Male Hormones About Watch and Favorite Watch Watching this resources will notify you when proposed changes or new versions are created so you can keep track of improvements that have been made. Favorite Favoriting this resource allows you to save it in the “My Resources” tab of your account. There, you can easily access this resource later when you’re ready to customize it or assign it to your students. Male Hormones The onset of puberty is controlled by two major hormones: FSH initiates spermatogenesis and LH signals the release of testosterone. Learning Objective Explain the function of male hormones in reproduction Key Points The onset of puberty is signaled by high pulses of GnRH secreted by the hypothalamus ; this in turn signals the release of FSH and LH from the pituitary gland . FSH causes the Sertoli cells of the testes (which help nurse developing sperm cells) to begin the process of spermatogenesis in the testes. LH triggers the production of testosterone from the Leydig cells of the testis; testosterone causes the development of secondary sex characteristics in the male.

As spermatogenesis and testosterone production increase, the Sertoli cells produce inhibin , which, together with rising levels of testosterone, inhibit the release of FSH and LH from the pituitary gland. Terms Male Hormones Puberty is a period of several years in which rapid physical growth and psychological changes occur, culminating in sexual maturity. The average onset of puberty is age 11 or 12 for boys. Some of the most significant parts of pubertal development involve distinctive physiological changes in individuals' height, weight, body composition, and circulatory and respiratory systems. These changes are largely influenced by hormonal activity. Hormones play an organizational role, priming the body to behave in a certain way once puberty begins, and an activational role, referring to changes in hormones during adolescence that trigger behavioral and physical changes. At the onset of puberty, the hypothalamus begins secreting high pulses of GnRH, or gonadotropin-releasing hormone . In response, the pituitary gland releases follicle stimulating hormone (FSH) and luteinizing hormone (LH) into the male system for the first time.

FSH enters the testes, stimulating the Sertoli cells, which help to nourish the sperm cells that the testes produce, to begin facilitating spermatogenesis. LH also enters the testes, stimulating the interstitial cells, called Leydig cells, to make and release testosterone into the testes and the blood. Testosterone, the hormone responsible for the secondary sexual characteristics that develop in the male during adolescence, stimulates spermatogenesis, or the process of sperm production in the testes. Secondary sex characteristics include a deepening of the voice, the growth of facial, axillary, and pubic hair, and the beginnings of the sex drive. A negative feedback system occurs in the male with rising levels of testosterone acting on the hypothalamus and anterior pituitary to inhibit the release of GnRH, FSH, and LH . The Sertoli cells produce the hormone inhibin, which is released into the blood when the sperm count is too high. This inhibits the release of GnRH and FSH, which will cause spermatogenesis to slow down. If the sperm count reaches 20 million/ml, the Sertoli cells cease the release of inhibin, allowing the sperm count to increase.

Disorders of Sex Development - Health Encyclopedia - University of Rochester Medical Center URMC / Encyclopedia / Content Disorders of Sex Development When a child's gender is in question at birth, the child has atypical genitalia (ambiguous genitalia). This means that the genitals may not appear to be clearly male or female. Atypical genitalia can be a difficult experience for families. How do the reproductive organs form? You have 46 chromosomes in each cell of your body. These are grouped into 23 pairs. The 23rd pair determines your gender. Females have two X chromosomes, and males have one X and one Y chromosome. The gender of a developing baby is determined at conception, when the embryo has either two XX chromosomes, or an X and a Y chromosome. Around the 6th week of fetal development, a gene on the Y chromosome of a developing boy tells the fetal tissue that will form the sex organs to become the testes. As the testes make testosterone, the penis, scrotum, and urethra form. Then, during the 7th to 8th month of the pregnancy, the testes descend into the scrotum.

Without the Y chromosome, the fetal tissue in a female fetus that will form the sex organs becomes the ovaries, uterus, and fallopian tubes. Certain hormones also can affect the development of the sexual organs. These hormones are secreted during the early weeks of gestation. How do disorders of sexual development happen? A variety of genetic and environmental factors can affect the developing baby and lead to atypical genitalia. Ambiguous genitalia may make it more difficult to determine a baby’s gender. But very few newborns with this condition have genitals that are so ambiguous that the healthcare provider can’t determine the gender at birth. These are far more common at birth: A girl baby with too much of the male hormones (virilization) who seems to have a small penis A boy baby with an abnormally small penis that looks like a female clitoris. This is either because the fetus did not respond to male hormones or the fetus did not make male hormones. What causes atypical genitalia? Atypical genitalia can have a number of different causes. In many cases, doctors don’t know the cause, and it seems to occur by chance. Children who are born with atypical genitalia may fall into one of the following groups.

True hermaphroditism Tissue that is related to both the ovaries and the testes Internal sex organs for both genders External genitalia that are partly ambiguous Chromosomes that are either normal female or male, or a mixture (mosaic) Gonadal dysgenesis Internal sex organs that are usually female External genitals that may vary between normal female and normal male. Most are female. Chromosomes that are normal, have only a X chromosome, or are a mixture (mosaic) Pure gonadal dysgenesis This affects girls. Those with this condition have male chromosomes, underdeveloped sex organs, internal female reproductive organs, and female external genitalia. Pseudohermaphroditism in males Children with this condition have questionable external genitalia, but have only one gender's internal sex organs. Male pseudohermaphrodite means the child has internal sex organs that are male. Female pseudohermaphrodite means the child has internal sex organs that are female. The two primary causes of male pseudohermaphroditism are androgen insensitivity syndrome and 5-alpha reductase deficiency.

