Skip to main content

Medical Management of Adolescents and Young Adults

  • Chapter
  • First Online:
Disorders of Sex Development

Abstract

Medical treatment beyond childhood is focused on hormonal treatment to suppress abnormal function or replace absent functions, as well as on-going anatomical problems requiring surgery. In addition, there are issues of restricted reproductive capabilities and the possible medical treatments for these. Perhaps the most important issues in adolescence and young adulthood are the existential ones. These have often been neglected in the past and systems need to be established to manage them.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahlquist JA (1994) Gender identity in testicular feminisation. Phenotypically, anatomically, legally, and socially female. BMJ 308(6935):1041

    Article  PubMed  CAS  Google Scholar 

  • Ahmed SF, Rodie M (2010) Investigation and initial management of ambiguous genitalia. Best Pract Res Clin Endocrinol Metab 24(2):197–218

    Article  PubMed  Google Scholar 

  • Bodri D, Vernaeve V, Figueras F et al (2006) Oocyte donation in patients with Turner’s syndrome: a successful technique but with an accompanying high risk of hypertensive disorders during pregnancy. Hum Reprod 21(3):829–832

    Article  PubMed  CAS  Google Scholar 

  • Bodri D, Guillen JJ, Schwenn K et al (2009) Poor outcome in oocyte donation after elective transfer of a single cleavage-stage embryo in Turner syndrome patients. Fertil Steril 91(4 Suppl):1489–1492

    Article  PubMed  Google Scholar 

  • Brain CE, Creighton SM, Mushtaq I et al (2010) Holistic ­management of DSD. Best Pract Res Clin Endocrinol Metab 24(2):335–354

    Article  PubMed  Google Scholar 

  • Cadeddu JA, Watumull L, Corwin TS et al (2001) Laparoscopic gonadectomy and excision of mullerian remnant in an adult intersex patient. Urology 57(3):554

    Article  PubMed  CAS  Google Scholar 

  • Cai LQ, Zhu YS, Katz MD et al (1996) 5 alpha-reductase-2 gene mutations in the Dominican Republic. J Clin Endocrinol Metab 81(5):1730–1735

    Article  PubMed  CAS  Google Scholar 

  • Carrascosa A, Gussinye M, Terradas P et al (2000) Spontaneous, but not induced, puberty permits adequate bone mass acquisition in adolescent Turner syndrome patients. J Bone Miner Res 15(10):2005–2010

    Article  PubMed  CAS  Google Scholar 

  • Cools M, Drop SL, Wolffenbuttel KP et al (2006) Germ cell tumors in the intersex gonad: old paths, new directions, ­moving frontiers. Endocr Rev 27(5):468–484

    Article  PubMed  CAS  Google Scholar 

  • Ernst E, Bergholdt S, Jorgensen JS et al (2010) The first woman to give birth to two children following transplantation of frozen/thawed ovarian tissue. Hum Reprod 25(5):1280–1281

    Article  PubMed  Google Scholar 

  • Faienza MF, Giordani L, Delvecchio M et al (2008) Clinical, endocrine, and molecular findings in 17beta-hydroxysteroid dehydrogenase type 3 deficiency. J Endocrinol Invest 31(1):85–91

    PubMed  CAS  Google Scholar 

  • Hoei-Hansen CE, Rajpert-De Meyts E, Daugaard G et al (2005) Carcinoma in situ testis, the progenitor of testicular germ cell tumours: a clinical review. Ann Oncol 16(6):863–868

    Article  PubMed  CAS  Google Scholar 

  • Grover S, Loughlin E. (2002) Recuring themes from psychotherapeutic group work leading to the development of a clinical practice checklist for women with intersex and related conditions. In: IX European Congress in Paediatric and Adolescent Gynaecology Florence

    Article  PubMed  CAS  Google Scholar 

  • Imperato-McGinley J, Guerrero L, Gautier T et al (1974) Steroid 5alpha-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science 186(4170):1213–1215

    Article  PubMed  CAS  Google Scholar 

  • Imperato-McGinley J, Miller M, Wilson JD et al (1991) A cluster of male pseudohermaphrodites with 5 alpha-reductase deficiency in Papua New Guinea. Clin Endocrinol (Oxf) 34(4):293–298

    Article  CAS  Google Scholar 

  • Jones BC, O’Brien M, Chase J et al (2009) Early hypospadias surgery may lead to a better long-term psychosexual outcome. J Urol 182(4 Suppl):1744–1749

    Article  PubMed  Google Scholar 

  • Karnis MF, Zimon AE, Lalwani SI et al (2003) Risk of death in pregnancy achieved through oocyte donation in patients with Turner syndrome: a national survey. Fertil Steril 80(3):498–501

    Article  PubMed  Google Scholar 

  • Levin HS (2000) Tumors of the testis in intersex syndromes. Urol Clin North Am 27(3):543–551, x

    Article  PubMed  CAS  Google Scholar 

  • Looijenga LH, Hersmus R, Oosterhuis JW et al (2007) Tumor risk in disorders of sex development (DSD). Best Pract Res Clin Endocrinol Metab 21(3):480–495

    Article  PubMed  CAS  Google Scholar 

  • Looijenga LH, Hersmus R, de Leeuw BH et al (2010) Gonadal tumours and DSD. Best Pract Res Clin Endocrinol Metab 24(2):291–310

