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Urology (Expert Forum)
(GHD) Delayed Puberty
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
(GHD) Delayed Puberty
by Iamdeppressed, Jul 31, 2005 12:00AM
Hello, I am 21 years old, and I have growth hormone deficiency. I look like I am about 16, which isn't a surprise because my bone age is 15 and 1/2. I started growth hormone at age 14, so it's been about 7 years. I use to be about 4'6, now I am 5'7 and still growning at a rate of approximately 3 quaters of an inch - an inch every three months. Obviously, I am going though a growth spurt at the moment, I have never grown that fast before (besides the first few months when I began taking it). Now to the bad part and following, my question...
My genitals are not that of a normal 16 year old. I have major delayed puberty (obviously because of my GHD). My penis has not grown any, ever, not that i've noticed anyway. My penis is about 4 inches erect. Actually, it's a little less than 4 inches, more than 3 quaters, but not the full inch. For arguments sake, lets say it's 4 inches. I'm pretty sure my testicles have grown some, but not like a full adult yet. I can ejaculate, but it isn't much, and it's clear. So it hasn't matured to being a full white color, and I don't ejaculate a lot of it like a matured man. I have full pubic hair, but it's not on my theighs yet, but it's quite thick. I guess stage four of pubic hair? The stage before it goes on to my thieghs. I have some under arm hair, it has gotten thicker recently, but still not as thick as a full grown man.
I have no chest hair(Well lil tiny hairs, but nothing thick that you can see it easily.). I have a lil thin mustache that has gotten a LITTLE bit thick recently, and I have lil check hairs also, but it isn't thick. You have to really look at my face to notice it. My voice still sounds like a girl, although I am told it changed a TINY bit, still sounds like a girl though. I have small girly hands,(which is weird, that's suppose to be the first thing that grows) but average size feet? I'm a size eleven in America.
My Endocrinologist is confident that I will finish puberty normall, and everything will be ok, but I keep doubting it. She always says that my body is really, really slow. She says that I can take steriods to speed it up and finish puberty, but it would limit my growth(being taller). So I decided to keep taking GH to grow taller, I really want to be 5'9. However, I am concerned about my penis size, and fertility, and to an extent my girly(but I can get surgery to make me sound like a man, so not too worried) voice.
From what I said, am I growing properly as if I were a 16yo boy? Why hasn't my penis grown significantly, if any;I really can't tell, I was so ashamed of myself before that I never looked at it, it just made me even more deppressed. Basically, am I still on track or should I start freaking out? I told you how my sperm development was, is that normal for my point in development? I really want to have kids...People that are infertile, do they still ejaculate Sperm/fluid? If so, what makes them infertile? Now I doubt that I am fertile...Please help me.
My genitals are not that of a normal 16 year old. I have major delayed puberty (obviously because of my GHD). My penis has not grown any, ever, not that i've noticed anyway. My penis is about 4 inches erect. Actually, it's a little less than 4 inches, more than 3 quaters, but not the full inch. For arguments sake, lets say it's 4 inches. I'm pretty sure my testicles have grown some, but not like a full adult yet. I can ejaculate, but it isn't much, and it's clear. So it hasn't matured to being a full white color, and I don't ejaculate a lot of it like a matured man. I have full pubic hair, but it's not on my theighs yet, but it's quite thick. I guess stage four of pubic hair? The stage before it goes on to my thieghs. I have some under arm hair, it has gotten thicker recently, but still not as thick as a full grown man.
I have no chest hair(Well lil tiny hairs, but nothing thick that you can see it easily.). I have a lil thin mustache that has gotten a LITTLE bit thick recently, and I have lil check hairs also, but it isn't thick. You have to really look at my face to notice it. My voice still sounds like a girl, although I am told it changed a TINY bit, still sounds like a girl though. I have small girly hands,(which is weird, that's suppose to be the first thing that grows) but average size feet? I'm a size eleven in America.
My Endocrinologist is confident that I will finish puberty normall, and everything will be ok, but I keep doubting it. She always says that my body is really, really slow. She says that I can take steriods to speed it up and finish puberty, but it would limit my growth(being taller). So I decided to keep taking GH to grow taller, I really want to be 5'9. However, I am concerned about my penis size, and fertility, and to an extent my girly(but I can get surgery to make me sound like a man, so not too worried) voice.
From what I said, am I growing properly as if I were a 16yo boy? Why hasn't my penis grown significantly, if any;I really can't tell, I was so ashamed of myself before that I never looked at it, it just made me even more deppressed. Basically, am I still on track or should I start freaking out? I told you how my sperm development was, is that normal for my point in development? I really want to have kids...People that are infertile, do they still ejaculate Sperm/fluid? If so, what makes them infertile? Now I doubt that I am fertile...Please help me.
Doctor's Answer
by Kevin Pho, MD, Aug 02, 2005 12:00AM
, Aug 02, 2005 12:00AM
There can be several reasons for delayed puberty - including thyroid problems, primary failure of the testes, or hypothalamic and pituitary disease.
A minimum workup to evaluate for these causes would be an MRI of the head, as well as testicular/pelvic ultrasound to evaluate the sex organs.
As for treatment - it is difficult to comment on without knowing a cause. The options for males would include testosterone or growth hormone therapy. Needless to say, if there are problems with the thyroid or the sex organs, that should be addressed first.
These options should be discussed with your endocrinologist or personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
A minimum workup to evaluate for these causes would be an MRI of the head, as well as testicular/pelvic ultrasound to evaluate the sex organs.
As for treatment - it is difficult to comment on without knowing a cause. The options for males would include testosterone or growth hormone therapy. Needless to say, if there are problems with the thyroid or the sex organs, that should be addressed first.
These options should be discussed with your endocrinologist or personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments (7)
by Iamdeppressed, Jul 31, 2005 12:00AM
To: Urology - General
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by Iamdeppressed, Aug 02, 2005 12:00AM
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by Iamdeppressed, Aug 02, 2005 12:00AM
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by cyagansta, Aug 27, 2005 12:00AM
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by lostinparadise, Aug 31, 2005 12:00AM
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by DepressedToo, Sep 15, 2005 12:00AM
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by helpmepleaseimdesperate, Sep 22, 2005 12:00AM
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