Androgen insensitivity syndrome Normal male chromosomes Normal female external genitalia This is called androgen insensitivity syndrome because male babies don’t respond to testosterone (androgens). This syndrome is inherited. It is caused by a problem with a gene on the X chromosome. This problem is called X-linked recessive. Mothers who carry the gene have a 50% chance of having a son with the syndrome. Daughters of mothers who carry the gene have a 50% chance of being carriers of the gene. 5-alpha-reductase deficiency Children with this condition have: Normal male chromosomes Genitals that are ambiguous Children with this condition lack the enzyme 5-alpha reductase. This enzyme is needed to help the male sex organs complete their development. This condition is inherited. It is caused by an autosomal recessive gene. Autosomal recessive means that each parent carries one copy of the gene and transmits the gene at the same time to the child. Carrier parents have a 1 in 8 chance of having a child with this condition with each pregnancy. It affects only male babies. Pseudohermaphroditism in females Female pseudohermaphroditism has a number of causes.

Congenital adrenal hyperplasia (CAH) Girl babies with this condition have male sex organs. The condition is caused by a lack of a certain enzyme in the adrenal gland. It is the most common cause of atypical genitalia in newborns. The condition is inherited and passed on by an autosomal recessive gene. Autosomal recessive means that each parent carries one copy of the gene and passes on the gene to the child. Carrier parents have a 1 in 4 chance of having a child with this condition with each pregnancy. Girl babies with the condition have atypical genitalia. Boy babies do not. In some cases, the mother of a child with this condition can be given medicines during pregnancy to lessen the effects of the enzyme deficiency if the fetus is female. Another type of CAH is called "salt-losing." This is very serious and often fatal. It causes an electrolyte collapse in the newborn. Treatment is available if diagnosed early. Boys and girls are equally affected. Other, rarer enzyme problems can also cause CAH in either boy babies or girl babies. Overproduction of male hormones before birth This condition is often caused by a problem with the adrenal glands.

High levels of male hormones may also enter the placenta via the mother. This could be when the mother is given progesterone to prevent a miscarriage or if she has a hormone-producing tumor. How is the gender determined in a child with atypical genitalia? When a child's genitalia appear ambiguous at birth, your child's healthcare provider will ask about your health history. The health history will include your health during pregnancy and a family history of any neonatal deaths or genital abnormalities. The provider will also do a physical exam of your child's external genitalia. Your child's provider will look for the underlying cause of the disorder. Your child may need a newborn screening test for CAH, hormone studies, and a biopsy of the sex organs. To determine the sex, your child's healthcare providers will consider the following: A pelvic ultrasound to check for the female sex organs. Or the provider may use direct cystoscopy or vaginoscopy.

A genitourethrogram to look at the urethra and vagina, if present A chromosome study to help determine the genetic sex of the child Evaluation of gene on the Y chromosome that starts development of the male sex organs How fertile a child may be who is a female pseudohermaphrodite Size and potential for growth of a penis present in a male pseudohermaphrodite Ability of an internal sex organ to make the appropriate sex hormones for the gender "assigned" to the child Risk of future health conditions such as cancer that may develop in the original sex organs later in life The actions of male or female hormones on the fetal brain Your opinion or preference Treatment for atypical genitalia Sometimes a child with atypical genitalia is at higher risk for tumors in the sex organs. Treatment for atypical genitalia depends of the type of the disorder, but will usually include surgery to remove or create sex organs appropriate for the gender of the child. Treatment may also include hormone therapy. Most important, you and your family should be involved early in the decision of assigning the sex of the child. Ask your healthcare provider about what is available for long-term psychological support.

Long-term outlook for children born with atypical genitalia Making a correct determination of gender is important for treatment. But is also important for the emotional well-being of the child. Some children born with atypical genitalia may have normal internal sex organs that allow them to live normal, fertile lives. But others may have problems with fertility as adults. Goode, Paula, RN, BSN, MSN Haldeman-Englert, Chad, MD Disorders of Growth, Puberty & Sexual Development Disorders of Growth, Puberty & Sexual Development Disorders of Growth, Puberty & Sexual Development Share: Twitter Google Plus Facebook Linked In Email Growth disorders are problems that prevent children from achieving normal height, weight or sexual maturity. Just because your child is not developing at the same rate as his or her friends is not always a cause for concern. Some children may be small for their age but still develop normally. Some children are short or tall because their parents are. Some children mature at a different rate than others. At Children’s Health℠, we work closely with both you and your primary care provider so that everyone involved has the information they need to create the best outcomes for your child.

Constitutional Growth Delay Constitutional growth delay is when children are small for their age but grow at a normal rate. They tend to reach puberty and other developmental milestones later than their friends. Because they also tend to grow until an older age, they usually catch up with their peers. These “late bloomers” do not have a growth disorder. Short parents tend to have short children. This is related to a family’s genetic makeup. Because children usually grow to about the same height as their parents, this is not considered to be a growth disorder. However, because they may be short, or may not enter puberty when their classmates do, some children may need extra help coping with teasing, or they may need reassurance that they will eventually go through full sexual development. Some children do have growth disorders. Very slow or very fast growth can sometimes signal an over- or underactive gland or other disease. Growth Hormone Deficiency Growth hormone (GH) deficiency occurs when the pituitary gland doesn’t secrete enough GH. This condition may be present at birth (congenital) or the result of a medical condition or severe brain injury. Most often, the cause is unknown.

