European Journal of Pediatrics

, Volume 154, Issue 12, pp 953–957 | Cite as

The effect of prolonged administration of an anabolic steroid (oxandrolone) on growth in boys with constitutionally delayed growth and puberty

  • Eelco J. Schroor
  • Mirjam M. van Weissenbruch
  • Pieter Knibbe
  • Henriette A. Delemarre-van de Waal
Endocrinology Original Paper


Short-term oxandrolone treatment is used to stimulate growth in boys with constitutional delay of growth and puberty (CDGP). Oxandrolone stimulates growth, but a beneficial effect on final height has not been established. In our study, we report the effect of long-term treatment (30–57 months) with oxandrolone in 18 boys with CDGP, compared with nine puberty-matched, untreated controls (group 1). The oxandrolone-treated boys were divided into two groups: four boys who received oxandrolone before onset of puberty (group 2), and 14 boys who started oxandrolone therapy during Tanner stage 2 (group 3). Height standard deviation scores for calender age (HSDSCA) between the three groups of patients at Tanner stage 2 (G2) were not different: −2.86 (SD 0.56) in the controls and −2.60 (SD 0.52) in group 2 and −2.81 (SD 0.59) in group 3. Age at G2 was 15.1 (SD 1.4) years (controls), 14.6 (SD 0.5) years (group 2) and 14.0 (SD 0.9) years (group 3). Height velocity in the time span from G2 to G5 was more pronounced in the oxandrolone-treated boys: 7.7 (SD 0.5) cm/year in group 2 and 7.7 (SD 1.4) cm/year in group 3 versus 5.1 (SD 0.9) cm/year in the controls. Height gain was significantly increased in the oxandrolone treated groups: 25.8 (SD 3.8) in group 2 and 25.2 (SD 3.7) in group 3 versus 19.8 (SD 4.9) in the controls (P<0.05). Final height did not differ significantly among the three groups: 168.5 (SD 7.0) cm in the controls and 173.0 (SD 4.0) cm in group 2 and 167.8 (SD 5.3) cm in group 3. HSDSCA increased during puberty in all three groups. At final height, HSDSCA (calculated at age=20 years) was −2.01 (SD 1.05), −1.34 (SD 0.59) and −2.12 (SD 0.79) respectively in groups 1, 2 and 3. An effect of oxandrolone on HSDSCA was not found. Target height was neither reached by the controls nor by the treated groups. Tempo of pubertal development was not different in the three groups, and ΔBA/ΔCA did not alter after start of oxandrolone treatment in groups 2 and 3.


Boys with CDGP may benefit from oxandrolone treatment in terms of increased height gain. Starting treatment before the onset of puberty may be favourable.

