Falling in love has been linked with decreases in men's testosterone levels while mixed changes are reported for women's testosterone levels. A link has also been found between relaxation following sexual arousal and testosterone levels. When testosterone-deprived rats were given medium levels of testosterone, their sexual behaviours (copulation, partner preference, etc.) resumed, but not when given low amounts of the same hormone. The plasma levels of various steroids significantly increase after masturbation in men and the testosterone levels correlate to those levels. In women, correlations may exist between positive orgasm experience and testosterone levels. Common side effects from testosterone medication include acne, swelling, and breast enlargement in males. Decline of testosterone production with age has led to interest in androgen replacement therapy. Similar challenges face other adolescents with chronic illnesses resulting in hypogonadism 100, 101. Hypogonadism affects most adolescents and emerging adults with DMD, likely the result of the underlying condition and high-dose, chronic glucocorticoid treatment 50, 99. Addressing such questions is likely to improve the outcomes of the multiple physiological processes occurring during puberty, such as growth and bone accrual, and affect the psychosocial well-being of the treated adolescent. Various regimens of TE and oral TU increase growth rate and lead to pubertal progression without reducing adult height 11, 59, 60, 83. A body of pediatric literature supports that short-term use of intermediate-duration T esters, such as TE, and oral TU are effective and safe in puberty induction in adolescents with CDGP 11, 59, 60, 83. It has been also successfully used for managing sex transition in transgender males, although its use for pubertal induction has yet to be formally evaluated . The literature on young males with hypogonadism, such as those with Klinefelter syndrome, describes associations between TRT and body composition, bone mass, and metabolic parameters. For example, there is little concrete evidence to guide the optimal timing for initiating T therapy in adolescents with either CDGP or hypogonadism . After initiation of puberty, T doses are gradually increased to mimic normal pubertal physiology over the course of 2 to 3 years until puberty is clinically completed and adult doses are reached. Likely advantages for adolescents include its potential for self-administration, reduced peak-to-trough T-concentration variability, and ability to accurately titrate to approximately physiologic T levels . 5α-DHT binds to the same androgen receptor even more strongly than testosterone, so that its androgenic potency is about 5 times that of T. Free testosterone (T) is transported into the cytoplasm of target tissue cells, where it can bind to the androgen receptor, or can be reduced to 5α-dihydrotestosterone (5α-DHT) by the cytoplasmic enzyme 5α-reductase. Androgens such as testosterone have also been found to bind to and activate membrane androgen receptors. Only the free amount of testosterone can bind to an androgenic receptor, which means it has biological activity. Reassuring evidence is emerging on the use of transdermal T to induce and maintain puberty. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. Call your child’s doctor for medical advice about side effects. If you have questions about side effects, call your child’s doctor. These are not all of the side effects that may occur.