GH is needed for normal growth, muscle and bone strength, as well as proper distribution of body fat. It also aids in the control of sugar and fat levels. Without enough GH, a child is likely to grow slowly and be much shorter than other children of the same age and sex. Your child’s doctor will keep track of a child’s progress by drawing their growth curve on a growth chart. Those with a GH deficiency will have a slow, or flat, rate of growth. Symptoms, including slow growth, may be noticed from infancy through 2 or 3 years of age. The thyroid gland is located in front of your child’s neck, roughly in the area a bowtie would cover. The butterfly-shaped gland makes hormones regulating the body’s use of energy and oxygen and the production of heat. Children who have undiagnosed hypothyroidism — in which the thyroid does not make enough thyroid hormone — will grow much slower than other children. Also, their arms and legs may be short in proportion to the rest of the body. They may not develop teeth when expected. Precocious Puberty Precocious puberty is when there are signs of secondary sexual maturation before 8 years of age in girls, or before 9 years of age in boys.

In addition, there may be a growth spurt in height, but with early bone maturity that can lead to shorter than normal adult height. Signs seen in girls include breast growth and a first period. Boys may have enlarged testicles and penis, facial hair and a deepening voice. Boys and girls both may have pubic or underarm hair growth, acne and body odor. Gonadotropin-dependent precocious puberty, also called central precocious puberty, is the most common form. It affects most girls, and about half the boys, with the disorder. The premature secretion of the gonadotropin hormones responsible for puberty sparks the early start of puberty. Peripheral precocious puberty can be linked to estrogen or testosterone, the major sex-related hormones. The release of these hormones causes problems with ovaries or testicles, as well as the adrenal or pituitary glands. This is the less common type. Other possible triggers include ovarian cysts and tumors in girls, and a tumor in the cells that make sperm or testosterone in boys. Tumors in the adrenal or pituitary glands may develop in both girls and boys from exposure to creams or ointments containing estrogen or testosterone.

Delayed Puberty The onset of puberty can also be delayed. Generally, this is defined as the lack of any signs of puberty by age 14 in either sex. Most often, it's simply a pattern of growth and development in a family. If the parents, uncle, aunt, siblings or cousins developed later than usual, this is called constitutional delay. It may just be that your child is a late bloomer and won’t require any treatment. Medical problems are a frequent reason for delays in puberty. Chronic illnesses such as diabetes, cystic fibrosis, kidney disease or asthma can cause puberty later, just because the illness makes it hard for the body to develop. Nutritional concerns may also contribute. A child who is malnourished either because of a lack of food or because of an eating disorder may lose so much weight that his or her body can’t develop properly. Girls who are otherwise well nourished but extremely active in sports may not have the proper amount of fat in their bodies to start puberty. Puberty can also be delayed if certain glands are not functioning correctly. The pituitary and thyroid glands produce hormones critical for body growth and development. Sexual Development The gonads are the main source of sex hormones in males and females.

In males, they are called testes and they secrete androgen hormones. The most important of these is testosterone. These hormones function to regulate the body changes associated with puberty. Enlargement of the penis Growth of facial and pubic hair Increased muscle strength In tandem with hormones from the pituitary gland, testosterone also is vital in the production of sperm in the testes. In girls, the gonads are the ovaries, which are found in the pelvis. They produce eggs and secrete female hormones, such as estrogen and progesterone. Estrogen is involved in developing sexual features such as: Breast growth Accumulation of body fat around the hips and thighs The growth spurt that occurs at puberty Both hormones regulate the menstrual cycle and support pregnancy. Congenital Adrenal Hyperplasia Congenital adrenal hyperplasia is a common genetic disorder that is usually seen at birth. It prevents the body from making enough cortisol. Those with congenital adrenal hyperplasia may have other hormone imbalances. For many children, the disease may never be diagnosed because the symptoms are not causing problems. Milder forms may be diagnosed in either children or adults. The more severe forms usually are found during childhood.

Symptoms of the milder form include shorter than average height, early puberty, acne, irregular menstrual periods after puberty, and extra facial hair in women. Symptoms of a more severe type include dehydration, low blood pressure and blood sugar, shorter than average height, early signs of puberty, irregular periods after puberty and excess facial hair in women. In girls, there may be differences in external genitals. This is usually seen at birth and may require surgery to correct. Turner Syndrome Turner syndrome is a genetic disorder that occurs in girls. It causes the girl to be short and to have an abnormal puberty. Many of the health problems can be managed and/or corrected with appropriate treatment. Symptoms include: Puffiness of hands and feet at birth Wideness and webbing of the neck Low hairline at the back of the neck Differences in the shape and position of the ears A broad chest with widely spaced nipples A large number of small brown moles on the skin and deep set nails As they get older, short stature (average adult height of 4-feet, 8-inches) is the most obvious symptom in a girl. Many have poorly formed or absent ovaries that don’t produce enough estrogen for complete sexual development.

