Aa
Delayed secondary sexual development
I am a 29 year old Caucasian male living in the UK. I am also a family physician, but given my relative lack of expertise in this particular area I wanted to post this problem to get the opinions of others including physicians.
For as long as I can recall, I have been bothered about the rate of my secondary development. This has had a fairly profound effect on me psychologically and, in all honestly, I'm not sure why I waited until now to ask about this.
My mother was not a late bloomer, my father may well have been given what he has said before (but he is not particularly forthcoming about these matters). I know that he certainly had developed normally by the time he was my age.
I probably got my first downy blonde pubic hair when I was about 14. By the time I left high-school, (17) I had only a very fine downy hair on my upper lip, and virtually no detectable axillary hair. I did not have hairy legs or arms. My height was average until mid-highschool; I then became a bit below average and have ended up at 5ft 8.5 inches. I suspect this is probably within the range to be expected from my father who is 5ft 10-ish and mother who is 5ft 3.5inches. My genital development, I believe, is probably normal too.
Througout University I hardly had to shave. I guess to make me feel more grown up, I tended to shave every few days with just a dry razor (not particularly good for my skin!) even though I could have gotten away without shaving. Even now, I really struggle to grow anything resembling a sideburn and the main concentration of my facial hair is on my upper lip and chin, with a very small sparse amount of it (both dark brown, similar to my pubic hair, and blonde) on my cheeks. This actually makes it sound much more than it truly is:- it is hardly visible except on close inspection. In the past 6 months I have developed a small amount (but definitely more than I had) of downy hair on my chest which starts blonde and some of which has become a little darker over time. Again, this is only visible on very close inspection.
I have become so bothered with my appearance that it was a real factor in my developing depression over the past few years. It has had a fair impact on my life with me avoiding dating/going to pool/beach/gym etc, and generally feeling inferior to other guys in my peer group who are developed. A number of people - strangers and less immediate family - have blurted out how young I look. My depression fortunately is much improved and is now stable over the past 12 months, but my physical development issues are still present.
I eventually decided the time had come to see my own family doctor and get some bloods done. The following are the results (bear in mind these are UK units/reference ranges in brackets):-
Renal function – normal
Liver function –
Alkaline phosphatase 126 IU/L (30-120)
Bilirubin – normal
AST – 74 IU/L (5-42)
ALT – 217 IU/L (5-60)
Cholesterol (total) 5.8 mmol/L (3.1-5.2)
Thyroid function – normal
Sex hormone profile -
FSH – 2.1 U/L (0.7 – 11.1)
LH – 2.6 U/L (1.3 – 70)
Prolactin – 220 microU/L (60 – 360)
Progesterone <2 (3 – 7)
Estradiol 218 pmol/L (0 – 206)
Testosterone 29.8 nmol/L (10 – 36)
SHBG 35.0 nmol/L (6 – 45)
Free Androgen Index 85.1% (36 – 156)
I have already had my liver function looked at, and given I don’t drink alcohol, it has been put down as hepatic steatosis. I am a little over-weight, but not obese, and my gastroenterologist thinks this is the reason for my deranged Liver function. My liver ultrasound was normal.
I am wondering if the raised estradiol levels could have any effect on delaying/counteracting my sexual development. I know it is marginal. Are the estradiol levels coming from my body fat; I can hardly believe this as there are plenty of males my age who are heavier and have still developed normally.
My family doctor has simply said the results were fine … end of story. I on the other hand think that I’d still like an answer to this problem. It gets extremely frustrating seeing others 10 or more years my junior who are more physically developed.
Does anyone have any experience of this, or wish to offer opinions on what I should do next/ how to take this further (given the fact that any secondary referrals have to go through my family doctor here in the UK). Am I over-reacting?
Cheers, in anticipation.
For as long as I can recall, I have been bothered about the rate of my secondary development. This has had a fairly profound effect on me psychologically and, in all honestly, I'm not sure why I waited until now to ask about this.
