Therapeutic target
In cases of proven hypogonadism (endocrine dysfunction of the testes leading to testosterone deficiency), induction of puberty.
Active substances (main indication) – in girls
Estrogens/gestagens
Active ingredients | Dosage | Duration of therapy |
Estradiol valerate | 0.2 mg/d (day of month: 1-28) | 6 months |
Estradiol valerate | 0.5 mg/dmonth 1-28) | 6th-12th month |
Estradiol valerate +chloromadinone acetate | 1-1.5 mg/d (day of month: 1-28)2 mg/d (day of month: 1-12) | In 2nd year (Tanner stage B3: glandular body > areola (nipple areola), flowing contour between areola and breast body). |
Estradiol valerate +chloromadinone acetate | 2 mg/d (day of month: 1-28)2 mg/d (day of month: 1-12) | From the 3rd year |
Alternative to chloromadionoacetate | ||
Progesterone (micronized) | 200 mg/d | |
Dydrogesterone | 10 mg/d |
- Side effects:
Active substances (main indication) – in boys
Hypogonadotropic hypogonadism (start: 13-14 years of age)/complete hypergonadotropic hypogonadism (start: 12-13 years of age)testosterone.
Active ingredient | Dosage | Duration of therapy |
Testosterone enanthate | 50 mg i.m. every 4 weeks. | 1st-6th month |
Testosterone enanthate | 100 mg i.m. every 4 weeks. | 7-12 months |
Testosterone enanthate | 250 mg i.m. every 4 weeks. | 2nd year |
Testosterone enanthate | 250 mg i.m. every 3 weeks. |
Partial hypergonadotropic hypogonadismTestosterone.
Active ingredient | Dosage | Special features |
Testosterone enanthate | 100-250 mg i.m. every 4 weeks. | Start when morg. Testosterone serum concentration below age norm at pubertal age. |
Constitutional/biological developmental delay (with pronounced psychological stress!)
Testosterone
Active substance | Dosage | Duration of therapy |
Testosterone enanthate | 100 mg i.m. every 4 weeks | Month 1-6; month 7-12 pauseReevaluate after month 12. |
- Side effects: Acne, mood swings, aggressiveness, premature epiphyseal closure.
- In hypogonadotropic hypogonadism can be alternatively started with hCG-/rhFSH administration (s.c.); also pulsatile GnRH therapy is possible → if male phenotype achieved, testicular growth completed as well as fertility, then can be further treated with testosterone until childbearing.