The usual signs of puberty do not occur unless replacement hormones are given. Infertility is not correctable most of the time. Klinefelter Syndrome Klinefelter syndrome (KS) occurs when a boy is born with an extra X-chromosome. Boys normally have only one X- and one Y-chromosome. The presence of the extra X chromosome (which can come from either parent) can cause some boys with this condition to have low testosterone levels, sometimes delaying the appearance of the physical changes commonly associated with puberty. Boys with Klinefelter syndrome often have smaller testes than expected for their age as they approach puberty, and can also have little facial hair (compared to their peers) and a female pattern of fat distribution on their bodies. Academic concerns can be common amongst boys with KS as well. Androgen Insensitivity Syndrome Androgen insensitivity syndrome (AIS) occurs when a child has one X- and one Y-chromosome, as a boy does, but the body doesn’t process, or is resistant to, male hormones. This results in a child with mostly female physical characteristics, but the genetic makeup of a man. The syndrome is divided into two main categories.

Complete AIS prevents the development of the penis and other male body parts. How many male traits the child has differs from one child to another in incomplete AIS. Incomplete AIS can include other disorders, such as: Failure of one or both testes to descend into the scrotum after birth Hypospadias, meaning the opening of the urethra is on the underside, instead of at the tip, of the penis Infertile male syndrome is also considered to be part of incomplete AIS. Those with complete AIS appear as a female but lack a uterus, and show little armpit and pubic hair. At puberty, female sex characteristics (such as breasts) develop. However, the person does not menstruate and cannot have children. Persons with incomplete AIS may have both male and female physical characteristics. Many have a partial closing of the outer vaginal lips, an enlarged clitoris, and a short vagina. There may be: A vagina, but no cervix or uterus A hernia in the thigh with testes that can be felt during a physical exam Normal female breasts Testes in the abdomen, or in other unusual places in the body Hypogonadism Hypogonadism occurs when the testicles do not produce enough testosterone.

Primary hypogonadism is when there is a problem or abnormality in the testicles themselves. Secondary or central hypogonadism occurs when there is a problem with the pituitary gland in the brain and the messages to produce the hormone aren’t sent. Causes of primary hypogonadism include: Certain disorders where the body mistakenly attacks healthy tissue Genetic and developmental disorders Causes of central hypogonadism include: Bleeding Certain medicines, including steroids and opiates Genetic problems Trauma Tumors In girls, hypogonadism will affect breast development and height. There may be a delay in beginning menstruation. If hypogonadism occurs after puberty, symptoms include: Hot flashes Loss of body hair Cessation of menstruation In boys, hypogonadism will most often be manifested as less than normal muscle development, very little or no facial hair and growth problems. After puberty, symptoms include: Breast enlargement Decreased facial and body hair Muscle loss Sexual problems If the symptoms are related to a brain tumor, your child may complain of headaches, possible loss of vision, a milky vaginal discharge (in girls) and symptoms of other hormonal problems such as hypothyroidism.

Children's Health is dedicated to supporting your child from the initial diagnosis through treatment and long-term care. We have developed programs that will help ensure a healthy future for your child. If you think your child may have a growth disorder, contact us — we're here to help. Tests and Diagnosis Tests and Diagnosis Laboratory tests for growth hormone (GH) deficiency will include examining blood levels to show if the problem is caused by the pituitary gland, by the amount of growth hormone in the blood or because of other hormones produced by the pituitary gland. GH stimulation tests measure the hormone’s level after your child receives a medication that triggers the release of GH, such as arginine or GH-releasing hormone. Other tests may be used to help diagnose the disease and also look for other problems triggered by a lack of GH.

These include: A dual-energy X-ray absorptiometry scan to check for bone thinning Magnetic resonance imaging of the brain to look for the size and presence of tumors on the pituitary gland and hypothalamus Hand X-rays (typically of the left hand) so your doctor can see bone abnormalities X-rays of the head to discern any problems with bone growth of the skull Blood tests for hypothyroidism are used to find out how well the gland is functioning by measuring thyroid-stimulating hormone (TSH) or levels of specific thyroid hormones. Your child’s doctor may test for certain antibodies to the thyroid if they think the immune system might be attacking it. X-rays and other radiologic tests look at how well the thyroid is working or search for abnormalities in the gland itself. Normally the pituitary gland produces more TSH when thyroid hormones are low. As the name implies, this causes the thyroid to produce more hormone, which then causes TSH output to drop. If the thyroid can’t produce more hormone, the pituitary keeps pumping out more TSH. If the TSH level is high, it indicates hypothyroidism. T4 is the main hormone produced by the thyroid and is seen in two forms.

One is bound to protein, meaning it is basically in storage until needed. The other, unbound or free T4 (FT4), is the active form of the hormone. If your child’s total T4 or FT4 is high, it suggests hyperthyroidism, whereas low total T4 or FT4 indicates hypothyroidism. A thyroid ultrasound helps to determine the size and number of nodules in the thyroid gland. Sound waves are bounced off the thyroid and returned to the machine. This exam can also detect if there are enlarged parathyroid glands or lymph nodes near the thyroid gland. Puberty Disorders One of the important concerns when diagnosing precocious puberty is to determine the type. Gonadotropin-releasing hormone production will be stimulated and a blood sample drawn. If central precocious puberty is occurring, there will be an increase in other hormone levels. If it is the peripheral type of precocious puberty, these other levels remain normal. Additional testing will often depend on which type is seen. Magnetic resonance imaging might be done to look for brain abnormalities that could cause the start of early puberty. There may also be thyroid testing if your child shows any signs of low thyroid function.