My mother was not a late bloomer, my father may well have been given what he has said before (but he is not particularly forthcoming about these matters). I know that he certainly had developed normally by the time he was my age.
I probably got my first downy blonde pubic hair when I was about 14. By the time I left high-school, (17) I had only a very fine downy hair on my upper lip, and virtually no detectable axillary hair. I did not have hairy legs or arms. My height was average until mid-highschool; I then became a bit below average and have ended up at 5ft 8.5 inches. I suspect this is probably within the range to be expected from my father who is 5ft 10-ish and mother who is 5ft 3.5inches. My genital development, I believe, is probably normal too.
Througout University I hardly had to shave. I guess to make me feel more grown up, I tended to shave every few days with just a dry razor (not particularly good for my skin!) even though I could have gotten away without shaving. Even now, I really struggle to grow anything resembling a sideburn and the main concentration of my facial hair is on my upper lip and chin, with a very small sparse amount of it (both dark brown, similar to my pubic hair, and blonde) on my cheeks. This actually makes it sound much more than it truly is:- it is hardly visible except on close inspection. In the past 6 months I have developed a small amount (but definitely more than I had) of downy hair on my chest which starts blonde and some of which has become a little darker over time. Again, this is only visible on very close inspection.
I have become so bothered with my appearance that it was a real factor in my developing depression over the past few years. It has had a fair impact on my life with me avoiding dating/going to pool/beach/gym etc, and generally feeling inferior to other guys in my peer group who are developed. A number of people - strangers and less immediate family - have blurted out how young I look. My depression fortunately is much improved and is now stable over the past 12 months, but my physical development issues are still present.
I eventually decided the time had come to see my own family doctor and get some bloods done. The following are the results (bear in mind these are UK units/reference ranges in brackets):-
Renal function – normal
Liver function –
Alkaline phosphatase 126 IU/L (30-120)
Bilirubin – normal
AST – 74 IU/L (5-42)
ALT – 217 IU/L (5-60)
Cholesterol (total) 5.8 mmol/L (3.1-5.2)
Thyroid function – normal
Sex hormone profile -
FSH – 2.1 U/L (0.7 – 11.1)
LH – 2.6 U/L (1.3 – 70)
Prolactin – 220 microU/L (60 – 360)
Progesterone <2 (3 – 7)
Estradiol 218 pmol/L (0 – 206)
Testosterone 29.8 nmol/L (10 – 36)
SHBG 35.0 nmol/L (6 – 45)
Free Androgen Index 85.1% (36 – 156)
I have already had my liver function looked at, and given I don’t drink alcohol, it has been put down as hepatic steatosis. I am a little over-weight, but not obese, and my gastroenterologist thinks this is the reason for my deranged Liver function. My liver ultrasound was normal.
I am wondering if the raised estradiol levels could have any effect on delaying/counteracting my sexual development. I know it is marginal. Are the estradiol levels coming from my body fat; I can hardly believe this as there are plenty of males my age who are heavier and have still developed normally.
My family doctor has simply said the results were fine … end of story. I on the other hand think that I’d still like an answer to this problem. It gets extremely frustrating seeing others 10 or more years my junior who are more physically developed.
Does anyone have any experience of this, or wish to offer opinions on what I should do next/ how to take this further (given the fact that any secondary referrals have to go through my family doctor here in the UK). Am I over-reacting?
Cheers, in anticipation.
I would hope it wasn't simply lab error as I paid a small fortune for those bloods privately! But I am getting them retested. Just wish something would get done.
