Testosterone exposure in childhood: discerning pathology from physiology. Expert Opin Drug Saf 2013 May;12(3):375-88
Date
03/23/2013Pubmed ID
23517636DOI
10.1517/14740338.2013.782000Scopus ID
2-s2.0-84876532069 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
INTRODUCTION: Testosterone (T) drives normal male sexual development both in utero and at puberty. Aberrant T exposure manifests as virilization of a female fetus, contrasexual precocity in girls, and isosexual precocity in boys. Evidence of pathologic T exposure warrants a prompt evaluation.
AREAS COVERED: The authors introduce the topic of T exposure in children by reviewing its physiology in the fetus and during childhood and adolescence. Pathologic conditions leading to virilization of a female fetus as well as androgen-mediated gonadotropin-independent precocious puberty in both genders are then discussed. The authors finish by noting exogenous T exposure in children and adolescents, focusing specifically on secondary exposure to topical T preparations.
EXPERT OPINION: Contrasexual precocity in a girl or sexual precocity in a boy should prompt evaluation for causes of gonadotropin-independent pubertal changes. Initial biochemical evaluation includes a bone age, T, 17-hydroxyprogesterone, androstenedione, dehydroepiandrosterone sulfate (DHEA-S) and high sensitivity gonadotropin levels. The provider must query exposure to topical androgen-containing preparations as unintentional secondary exposure to topical T must be considered. Hyperandrogenism is temporally related to exposure of topical T and removal of exposure results in a marked decrease in serum T as well as resolution or stabilization of the signs and symptoms.
Author List
Cabrera SM, Rogol ADAuthor
Susanne M. Cabrera MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentChild
Female
Humans
Male
Puberty, Precocious
Sexual Maturation
Testosterone