For those diagnosed with the peripheral type of precocious puberty, blood tests for other hormone levels may be ordered. In girls, an ultrasound may be used to check for an ovarian cyst or tumor. If the results of a complete medical history and physical examination suggest that your child may have delayed puberty, the next step is often blood tests that look at chromosomal abnormalities, hormone levels and for diabetes and other conditions that can delay puberty. An X-ray may be obtained to assess bone maturity. More sophisticated X-ray and imaging techniques such as computed tomography and magnetic resonance imaging may be used to obtain more detailed pictures. Sexual Disorders The diagnosis of congenital adrenal hyperplasia usually begins with a physical examination by your child’s doctor. If the outcome suggests the disease, blood tests will be done to measure the levels of cortisol, aldosterone and androgens produced by the adrenal glands. A diagnosis can be made when there are abnormal levels of these hormones. In some cases, Turner syndrome can be diagnosed by an analysis of chromosomes before birth. Most often, your child’s doctor will perform a physical exam looking for signs of slow development and swollen hands and feet. Blood tests looking for abnormal levels of luteinizing and follicle-stimulating hormone will be obtained.

A change in estrogen levels in the blood and urine is another factor in making the diagnosis. In addition, heart tests, magnetic resonance imaging of the chest, pelvic exams and ultrasound testing of the kidneys and reproductive organs may be done to check for other conditions. Blood and urine tests for abnormal hormone levels are often ordered when diagnosing Klinefelter syndrome in males. To confirm the diagnosis, your child’s doctor will obtain a blood sample for a karyotype analysis. This checks the shape and number of chromosomes. A physical examination of your son’s genital area, chest and assessment of reflexes are common. Complete androgen insensitivity syndrome isn’t usually discovered during childhood. In a few children, a growth may be found during routine physical examinations in the abdomen or the groin. Exploratory surgery may identify the growth as a testicle. The majority of girls will be diagnosed later in life if they don’t get a menstrual period or have problems getting pregnant. Incomplete androgen insensitivity syndrome is often discovered during childhood because the child may have both male and female physical traits.

Tests used to diagnose this condition may include: Blood work to check levels of testosterone, luteinizing hormone and follicle-stimulating hormone, important in regulating the menses and the production of eggs and sperm Genetic testing (karyotyping) Pelvic ultrasound Other blood tests may be done to help tell the difference between androgen insensitivity syndrome and androgen deficiency. The tests for hypogonadism will include checking the estrogen level in women and the testosterone level in men. Blood levels of luteinizing hormone and follicle-stimulating hormone, the pituitary hormones that stimulate the gonads, are likely to be obtained. Other tests may include checking thyroid hormone levels and in males, sperm count. Blood tests for anemia and genetic analysis may also be done. Imaging of the ovaries may be necessary. If diseases of the pituitary gland are suspected, brain imaging to search for tumors or other abnormal structures may be pursued. Not every child needs all these tests. Your physician will tell you exactly what the next steps are. Each year, the endocrinology specialists at Children’s Health see more than 12,000 pediatric patients for growth disorders and other endocrine-related conditions.

We have the skill and resources necessary to provide comprehensive and compassionate care for your child. Treatments Treatments Constitutional growth delay is seen as a natural occurrence, because the child is usually developing normally, just at a later age than most. Because of this, there is usually no treatment prescribed for the condition. Your child’s physician will keep a close eye on your child’s growth to make sure it remains on track. If the examination and testing reveals a deficiency in growth hormone, treatment will involve growth hormone injections. These are usually given once a day, at home. The earlier treatment is started, the more likely the child will grow to normal height. The fastest growth will occur during the first 3 years of treatment, then taper off. However, growth hormone replacement therapy does not work for all children. For many with hypothyroidism, hormone replacement therapy will be all that is needed. A manmade (synthetic) version of thyroxine (T4), which works in the same way as your child’s own thyroid hormone, is given by mouth. The goal of therapy is to mimic normal functioning as closely as possible. Precocious Puberty Treatment Treatment for central precocious puberty is usually done through medication.

The drugs used are called gonadotropin-releasing hormone analogues, and they work to interfere with production of the hormones that control puberty. Your child will stay on these medications until reaching the teenage years. When they are stopped, the child’s own hormone production will start again soon after. Treatment for peripheral precocious puberty focuses on the cause. For example, if a tumor is producing hormones, puberty will usually stop when the tumor is removed. Constitutional delayed puberty is generally looked upon as a normal (for that particular child) pattern. Because of this, no intervention is usually suggested. The same approach may be used if the delay is related to a chronic illness, which can cause delays that eventually resolve themselves. Treatment of the illness is an important factor. A delayed start to puberty may be related to the function of certain glands, such as the pituitary and thyroid. If this is the diagnosis, hormone replacement may be used to bring the body back into the proper balance. Sexual Development Treatment Congenital adrenal hyperplasia is a disease that can’t be cured, but can be controlled. Usually this requires taking medication to replace the hormones the body isn’t making.

The doctor will decide if the medicine needs to be taken all the time, or just when there are symptoms. Girls with Turner syndrome will often be given growth hormones to help them grow taller. When she reaches the age of 12 or 13, estrogen replacement therapy is often started to trigger the development of breasts, pubic hair and other sexual characteristics. The treatment for Klinefelter Syndrome in a boy will often depend on test results. Roughly half of the children will have low testosterone levels that respond to hormone replacement therapies. If there is enlargement of the breasts (gynecomastia), surgery may be needed to remove or reduce their size. Testicles that are in the wrong place because of androgen insensitivity syndrome are usually not removed until the boy has gone through puberty and has achieved his maximum growth. They are often removed because it carries a higher risk for cancer. For boys with hypogonadism, testosterone replacement therapy can trigger puberty and start the development of increased muscle mass, facial and pubic hair and growth of the penis. Pituitary hormones may be prescribed to stimulate testicular growth. Hormone replacement is also widely prescribed for girls with hypogonadism.

