Author: Pamela A Clark, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Medication

Medication Summary

Because constitutional growth delay (CGD) is not a disorder but rather a variation of normal growth, medical treatment is not necessary. However, short courses of sex hormones are an option for those patients experiencing psychological distress because of their delay in growth and development. In males, androgens can be used to accelerate linear growth and onset of pubertal changes. When used appropriately, no detrimental effects on adult height are evident. Therapy does not increase adult stature.

A retrospective study by Giri et al indicated that in adolescent boys with constitutional delay of growth and puberty, height velocity is improved 1 year after treatment with intramuscular testosterone, although, as stated above, final predicted height is not affected by the therapy. The investigators found that at 1 year posttherapy, treated patients had a mean height velocity of 8.4 cm/year, compared with 6.1 cm/year in untreated patients. [11]

A study by Chioma et al indicated that transdermal testosterone gel and intramuscular testosterone are each effective in increasing height velocity in boys with constitutional delay of growth and puberty (as observed after 6 months). However, untreated patients were found to have a greater increase in testicular volume. [12]

Alternatives to testosterone being investigated for boys with low predicted adult stature include oxandrolone, a weaker anabolic steroid than testosterone, and aromatase inhibitors. [13] The latter are used to decrease estrogen-stimulated epiphyseal fusion, resulting in a longer period of growth. [14, 15] Guidelines have been established for children in whom growth hormone (GH) therapy is indicated. [5, 16, 17]

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Anabolic steroids

Class Summary

These agents promote growth and sexual maturation.

Testosterone (Delatestryl, Depo-Testosterone)

The depot preparation of testosterone is available as enanthate or cypionate salt. It is available in a multiuse vial for intramuscular injection. Transdermal preparations are available and have been used successfully in this context, although no established protocols are available.

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