Sorry about the lab confusion, I know how horrible this is for people. It must be hard for you being a family physician dealing with such issues and your job also but now know firsthand how some of your patients feel solely depending on chemical testing
Some labs use different ranges and the last one that checked you is a huge range of "normal" compared to the first and it could simply be a laboratory error that you are at the lower end of the range they are using. It is clear you need testing again with that result.
http://nptech.co.uk/bloodtests.html - This is another option to see a very good snapshot of things. I think they will check Reverse t3 aswell if you contact them if not iwdl.net certainly will
Hope you get to the bottom of all this
Some labs use different ranges and the last one that checked you is a huge range of "normal" compared to the first and it could simply be a laboratory error that you are at the lower end of the range they are using. It is clear you need testing again with that result.
http://nptech.co.uk/bloodtests.html - This is another option to see a very good snapshot of things. I think they will check Reverse t3 aswell if you contact them if not iwdl.net certainly will
Hope you get to the bottom of all this
My condition almost same as yours .
I'm 29 years old software professional , 60Kilograms, BP,BIOCHEMISTRY, HAEMATOLOGY etc normal. I don't have secondary sexual characteristics developed.
I'm 29 years old software professional , 60Kilograms, BP,BIOCHEMISTRY, HAEMATOLOGY etc normal. I don't have secondary sexual characteristics developed.
Cheers guys, I am becoming a DIY doctor I have to say! I have organised to check GH, IGF-1, Coeliac screen, Ferritin, LFTs and thyroid autoantibodies on my next bloods (next week). Also I'm going to put in a semen sample to check fertility. My oestradiol is now normal (83). I am trying to reduce my weight (it's not absolutely horrendous) and remain basically teetotal. Am now somewhat concerned that because my last bloods were done in England (I went for a second opinion there) that the ones I next have will be done in the original lab that said my testosterone was normal. I know, I know, it sounds crazy, but it is going through my head that the results will be normal ... again. I would actually prefer it remains low-normal. How many times do they need to repeat these bloods to determine some treatment is merited!????
Your liver funtion tests must be causing problems. Have you had a full MOT in bloodscreening tests for Coeliacs, lymes, systemic candida infection and the like? It must be frustrating not knowing what is causing that. Much of T4 and other hormones get converted in the liver as you will know so it could be worth looking into further investigation of whats causing them results
I know I mentioned this before but shbg looks elevated that can be the result of T4 not being converted and used effectively by the body that could again be attribued to your poor liver function. I don't know what to think on that score without knowing your thyroid results and if you have more than one tsh and free t4 result? With your LFT I think getting the active hormone free t3 tested could give a good account of things. They generally don't test for this to save the NHS money. Sad but true
What is happening with sex hormones now is anyones guess on your latest update but at least now you have a log of results to keep track of. I would keep an eye on the next main sex hormone Prolactin with such a contrast of results. Just because you aren't getting headaches or visual disturbances doesn't mean there may not be some sort of pituitary disorder going on.
I would get IGF-1 (Insulin-like growth factor) tested aswell
Suppliment some iron pills to get your Ferritin up and Zinc to control E2. I would check your B12 also for your next bloodwork
I know I mentioned this before but shbg looks elevated that can be the result of T4 not being converted and used effectively by the body that could again be attribued to your poor liver function. I don't know what to think on that score without knowing your thyroid results and if you have more than one tsh and free t4 result? With your LFT I think getting the active hormone free t3 tested could give a good account of things. They generally don't test for this to save the NHS money. Sad but true
What is happening with sex hormones now is anyones guess on your latest update but at least now you have a log of results to keep track of. I would keep an eye on the next main sex hormone Prolactin with such a contrast of results. Just because you aren't getting headaches or visual disturbances doesn't mean there may not be some sort of pituitary disorder going on.
I would get IGF-1 (Insulin-like growth factor) tested aswell
Suppliment some iron pills to get your Ferritin up and Zinc to control E2. I would check your B12 also for your next bloodwork
"When does emotional distress become a big enough problem for someone to realise they have to try something, even if it fails?? "
My problem is different to yours but I know exactly how you feel about just taking a gamble and hpoing for the best.
Don't know anything about hormones but hopefully someone here will be able to give you some guidance.
Best of luck bud.
My problem is different to yours but I know exactly how you feel about just taking a gamble and hpoing for the best.
Don't know anything about hormones but hopefully someone here will be able to give you some guidance.
Best of luck bud.
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