Can you have XXY chromosome
One X too many for the man
One effect of the testosterone deficiency is that the men affected are sterile. They do not produce any functioning sperm (azoospermia). Individuals affected have a small number of sperm in their seminal fluid, but these are not sufficient for fertilization in a natural way. The sperm can be removed from the tissue through a testicular biopsy and can then be used for in vitro fertilization.
Replacement of the hormone
Since the sex hormone has such important functions in the organism, the deficiency should be compensated for. "Most of those affected need testosterone substitution in the course of their lives and then throughout their lives," said the endocrinologist and andrologist Professor Dr. Eberhard Nieschlag from the advisory board of the German Klinefelter Syndrome Association to the PZ. In some men, the hormone levels can be in the normal range of 12 to 35 nmol / l, but they are usually well below that. "As soon as the values are below the norm or the symptoms are very pronounced, testosterone therapy should be started," says Nieschlag. Before that, however, prostate cancer should be ruled out because testosterone stimulates the growth of the prostate. In addition, the patient should be carefully monitored during therapy. This includes regular monitoring of prostate growth and blood counts in order to prevent excessive production of red blood cells. In addition to testosterone, the levels of luteinizing hormone (LH) and estradiol are also determined. Because with high-dose testosterone therapy, the levels of female sex hormones can also rise sharply, which can lead to breast development (gynecomastia). Since Klinefelter patients have a 20-fold higher risk of developing breast cancer than the general population, regular breast palpation is one of the medical check-ups. In addition, the bone density should be determined every two to three years.
Testosterone can be delivered to the body in a number of ways: Patches, gels and syringes are available. "There are no serious medical reasons that speak for or against a specific preparation," says Nieschlag. "In principle, the patients can decide according to their preferences." Younger men usually preferred depot syringes that only have to be administered every three months. Older sufferers like to work with gels, the expert reported. The respective manufacturers specify standard dosages for the various preparations that are also used in Klinefelter patients. The dose would then have to be individually adjusted by the doctor.
There are a few things to consider when using the various forms of application. Gels are usually applied once a day - on the abdomen, shoulders or upper arms. They dry quickly and lead to even testosterone levels. After applying the gel, patients should wash their hands thoroughly with soap and water to prevent transmission of the hormone to other people.
The testosterone patches are placed on the hairless skin on the upper arm, thigh or lower back, where they remain for two days. Despite the lower levels of hormones, they lead to levels similar to those of the testosterone gels. Since the patches still contain remnants of the hormone even after 24 hours of wear and therefore pose a potential danger to other people (especially pregnant women and children), they should be disposed of safely. A collection container is included in each package for this purpose.
Depot syringes require less compliance than gels and patches. In these, the hormone is injected into the gluteal or thigh muscle as an oily solution. Depending on the preparation, the effect lasts for three to four weeks or three months.
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