Estrogen and progesterone are usually given together. Children’s Health uses a multidisciplinary approach to care for your child. This allows us to offer care from multiple specialists and experts, in a single appointment, at one location. If your child has symptoms of a growth disorder, contact us. We provide the comprehensive and individualized care necessary to put your child back on the path to a healthy life. Teenage Hormones, Sexuality, and Mental Health When to Look for Support You may also feel more impulsive and more inclined to take risks, like experimenting with drugs or alcohol , driving without a license or having unsafe sex. Adolescence can be a risky time. Although all of the changes you experience in puberty are natural and healthy, teens don’t always react to these changes in a safe or healthy way. Peer pressure, low self-esteem and hormonal surges can lead you to take chances that could have a negative effect on your future. As you enter your teenage years, it’s important to have a support system you can rely on. Parents, siblings, counselors, teachers and true friends can provide strength and advice as you go through this challenging, exciting period. Dealing With Hormones Without hormones, normal physical and sexual development wouldn’t be possible.

At the beginning of puberty, your brain releases a hormone called gonadotropin-releasing hormone (GnRH) . GnRH triggers the pituitary gland — a small but significant gland that controls the production of several major hormones — to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH) into your bloodstream. FSH and LH have different effects on males and females. In girls, FSH and LH instruct the ovaries to begin producing estrogen, one of the primary female sex hormones, and eggs. In boys, the same hormones tell the testes to begin producing testosterone, the male sex hormone, and sperm. At the same time, you’ll notice other significant changes: Your body will grow taller and you’ll put on weight and muscle mass. Girls will begin to have menstrual periods and will develop fuller breasts and wider hips. Boys will develop larger sex organs and will be able to ejaculate (release sperm). Both boys and girls will develop body hair on the legs, under the arms and over the sex organs. Both boys and girls will produce stronger body odors and may develop acne or other skin problems.

Physical and Mental Affects Hormones affect your moods, emotions and impulses as well as your body. According to the Nemours Foundation , a lot of the mood swings that teens experience are caused by fluctuations in estrogen, progesterone and testosterone — the sex hormones. These same hormones will also affect the way you think about dating and sex. Teens become much more interested in sex, sometimes to the point of obsession. You may find yourself attracted to other people in your peer group, even if you never dreamed that you’d think of them in a sexual way. It’s hard to feel that your body and mind are being controlled by the forces of nature instead of your own decisions. A lot of teens feel that the changes they’re experiencing are weird, freakish or unnatural, but in fact, almost everything that you go through during adolescence is a normal part of your development. Chances are that if you’ve experienced a new urge or experimented with different behaviors, at least one adult in your life has been through the same thing. Discovering Dating Some teens look forward to the time when they can start dating; others dread this adolescent ritual.

But no matter how you feel about spending time with other teens, learning how to socialize with your peers is an important part of growing up. If you’re nervous about dating, start by simply making friends with girls or boys you find attractive. Group dates are a great way for shy teens to get to know others without the pressures of one-on-one dating. Use these dating tips to get started: Focus on the other person. One of the best ways to get over being self-conscious and nervous is to focus on someone else. Ask your date questions about herself. Find out about her likes and dislikes. Your interest will help you start your relationship from a basis of friendship. Find non-romantic things to do. Dating doesn’t necessarily have to be about hearts, flowers and candy. If you’re nervous about being in an intimate situation with someone, invite him to go on a hike with a few other friends or attend a football game at your school. Seek out people who share your interests. Physical attraction often guides dating decisions in the teenage years, but the prettiest girl or the hottest guy doesn’t necessarily make the best dating partner. Join clubs or participate in sports activities where you can meet people who share your hobbies and interests.

You’re much more likely to have an interesting, satisfying date with someone you can relate to on a personal level. Don’t let rejection get you down. Learning how to accept rejection without taking it personally isn’t easy, but if you can develop this skill, it will help you throughout your life. When you ask someone out on a date, you’re taking a risk that he or she will say “no.” If your offer is refused, give yourself a few minutes to feel bad about it, and then move on. Brush yourself off, then invite someone else to go out with you. Sooner or later, you’ll find the right person. Columbia University says that dating isn’t just about building social skills or finding a romantic partner; it’s an opportunity to learn about your personal values, needs and desires. Spending time with others is a way to identify what you like and don’t like in other people, and in yourself. Exploring Sexuality With all those hormones raging through your bloodstream, it’s inevitable that you’ll think about sex. It’s also likely that you’ll experiment with sex, according to statistics from the Centers for Disease Control and Prevention (CDC).

The CDC reports that in 2011, 47.4 percent of teenagers who were surveyed reported that they had had intercourse at some point during their lives. Within the past three months, 33.7 percent had had sex at least once. Out of that group, the majority did not use birth control to prevent pregnancy or sexually transmitted disease (STD). Learning about sexuality is a vital part of growing up. But learning about sex shouldn’t involve unwanted pregnancy or getting an STD. The Guttmacher Institute reports that teenage pregnancy declined significantly between 1990 and 2008, partly because more teens were using birth control, and partly because a larger percentage of teens were waiting longer to have sex. Psychology Today notes that teens tend to assume that their friends are having sex, even if they’re not. You should never rush into intimacy because you’re afraid of being the only virgin in your class; there are probably a lot more abstinent teens in your peer group than you think. Teens who feel comfortable talking openly to a parent or another adult about sex may be less likely to go through an unplanned pregnancy or contract an STD. Parents of teens should encourage honest discussions of sexuality and answer questions as frankly as possible.

