Longitudinal Clinical Course in Patients With 5α-Reductase Type 2 Deficiency Treated With Testosterone and Dihydrotestosterone During Infancy and Puberty
October 2022
in “
Endocrine journal
”
TLDR Testosterone and dihydrotestosterone treatments can help with penile growth in males with 5α-reductase type 2 deficiency, with dihydrotestosterone being more effective in infancy.
In a study of four patients with 5α-reductase type 2 (5αRD2) deficiency, a condition affecting male sexual development, testosterone (T) and dihydrotestosterone (DHT) therapies were evaluated for their effectiveness in penile enlargement. During infancy, T replacement therapy increased stretched penile length (SPL) in three patients but was ineffective in one. Subsequent DHT therapy further increased SPL in the three responsive patients. During and after puberty, T replacement therapy was effective in increasing SPL in two patients, suggesting increased conversion of T to DHT via 5α-reductase type 1 activity. One patient exhibited cryptozoospermia at age 27 despite normal testicular volume. The study suggests that DHT therapy is preferable for penile enlargement during infancy, while T replacement therapy can be effective during puberty for patients with 5αRD2 deficiency.