Key words

Growth Oxandrolone Puberty, delayed 



bone age


calender age


constitutional delay of growth and puberty


final height


height standard deviation score for calender age


height velocity


predicted adult height


target height


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Albanese A, Stanhope R (1993) Does constitutional delayed puberty cause segmental disproportion and short stature. Eur J Pediatr 152:293–296Google Scholar
  2. 2.
    Bettmann HK, Goldman HS, Abramowicz M, Sobel EH (1971) Oxandrolone treatment of short stature: effect on predicted mature height. J Pediatr 79:1018–1023Google Scholar
  3. 3.
    Bierich JR, Potthoff K (1979) Die Spontansekretion des Wachstumshormons bei der konstitutionellen Entwicklungsverzögerung und der frühnormalen Pubertät (Spontaneous secretion of growth hormone in children with constitutional delay of growth and adolescence and with early normal puberty). Monatsschr Kinderheilkd 27:561–565Google Scholar
  4. 4.
    Bourguignon JP (1988) Variations in duration of pubertal growth: a mechanism compensating for differences in timing of puberty and minimizing their effects on final height. Acta Pediatr 347:16–24Google Scholar
  5. 5.
    Buyukgebiz A, Hindmarsh PC, Brook CG (1990) Treatment of constitutional delay of growth and puberty with oxandrolone compared with growth hormone. Arch Dis Child 65:448–449Google Scholar
  6. 6.
    Clayton PE, Shalet SM, Price DA, Addison GM (1988) Growth and growth hormone responses to oxandrolone in boys with constitutional delay of growth and puberty (CDGP). Clin Endocrinol 29:123–130Google Scholar
  7. 7.
    Crowne EC, Shalet SM, Wallace WHB, Eminson DM, Price DA (1990) Final height in boys with untreated constitutional delay in growth and puberty. Arch Dis Child 65:1109–1112Google Scholar
  8. 8.
    Fox M, Minot AS, Liddle GW (1962) Oxandrolone: a potent anabolic steroid of novel chemical configuration. J Clin Endocrinol Metab 22:921–924Google Scholar
  9. 9.
    Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, StanfordGoogle Scholar
  10. 10.
    Hopwood NJ, Kelch RP, Zipf WB, Hernandez RJ (1979) The effect of synthetic androgens on the hypothalamic-pituitary-gonadal axis in boys with constitutionally delayed growth. J Pediatr 94:657–662Google Scholar
  11. 11.
    Joss EE, Schmidt HA, Zuppinger KA (1989) Oxandrolone in constitutionally delayed growth, a longitudinal study up to final height. J Clin Endocrinol Metab 69:1109–1115Google Scholar
  12. 12.
    Keenan BS, Richards GE, Ponder SW, Dallas JS, Nagamani M, Smith ER (1993) Androgen-stimulated pubertal growth: the effects of testosterone and dihydrotestosterone on growth hormone and insulin-like growth factor-I in the treatment of short stature and delayed puberty. J Clin Endocrinol Metab 76:996–1001Google Scholar
  13. 13.
    LaFranchi S, Hanna CE, Mandel SH (1991) Constitutional delay of growth: expected versus final adult height. Pediatrics 87:82–87Google Scholar
  14. 14.
    Link K, Blizzard RM, Evans WS, Kaiser DL, Parker MW, Rogol AD (1986) The effect of androgens on the pulsatile release and the twenty-fourhour mean concentration of growth hormone in peripubertal males. J Clin Endocrinol Metab 62:159–164Google Scholar
  15. 15.
    Malhotra A, Poon E, Tse W-Y, Pringle PJ, Hindmarsh PC, Brook CGD (1993) The effects of oxandrolone on the growth hormone and gonadal axes in boys with constitutional delay of growth and puberty. Clin Endocrinol 38:393–398Google Scholar
  16. 16.
    Marti Henneberg C, Niirianen AK, Rappaport R (1975) Oxandrolone treatment of constitutional short stature in boys during adolescence: effect on linear growth, bone age, pubic hair, and testicular development. J Pediatr 86:783–788Google Scholar
  17. 17.
    Moore DC, Tattoni DS, Limbeck GA, Ruvelcaba RHA, Lindner DS, Gareis FJ, Al-Agba S, Kelley VC (1976) Studies of anabolic steroids: V. Effect of prolonged oxandrolone administration on growth in children and adolescents with uncomplicated short stature. Pediatrics 58:412–422Google Scholar
  18. 18.
    Papadimitriou A, Wacharasindhu S, Pearl K, Preece MA, Stanhope R (1991) Treatment of constitutional growth delay in prepubertal boys with a prolonged course of low dose oxandrolone. Arch Dis Child 66:841–843Google Scholar
  19. 19.
    Roede MJ, Wieringen JC van (1985) Growth diagrams 1980. Tijdschr Sociale Gezondheidszorg 63 [Suppl]: 1–34Google Scholar
  20. 20.
    Stanhope R, Brook CG (1985) Oxandrolone in low dose for constitutional delay of growth and puberty in boys. Arch Dis Child 60:379–381Google Scholar
  21. 21.
    Stanhope R, Buchanan CR, Fenn GC, Preece MA (1988) Double blind placebo controlled trial of low dose oxandrolone in the treatment of boys with constitutional delay of growth and puberty. Arch Dis Child 63:501–505Google Scholar
  22. 22.
    Tanner JW (1962) Growth at adolescence. Blackwell and Mott Ltd, OxfordGoogle Scholar
  23. 23.
    Tse WY, Buyukgebiz A, Hindmarsh PC, Stanhope R, Preece MA, Brook CG (1990) Long-term outcome of oxandrolone treatment in boys with constitutional delay of growth and puberty. J Pediatr 117:588–591Google Scholar
  24. 24.
    Ulloa-Aguirre A, Blizzard RM, Garcia-Rubi E, Rogol AD, Link K, Cristie M, Johnson ML, Veldhuis JD (1990) Testosterone and oxandrolone, a nonaromatizable androgen, specially amplify the mass and rate of growth hormone (GH) secreted per burst without altering GH secretory burst duration or frequency or the GH half-life. J Clin Endocrinol Metab 71:846–854Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Eelco J. Schroor
    • 1
  • Mirjam M. van Weissenbruch
    • 1
  • Pieter Knibbe
    • 1
  • Henriette A. Delemarre-van de Waal
    • 1
  1. 1.Department of PaediatricsFree University Hospital AmsterdamAmsterdamThe Netherlands

Personalised recommendations