Every family has its own values and beliefs about sexual activity in the teenage years. The important thing is that these beliefs are communicated clearly and that the opportunity to talk is always left open. Experimenting With Drugs and Alcohol Along with the pressures to date and have sex, teens often face pressure from their peers to try drugs or alcohol. Neurological studies of the adolescent brain indicate that teens may be more likely to experiment with drugs than adults because of differences in their brain development. In adolescence, the area of the brain that’s responsible for judgment and decision-making is still immature, according to a report from the Mentor Foundation . This area, the prefrontal cortex, doesn’t become fully mature until the 20s. Meanwhile, the part of the brain that controls impulses and emotions is maturing in adolescence, increasing the urge to take risks. In your teens, your life as an adult may seem impossibly far away. With so much time ahead of you, the choices you make today might seem inconsequential. But in fact, getting involved with drugs or alcohol could have severe consequences, not only in the immediate future but for years to come. Teenagers who engage in substance abuse are more likely to develop full-blown addictions as adults.

They are also more likely to engage in behaviors that could cause serious injuries or legal problems, such as: Motor vehicle accidents Altercations Suicide attempts Hormones, sex and drugs can be a dangerous mix. When your emotions and sexual urges are already in a volatile state, adding intoxicating substances could put you at risk of making life-altering decisions. Taking chances with your future just isn’t worth the risk. If you feel pressured by your peers or by your own emotions to do things that you know are dangerous, talk with a parent, mental health professional or addiction specialist about how you can get through this tough period safely. Identity, Moods and Emotions Discovering who you are is one of the biggest challenges of adolescence. In the teenage years, your identity may change from one month to the next. You have the opportunity to experiment with your personal values, your style, your beliefs and your sexuality. If you have a healthy self-esteem and a strong support system, you can build your new identity with confidence. But many teenagers struggle with their sense of self-worth, feeling that they don’t measure up to the standards of their parents, teachers or friends.

Teenagers who suffer from low self-esteem are more vulnerable to the negative influences of peer pressure and more likely to abuse drugs and alcohol, according to Health Education Quarterly . They are also more likely to become depressed. Parents and educators can help teenagers build a strong sense of identity by nurturing their self-esteem and validating their self-confidence. Adults should be aware of the signs of low self-esteem in teenagers, such as: Withdrawal from friends and social activities Poor hygiene or a lack of concern for appearance Abandoning good friends in favor of a new social crowd Sleeping too much or too little Changes in weight or eating habits Unusual mood swings Tearfulness and a sense of hopelessness Expressing thoughts of suicide It’s not unusual for teens to go through periods of feeling sad, lonely or irritable. But if these feelings persist for more than a week or two, your teen may be depressed. The emotional turmoil of adolescence can sometimes hide a serious mental health condition that must be treated promptly. When to Look for Support If the natural hormonal changes of adolescence turn into something more dangerous, don’t hesitate to turn to professionals for help. In today’s challenging world, many families need support to handle the effects of emotional disturbances, impulse control disorders or substance abuse.

In some cases, a personalized rehab program is what it takes to get a teenager’s life back on track. For answers to your questions about teenage drug abuse, sexuality or emotional identity, contact the professionals at Newport Academy . We specialize in helping young people and their families build the futures that they deserve. Image courtesy of Redd Angelo via Unsplash. Puberty in Boys - Men's Health Issues - Merck Manuals Consumer Version Puberty may begin as early as age 9 and continue until age 16. At puberty, the testes increase testosterone production. Testosterone causes reproductive organs to mature, muscle and bone to grow, facial and pubic hair to appear, and the voice to deepen. Puberty is the stage during which people reach full reproductive ability and develop the adult features of their gender. In boys, puberty usually occurs between the ages of 10 and 14 years. However, it is not unusual for puberty to begin as early as age 9 or to continue until age 16. The hypothalamus and pituitary gland, which are in the brain, initiate puberty.

The hypothalamus secretes luteinizing hormone-releasing hormone, which stimulates the pituitary to secrete luteinizing hormone and follicle-stimulating hormone. Luteinizing hormone causes the testes to produce testosterone. Follicle-stimulating hormone (plus testosterone) causes the testes to produce sperm. Testosterone is responsible for the development of secondary sex characteristics, features that stimulate male development (including characteristics that are not part of the reproductive system, such as facial hair growth and voice change). Sexual development occurs in a set sequence: Enlargement of the scrotum, and testes Lengthening of the penis (around age 11½ to 13 years) Enlargement of seminal vesicles and prostate gland Growth of pubic hair Growth of hair on face and in the underarms (about 2 years after pubic hair growth starts) Ejaculation becomes possible (usually in mid-adolescence, around age 12½ to 14 years) Fertility is not attained until later in adolescence. Breast enlargement ( gynecomastia ) on one side or both may occur among young adolescent boys and usually disappears within a year.

