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Suggest dosage of Testosterone injection for penile growth

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Posted on Fri, 9 Oct 2015
Question: I had previously asked questions about testosterone injections for my son (possible micro pennies or small penis) who is not in full blown puberty as of yet. I was very satisfied with the answer I received but I have some other concerns I thought of since on the same topic. First question- if he does not have a micropenis but it's just small can the 3 small dose testosterone injections still help with increasing size? Secondly- Should he be having lab work done to get a baseline on his endocrine system, etc. prior to receiving these injections or is that unnecessary? Thirdly, if the doctor prescribed a 100mg dosage & not 50mg as you usually do- is that too high? And can he start getting acne or anything else as a result? Also, I read somewhere that these injections are painful- is there any other way of taking testosterone that's less painful for the purpose of increasing penis size in an 11 year old boy? Lastly, do you have any suggestions about what I can tell him this treatment is for? I do not want him knowing it thinking that we are concerned that he has a very small penis & I that we are trying to help him get more normalized. If he knew it could be traumatic and detrimental to his emotional well being.
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Answered by Dr. Binu Parameswaran Pillai (3 hours later)
Brief Answer:
Answers to your question

Detailed Answer:
Good day,
Welcome back.
Noted your question.
In my practice, i generally give 50 mg Testosterone as an injection once a month for 3 months. This is usually sufficient to increase penis length. In delayed puberty, it helps to kick start puberty. Let me explain you the normal testosterone production process in a boy.

First stage.
While in mother's uterus, testosterone is produced in small amount under the influence of placental hCG and also baby's own pituitary hormones. This is essential for male organs to form and also for testes to descend from abdomen to scrotum. Just before birth, the testosterone levels fall to baseline. Penis length is also influenced by hormones like Thyroid and growth hormones.

Second stage:
Around one month after birth, the testosterone start to rise again and at that stage, you can note the penis to enlarge in size and small erections also can be observed. This stage will last for few months. This stage is useful to improve penile length and also to increase testes size. After few months, the testosterone again falls to baseline until puberty.

Third stage:
The next step is puberty where a boy generally start producing high levels of testosterone . Puberty in boys usually start between 10 to 14 years. If puberty delays beyong 14 years, it is abnormal in a boy. During puberty, over next few years, the penis size and testes size further increase to adult size.

In your son's case, testosterone injections would ceertainly help to increase penile size. But i would recommend 50 mg, not 100mg to begin with.

Below is an extract from XXXXXXX guideline on testosterone treatment for your information.

"Testosterone therapy — Testosterone can be administered by several routes, and patient preferences should be consulted. An oral preparation of testosterone undecanoate is available in some countries, but the levels of testosterone achieved with this preparation seem to be slightly more erratic. The use of testosterone gel transdermally seems appealing because of its efficacy and convenience in adult males with hypogonadism but it has not yet been widely tested or approved in males younger than age 18 years. Most studies in adolescents have been done with low dose intramuscular injections of testosterone esters .

Testosterone doses should initially be relatively low (eg, 50 mg of testosterone enanthate or testosterone cypionate once a month). Such a dose (about 15 to 25 percent of the adult dose) is usually sufficient to achieve early virilization and growth over time (ie, three to six months), without unduly advancing epiphyseal maturation (bone age).

The above paragraph answers many of your question. Testosterone Tablets and gels are not recommended below 18 years. Initial dose should be 50 mg once a month. Higher doses has a risk of acne and advancing bone fusion.
Yes, it is slightly painful, but not excessively painful.

At this age, you may mention him that it is a vitamin injection or so. However, when he is old enough to think in a mature way, it is better to reveal about testosterone treatment. This is not rare. Many kids get testos shots for brief period.

As i mentioned earlier, many hormones play an esential role in penis growth apart from testosterone. The are growth hormone and thyroid hormones mainly. Hence,It is important to assess baseline LH, FSH, testosterone levels, IGF-1 level and thyroid blood works before starting testosterone treatment.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (6 hours later)
Thank you so much for your detailed response which really helped me to understand the situation much more fully. You seem amazing to me and I am wondering if it is possible for my son to be treated by you personally. We live on Long Island in New York. Are you practicing any where near where we live?
XXXX
doctor
Answered by Dr. Binu Parameswaran Pillai (5 hours later)
Brief Answer:
Muscat

Detailed Answer:
Thank you. Unfortunately, i live and work in Muscat ( Oman) which is more than 20 hours away from USA. I am sure that you will be able to find a pediatric endocrinologist in Newyork itself who will be able to guide you further.

Wishing your son good health and a happy life.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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Suggest dosage of Testosterone injection for penile growth

Brief Answer: Answers to your question Detailed Answer: Good day, Welcome back. Noted your question. In my practice, i generally give 50 mg Testosterone as an injection once a month for 3 months. This is usually sufficient to increase penis length. In delayed puberty, it helps to kick start puberty. Let me explain you the normal testosterone production process in a boy. First stage. While in mother's uterus, testosterone is produced in small amount under the influence of placental hCG and also baby's own pituitary hormones. This is essential for male organs to form and also for testes to descend from abdomen to scrotum. Just before birth, the testosterone levels fall to baseline. Penis length is also influenced by hormones like Thyroid and growth hormones. Second stage: Around one month after birth, the testosterone start to rise again and at that stage, you can note the penis to enlarge in size and small erections also can be observed. This stage will last for few months. This stage is useful to improve penile length and also to increase testes size. After few months, the testosterone again falls to baseline until puberty. Third stage: The next step is puberty where a boy generally start producing high levels of testosterone . Puberty in boys usually start between 10 to 14 years. If puberty delays beyong 14 years, it is abnormal in a boy. During puberty, over next few years, the penis size and testes size further increase to adult size. In your son's case, testosterone injections would ceertainly help to increase penile size. But i would recommend 50 mg, not 100mg to begin with. Below is an extract from XXXXXXX guideline on testosterone treatment for your information. "Testosterone therapy — Testosterone can be administered by several routes, and patient preferences should be consulted. An oral preparation of testosterone undecanoate is available in some countries, but the levels of testosterone achieved with this preparation seem to be slightly more erratic. The use of testosterone gel transdermally seems appealing because of its efficacy and convenience in adult males with hypogonadism but it has not yet been widely tested or approved in males younger than age 18 years. Most studies in adolescents have been done with low dose intramuscular injections of testosterone esters . Testosterone doses should initially be relatively low (eg, 50 mg of testosterone enanthate or testosterone cypionate once a month). Such a dose (about 15 to 25 percent of the adult dose) is usually sufficient to achieve early virilization and growth over time (ie, three to six months), without unduly advancing epiphyseal maturation (bone age). The above paragraph answers many of your question. Testosterone Tablets and gels are not recommended below 18 years. Initial dose should be 50 mg once a month. Higher doses has a risk of acne and advancing bone fusion. Yes, it is slightly painful, but not excessively painful. At this age, you may mention him that it is a vitamin injection or so. However, when he is old enough to think in a mature way, it is better to reveal about testosterone treatment. This is not rare. Many kids get testos shots for brief period. As i mentioned earlier, many hormones play an esential role in penis growth apart from testosterone. The are growth hormone and thyroid hormones mainly. Hence,It is important to assess baseline LH, FSH, testosterone levels, IGF-1 level and thyroid blood works before starting testosterone treatment. Regards Binu