Medication Summary

Testosterone therapy has been shown to increase phallus size in infants with micropenis.^[41]

Class Summary

Testosterone is the main androgenic hormone predominantly formed in the interstitial (Leydig) cells of the testes. In target tissues, it is converted to the more active form (DHT) by 5-alpha reductase. Testosterone controls the development and maintenance of the male sex organs and the male secondary sex characteristics. It also produces systemic anabolic effects to include increased erythropoietin, increased protein production, and increased retention of calcium. Testosterone is a schedule C-III controlled substance.

Testosterone cypionate or enanthate (Andro-LA, Delatest, Depo-Testosterone)

View full drug information

Testosterone cypionate or enanthate promotes and maintains secondary sex characteristics in males with androgen deficiency.

Follow-up

Alsaleem M, Saadeh L. Micropenis. StatPearls. 2021 Jan. [QxMD MEDLINE Link]. [Full Text].
Feldman KW, Smith DW. Fetal phallic growth and penile standards for newborn male infants. J Pediatr. 1975 Mar. 86(3):395-8. [QxMD MEDLINE Link].
Bin-Abbas B, Conte FA, Grumbach MM. Congenital hypogonadotropic hypogonadism and micropenis: effect of testosterone treatment on adult penile size why sex reversal is not indicated. J Pediatr. 1999 May. 134(5):579-83. [QxMD MEDLINE Link].
Schonfeld WA, Beebe GW. Normal growth and variation in male genitalia from birth to maturity. J Urol. 1942. 64:759-777.
Wessells H, Lue TF, McAninch JW. Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol. 1996 Sep. 156(3):995-7. [QxMD MEDLINE Link].
Bhakhri BK, Meena SS, Rawat M, Datta V. Neonatal stretched penile length: relationship with gestational maturity and anthropometric parameters at birth. Paediatr Int Child Health. 2014 Jan 26. [QxMD MEDLINE Link].
Tuladhar R, Davis PG, Batch J. Establishment of a normal range of penile length in preterm infants. J Paediatr Child Health. 1998 Oct. 34(5):471-3. [QxMD MEDLINE Link].
Kahl L, Hughes H, eds. The Harriet Lane Handbook. 21st ed. Philadelphia, PA: Elsevier; 2018. Chapter 10.
Calikoglu AS. Should boys with micropenis be reared as girls? [editorial]. J Pediatr. 1999 May. 134(5):537-8. [QxMD MEDLINE Link].
Wisniewski AB, Migeon CJ, Gearhart JP, et. al. Congenital micropenis: Long-term medical, surgical, and psychosexual follow-up of individuals raised male or female. Hormone Research. 2001. 56:3-11. [QxMD MEDLINE Link].
Hughes IA. The Testes: Disorders of Sexual Differentiation and Puberty in the Male. Sperling MA. Pediatric Endocrinology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2008. Chapter 16.
Achermann JC, Hughes IA. Disorders of Sex Development. Melmed. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011. Chapter 23.
Grumbach MM. A window of opportunity: the diagnosis of gonadotropin deficiency in the male infant. J Clin Endocrinol Metab. 2005 May. 90(5):3122-7. [QxMD MEDLINE Link].
Quigley CA. Editorial: The postnatal gonadotropin and sex steroid surge - Insights from the androgen insensitivity syndrome. J Clin Endocrinol Metab. 2002. 87:24-28. [QxMD MEDLINE Link].
Witchel SF, Lee PA. Ambiguous Genitalia. Sperling MA. Pediatric Endocrinology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2008. 127-164. Chapter 4.
Maimon L, Philibert P, Cammas B, et. al. Phenotypical, biological, and molecular heterogeneity of 5-alpha-reductase deficiency: An extensive international experience of 55 patients. J Clin Endocrinol Metab. Feb 2011. 96(2):296-307. [QxMD MEDLINE Link].
Achermann JC, Ozisik G, Meeks JJ. Genetic causes of human reproductive disease. J Clin Endocrinol Metab. 2002. 87:2447-2454. [QxMD MEDLINE Link].
Lopez-Soto A, Bueno-Gonzalez M, Urbano-Reyes M, et al. Stretched penile length at birth: a systematic review. J Pediatr Endocrinol Metab. 2021 Oct 26. 34 (10):1211-23. [QxMD MEDLINE Link].
Hayes FJ, Seminara SB, Crowley WF. Hypogonadotropic hypogonadism. Endocrinol Metab Clin North Am. 1998. 27:739-763. [QxMD MEDLINE Link].
Pallais JC, Au M, Pitteloud N, et al. Kallmann Syndrome. GeneReviews. Available at http://www.ncbi.nlm.nih.gov/books/NBK1334/. Accessed: 3 July 2011.
Bonomi M, Vezzoli V, Krausz C, et al. Characteristics of a nationwide cohort of patients presenting with isolated hypogonadotropic hypogonadism (IHH). Eur J Endocrinol. 2018 Jan. 178 (1):23-32. [QxMD MEDLINE Link].
Toogood AA, Stewart PM. Hypopituitarism: clinical features, diagnosis, and management. Endocrinol Metab Clin North Am. 2008 Mar. 37(1):235-61, x. [QxMD MEDLINE Link].
Melmed S, Kleinberg D, Ho K. Pituitary Physiology and Diagnostic Evaluation. Melmed S. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011. Chapter 8.
Tsigos C, Latronico C, Chrousos GP. Luteinizing hormone resistance syndromes. Ann N Y Acad Sci. 1997 Jun 17. 816:263-73. [QxMD MEDLINE Link].
Boehmer AL, Brinkmann AO, Sandkuijl LA, et al. 17Beta-hydroxysteroid dehydrogenase-3 deficiency: diagnosis, phenotypic variability, population genetics, and worldwide distribution of ancient and de novo mutations. J Clin Endocrinol Metab. 1999 Dec. 84(12):4713-21. [QxMD MEDLINE Link].
Lee YS, Kirk JM, Stanhope RG, et al. Phenotypic variability in 17beta-hydroxysteroid dehydrogenase-3 deficiency and diagnostic pitfalls. Clin Endocrinol (Oxf). 2007 Jul. 67(1):20-8. [QxMD MEDLINE Link].
Gad YZ, Nasr H, Mazen I. 5 alpha-reductase deficiency in patients with micropenis. J Inherit Metab Dis. 1997 Mar. 20(1):95-101. [QxMD MEDLINE Link].
Sinnecker GH, Hiort O, Dibbelt L. Phenotypic classification of male pseudohermaphroditism due to steroid 5 alpha-reductase 2 deficiency. Am J Med Genet. 1996 May 3. 63(1):223-30. [QxMD MEDLINE Link].
Palmer JS. Genitourinary manifestations in boys and girls associated with genetic disease. J Men's Health Gend. March 2006. 3(1):71-79.
Cassidy SB, Schwartz S. Prader-Willi Syndrome. GeneReviews. Available at http://www.ncbi.nlm.nih.gov/books/NBK1330/. Accessed: 2 July 2011.
Waters AM, Beales PL. Bardet-Biedl Syndrome. GeneReviews. Available at http://www.ncbi.nlm.nih.gov/books/NBK1363/. Accessed: 2 July 2011.
Allanson JE. Noonan Syndrome. GeneReviews. Available at http://www.ncbi.nlm.nih.gov/books/NBK1124/. Accessed: 2 July 2011.
Ragan DC, Casale AJ, Rink RC. Genitourinary anomalies in the CHARGE association. J Urol. 1999 Feb. 161(2):622-5. [QxMD MEDLINE Link].
Lalani SR, Hefner MA, Belmont JW et al. CHARGE Syndrome. GeneReviews. Available at http://www.ncbi.nlm.nih.gov/books/NBK1117/. Accessed: 2 July 2011.
Bourgeois MJ, Jones B, Waagner DC. Micropenis and congenital adrenal hypoplasia. Am J Perinatol. 1989 Jan. 6(1):69-71. [QxMD MEDLINE Link].
Becker D, Wain LM, Chong YH, et al. Topical dihydrotestosterone to treat micropenis secondary to partial androgen insensitivity syndrome (PAIS) before, during, and after puberty - a case series. J Pediatr Endocrinol Metab. 2016 Feb. 29 (2):173-7. [QxMD MEDLINE Link].
Xu D, Lu L, Xi L, et al. Efficacy and safety of percutaneous administration of dihydrotestosterone in children of different genetic backgrounds with micropenis. J Pediatr Endocrinol Metab. 2017 Nov 27. 30 (12):1285-91. [QxMD MEDLINE Link].
Stoupa A, Samara-Boustani D, Flechtner I, et al. Efficacy and Safety of Continuous Subcutaneous Infusion of Recombinant Human Gonadotropins for Congenital Micropenis during Early Infancy . Horm Res Paediatr. 2017 Jan 12. [QxMD MEDLINE Link].
Krishnan A, Chagani S, Rohl AJ. Preoperative Testosterone Therapy Prior to Surgical Correction of Hypospadias: A Review of the Literature. Cureus. 2016 Jul 8. 8 (7):e677. [QxMD MEDLINE Link]. [Full Text].
Papadimitriou DT, Chrysis D, Nyktari G, et al. Replacement of Male Mini-Puberty. J Endocr Soc. 2019 Jul 1. 3 (7):1275-82. [QxMD MEDLINE Link]. [Full Text].
Drugs: Testosterone. MD Consult. Available at http://www.mdconsult.com. Accessed: 2 July 2011.
Gaspari L, Tessier B, Paris F, et al. Endocrine-Disrupting Chemicals and Disorders of Penile Development in Humans. Sex Dev. 2021. 15 (1-3):213-28. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

