Sexual precocity in the setting of parental use of a compounded testosterone cream: case report and review of the literature

Elena Georges; Vanessa Cedarbaum; Daniel Isaac Bisno; Ian Marshall

doi:10.1515/jpem-2022-0521

Article

Sexual precocity in the setting of parental use of a compounded testosterone cream: case report and review of the literature

Elena Georges , Vanessa Cedarbaum , Daniel Isaac Bisno and Ian Marshall

Published/Copyright: January 6, 2023

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 36 Issue 3

Abstract

Objectives

Person-to-person transmission of transdermal testosterone – termed secondary exposure – is a rare but important cause of precocious puberty.

Case presentation

A 3.5-year-old male was evaluated for precocious puberty based on a 6 month history of penile growth, development of secondary sexual characteristics, and growth spurt. Total testosterone level was significantly elevated at 1,460 ng/dL with normal prepubertal gonadotropin levels. Further history revealed that the father had been using transdermal testosterone for about 1 year. Within 2 months of discontinuation, total testosterone level was 20 ng/dL.

Conclusions

Given the recent increase in transdermal testosterone prescriptions, clinicians must consider exogenous hormonal exposure as an etiology for precocious puberty. Prescribers should counsel their patients about the significant risk of secondary exposure.

Keywords: exogenous testosterone exposure; precocious puberty; transdermal testosterone

Corresponding author: Ian Marshall, MD, Professor of Pediatrics, Chief, Division of Pediatric Endocrinology, Rutgers Robert Wood Johnson Medical School, 89 French Street, New Brunswick, NJ, 08901, USA, Phone: 732-235-9378, E-mail: marshaia@rwjms.rutgers.edu

Research funding: None declared.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2022-10-11

Accepted: 2022-12-07

Published Online: 2023-01-06

Published in Print: 2023-03-28

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Articles in the same Issue

https://doi.org/10.1515/jpem-2022-0521

Keywords for this article

exogenous testosterone exposure; precocious puberty; transdermal testosterone