Testosterone Therapy in Children

Testosterone therapy is an option for children who have what’s known as constitutional growth delay. Constitutional growth delay (CGB) is not a life-threatening medical condition. Parents who do consider hormone therapy for their child should do so with discretion. Slow development, however, should not be ignored because there are serious medical conditions that may stunt growth and development.

What is Consitutional Growth Delay?

• Constitutional growth delay (CGD) is the most common cause of short stature. It is also called idiopathic short stature--"idiopathic" means that the cause in unknown--and non-growth hormone deficient short stature. The first signs of delayed growth appear after the first three months when growth slows down. During puberty, the growth spurt occurs later than average. What must be stressed, however, is that this is not an disorder; it is only a variation of normal growth. Treatment is not necessary. Children who are small do not differ from other children in terms of academic performance or social skills. However, if psychological problems and stress persist due to slow physical maturity, treatment may be considered.

Causes of Consitutional Growth Delay

• Constitutional growth delay is thought to be genetic and inherited from multiple genes from both parents. Dr. Pamela Clark, a pediatric endocrinologist, indicates in an eMedicine article that there is 60 to 90 percent likelihood of developing CGB from a family member of the same or opposite sex. According the University of Maryland Medical Center, if two parents who are relatively short, but healthy, have a child, it’s likely that the child will fall in the shortest 5 percent.

Treatment of CGD

• Again short stature caused by genetics is not a serious health problem, but if parents are concerned about the emotional well-being of their child, they may consider hormone treatment. General treatment of CGD involves giving a child with delayed puberty low doses of anabolic steroids, synthetic hormones that are derivatives of testosterone. Anabolic steroids promote growth and sexual maturation.

Is hormone therapy safe?

• There has been controversy surrounding the use of hormone therapy in boys. The concern stems from the possibility that anabolic steroids promote sexual maturation, but stunt growth. According to the "New England Journal of Medicine," a study was conducted with boys (average age 14.1) who showed signs of delayed constitutional growth and were given testosterone enanthate (50mg) for 1.2 years. Sexual maturation progressed, but the final height was not affected. In conclusion, researchers claim that low-dose testosterone treatment is effective in boys with delayed growth and development and does not reduce final adult height.

Other causes of delayed growth and development

• Again if both parents are of short stature and healthy, then there is no reason to be concerned about having a child that is smaller than average. There are, however, medical conditions that lead to delayed growth. These conditions include growth hormone deficiency and chronic diseases such as congenital heart disease, kidney disease, sickle cell anemia and hypothyroidism. Infections of the fetus during pregnancy also lead to growth problems. Finally, malnutrition plays a detrimental role in a child’s growth and development.