of 0

Author

Karen S Vogt, MD Pediatric Endocrinologist and Program Director, Department of Pediatrics, Division of Endocrinology, Walter Reed National Military Medical Center; Associate Professor of Pediatrics, Uniformed Services University of the Health Sciences

Karen S Vogt, MD is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, Endocrine Society, Pediatric Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

Michael J Bourgeois, MD Director of Pediatric Undergraduate Medical Education, Associate Professor, Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, Texas Tech University School of Medicine

Michael J Bourgeois, MD is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, Texas Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) Professor and Chair, First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, Greece; UNESCO Chair on Adolescent Health Care, University of Athens, Greece

George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) is a member of the following medical societies: American Academy of Pediatrics, American College of Physicians, American Pediatric Society, American Society for Clinical Investigation, Association of American Physicians, Endocrine Society, Pediatric Endocrine Society, Society for Pediatric Research, American College of Endocrinology

Disclosure: Nothing to disclose.

Chief Editor

Sasigarn A Bowden, MD, FAAP Professor of Pediatrics, Section of Pediatric Endocrinology, Metabolism and Diabetes, Department of Pediatrics, Ohio State University College of Medicine; Pediatric Endocrinologist, Division of Endocrinology, Nationwide Children’s Hospital; Affiliate Faculty/Principal Investigator, Center for Clinical Translational Research, Research Institute at Nationwide Children’s Hospital

Sasigarn A Bowden, MD, FAAP is a member of the following medical societies: American Society for Bone and Mineral Research, Central Ohio Pediatric Society, Endocrine Society, International Society for Pediatric and Adolescent Diabetes, Pediatric Endocrine Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Additional Contributors

Arlan L Rosenbloom, MD Adjunct Distinguished Service Professor Emeritus of Pediatrics, University of Florida College of Medicine; Fellow of the American Academy of Pediatrics; Fellow of the American College of Epidemiology

Arlan L Rosenbloom, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Epidemiology, American Pediatric Society, Endocrine Society, Pediatric Endocrine Society, Society for Pediatric Research, Florida Chapter of The American Academy of Pediatrics, Florida Pediatric Society, International Society for Pediatric and Adolescent Diabetes

Disclosure: Nothing to disclose.