Milestones in Sexual Development During puberty, sexual development occurs in a set sequence. However, when the changes begin and how quickly they occur vary from person to person. For boys, puberty begins at age 9½ to 10½ years and lasts about 3 years. The chart shows a typical sequence and normal range of development for the milestones of sexual development. Resources In This Article Drugs Mentioned In This Article Generic Name Androgen (testosterone) deficiency | Andrology Australia Symptoms & causes What are androgens? Hormones are chemical messengers made by glands in the body that are carried in the blood to act on other organs in the body. Hormones are needed for growth, reproduction and well-being. Androgens are male sex hormones that increase at puberty and are needed for a boy to develop into a sexually mature adult who can reproduce. The most important androgen is testosterone. What is testosterone? Testosterone is the most important androgen (male sex hormone) in men and it is needed for normal reproductive and sexual function. Testosterone is important for the physical changes that happen during male puberty, such as development of the penis and testes, and for the features typical of adult men such as facial and body hair.

Testosterone also acts on cells in the testes to make sperm. Testosterone is also important for overall good health. It helps the growth of bones and muscles, and affects mood and libido (sex drive). Some testosterone is changed into oestrogen, the female sex hormone, and this is important for bone health in men. Testosterone is mainly made in the testes. A small amount of testosterone is also made by the adrenal glands, which are walnut-sized glands that sit on top of the kidneys. How do hormones control the testes? The pituitary gland and the hypothalamus, located at the base of the brain, control the production of male hormones and sperm. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are the two important messenger hormones made by the pituitary gland that act on the testes. LH is needed for the Leydig cells in the testes to make testosterone, the male sex hormone. Testosterone and FSH from the pituitary gland then act together on the seminiferous tubules (sperm-producing tubes) in the testes to make sperm. What is androgen (or testosterone) deficiency?

Androgen, or testosterone, deficiency is when the body is not able to make enough testosterone for the body to function normally. Although not a life-threatening problem, androgen deficiency can affect your quality of life. How common is androgen deficiency? Androgen deficiency due to diseases of the testes or hypothalamus-pituitary affects about one in 200 men under 60 years of age. It is likely that androgen deficiency is under-diagnosed and that many men are missing out on the benefits of treatment. About one in 10 older men may have testosterone levels lower than those in young men, but this is usually linked with chronic illness and obesity. The benefits of testosterone treatment for such men are not yet known. How does ageing affect testosterone levels? Testosterone levels in men are highest between the ages of 20 and 30 years. As men age there is a small, gradual drop in testosterone levels; they may drop by up to one third between 30 and 80 years of age. Some men will have a greater drop in testosterone levels as they age, especially when they are obese or have other chronic (long-term) medical problems.

On the other hand, healthy older men with normal body weight may not experience any drop in serum testosterone levels. There is no such thing as ‘male menopause’ or ‘andropause’ that can be compared to menopause in women. What are the symptoms of androgen deficiency? Low energy levels, mood swings, irritability, poor concentration, reduced muscle strength and low sex drive can be symptoms of androgen deficiency (low testosterone). Symptoms often overlap with those of other illnesses. The symptoms of androgen deficiency are different for men of different ages. Stages Of life • Osteoporosis (thinning of bones) What causes androgen deficiency? Androgen deficiency can be caused by genetic disorders, medical problems, or damage to the testes or pituitary gland. Androgen deficiency happens when there are problems within the testes or with hormone production in the brain. A common chromosomal disorder that causes androgen deficiency is Klinefelter’s syndrome. Diagnosis How is androgen deficiency diagnosed? A diagnosis of androgen deficiency involves having a thorough medical evaluation and at least two blood samples (taken in the morning on different days) to measure hormone levels.

Diagnosis should not be simply based on symptoms as these could be caused by other health problems that need different treatment. A diagnosis of androgen deficiency is only confirmed when blood tests show a lower than normal testosterone level. What is the ‘normal’ testosterone range? A reference range is used as a guide by testing laboratories and doctors to decide whether a person’s hormone levels are normal or low, and whether treatment is needed. Testosterone is measured in units called nanomalor. The ‘normal’ testosterone reference range for healthy, young adult men is about 8 to 27 nanomolar but these numbers vary between measurement systems. Treatment How is androgen deficiency treated? Androgen deficiency is treated with testosterone therapy; this means giving testosterone in doses that return the testosterone levels in the blood to normal. Testosterone is prescribed for men with androgen deficiency confirmed by blood tests. Once started, testosterone therapy is usually continued for life and the man needs to be checked regularly by a doctor. What are the main forms of testosterone therapy? In Australia testosterone therapy is available in the form of injections, gels, lotions, creams, patches and tablets, and works very well for men with confirmed androgen (testosterone) deficiency.

The type of treatment prescribed can depend on patient convenience, familiarity and cost. Commercial testosterone products contain only the natural testosterone molecule that is chemically produced from plant materials. What are the side-effects of testosterone therapy? Side-effects are not expected because testosterone therapy aims to bring a man’s testosterone levels back to normal. However, testosterone therapy can increase the growth of the prostate gland which can make the symptoms of benign prostate enlargement (such as needing to urinate more often) worse. In the case of prostate cancer, testosterone therapy is not used because of concerns that it can make the tumour grow. Too high a dose of testosterone can lead to acne, weight gain, gynaecomastia (breast development), male-pattern hair loss and changes in mood. Any side-effects should be managed by a doctor and the testosterone dose lowered. Can herbal products help androgen deficiency? There are many herbal products marketed, particularly on the Internet, as treatments that can act like testosterone and improve muscle strength and libido (sex drive). However, there are no known herbal products that can replace testosterone in the body and be used to treat androgen deficiency.

Question: Which hormone causes male sexual development?
Answer: Testosterone