    Article  PubMed  Google Scholar 

  • Maimoun L, Philibert P, Cammas B et al (2011) Phenotypical, biological, and molecular heterogeneity of 5alpha-reductase deficiency: an extensive international experience of 55 patients. J Clin Endocrinol Metab 96(2):296–307

    Article  PubMed  CAS  Google Scholar 

  • Marcus R, Leary D, Schneider DL et al (2000) The contribution of testosterone to skeletal development and maintenance: lessons from the androgen insensitivity syndrome. J Clin Endocrinol Metab 85(3):1032–1037

    Article  PubMed  CAS  Google Scholar 

  • Mazur T (2005) Gender dysphoria and gender change in androgen insensitivity or micropenis. Arch Sex Behav 34(4):411–421

    Article  PubMed  Google Scholar 

  • McDonnell CM, Coleman L, Zacharin MR (2003) A 3-year prospective study to assess uterine growth in girls with Turner’s syndrome by pelvic ultrasound. Clin Endocrinol (Oxf) 58(4):446–450

    Article  Google Scholar 

  • Meirow D, Levron J, Eldar-Geva T et al (2005) Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med 353(3):318–321

    Article  PubMed  CAS  Google Scholar 

  • Meyer-Bahlburg HF (2001) Gender and sexuality in classic ­congenital adrenal hyperplasia. Endocrinol Metab Clin North Am 30(1):155–171, viii

    Article  PubMed  CAS  Google Scholar 

  • Meyer-Bahlburg HF (2002) Gender assignment and reassignment in intersexuality: controversies, data, and guidelines for research. Adv Exp Med Biol 511:199–223

    Article  PubMed  Google Scholar 

  • Meyer-Bahlburg HF, Migeon CJ, Berkovitz GD et al (2004) Attitudes of adult 46, XY intersex persons to clinical management policies. J Urol 171(4):1615–1619; discussion 1619

    Article  PubMed  CAS  Google Scholar 

  • Migeon CJ, Wisniewski AB, Brown TR et al (2002) 46, XY intersex individuals: phenotypic and etiologic classification, knowledge of condition, and satisfaction with knowledge in adulthood. Pediatrics 110(3):e32

    Article  PubMed  Google Scholar 

  • Nishi MY, Domenice S, Medeiros MA, Mendonca BB, Billerbeck AE (2002) Detection of Y-specific sequences in 122 patients with Turner syndrome: nested PCR is not a reliable method. AM J Med Genet Feb 1;107(4)299–305

    Article  PubMed  CAS  Google Scholar 

  • Ogilvie CM, Rumsby G, Kurzawinski T et al (2006) Outcome of bilateral adrenalectomy in congenital adrenal hyperplasia: one unit’s experience. Eur J Endocrinol 154(3):405–408

    Article  PubMed  CAS  Google Scholar 

  • Paterson WF, Hollman AS, Donaldson MD (2002) Poor uterine development in Turner syndrome with oral oestrogen therapy. Clin Endocrinol (Oxf) 56(3):359–365

    Article  CAS  Google Scholar 

  • Practice Committee of American Society for Reproductive Medicine (2008) Increased maternal cardiovascular mortality associated with pregnancy in women with Turner syndrome. Fertil Steril 90:S185–186

    Article  PubMed  CAS  Google Scholar 

  • Ricketts S, Hunter-Smith DJ, Coombs CJ (2011) Quality of life after penile reconstruction using the radial forearm flap in adult bladder exstrophy patients – technique and outcomes. ANZ J Surg 81(1–2):52–55

    Article  PubMed  Google Scholar 

  • Sheean LA, Goldfarb JM, Kiwi R et al (1989) In vitro ­fertilization (IVF)-surrogacy: application of IVF to women without functional uteri. J In Vitro Fert Embryo Transf 6(3):134–137

    Article  PubMed  CAS  Google Scholar 

  • Warne GL, Grover S, Zajac JD (2005) Hormonal therapies for individuals with intersex conditions: protocol for use. Treat Endocrinol 4(1):19–29

    Article  PubMed  CAS  Google Scholar 

  • Wilkins L (1965) The diagnosis and treatment of endocrine disorders in childhood and adolescence, 3rd edn. Charles C. Thomas, Springfield, Illinois

    Google Scholar 

  • Wisniewski AB, Migeon CJ, Meyer-Bahlburg HF et al (2000) Complete androgen insensitivity syndrome: long-term medical, surgical, and psychosexual outcome. J Clin Endocrinol Metab 85(8):2664–2669

    Article  PubMed  CAS  Google Scholar 

  • Young MC, Hughes IA (1990) Dexamethasone treatment for congenital adrenal hyperplasia. Arch Dis Child 65(3):312–314

    Article  PubMed  CAS  Google Scholar 

  • Zielinska D, Zajaczek S, Rzepka-Gorska I (2007) Tumors of dysgenetic gonads in Swyer syndrome. J Pediatr Surg 42(10):1721–1724

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John M. Hutson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Hutson, J.M., Warne, G.L., Grover, S.R. (2012). Medical Management of Adolescents and Young Adults. In: Hutson, J., Warne, G., Grover, S. (eds) Disorders of Sex Development. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-22964-0_22

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-22964-0_22

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-22963-3

  • Online ISBN: 978-3-642-22964-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics