Low-dose testosterone therapy improves generic quality of life and mood in boys with self-limited delayed puberty, likely reflecting successful pubertal progression.
Key Findings
Results
Both testosterone treatment regimens induced pubertal progression with a mean growth of 9.3 cm over 12 months.
Twenty-seven boys aged 14-16 years with delayed or slowly progressing puberty were enrolled in the Pubertal Replacement in Boys Study.
Boys were randomized to testosterone enanthate (75 mg/month for 6 months; n=12) or testosterone undecanoate (250 mg every 3 months; n=15).
Mean growth of 9.3 cm was measured 12 months after start of replacement treatment.
Twenty-six of twenty-seven boys completed the study.
Results
Significant improvements were observed in generic quality of life following low-dose testosterone treatment.
Generic quality of life was the primary outcome, assessed using standardized self-report questionnaires.
Assessments were conducted at baseline, 6 months, and 12 months.
Early gains in generic quality of life were sustained through 12 months.
No statistical differences in generic quality of life were found between the two treatment groups at 6 or 12 months.
Results
Significant improvements in depressive symptoms were observed, with early gains sustained through 12 months.
Depressive symptoms were assessed using standardized self-report questionnaires.
Improvements in depressive symptoms were observed across both treatment regimens.
Early gains in depressive symptoms were sustained through 12 months.
No statistical differences in depressive symptoms were found between the two treatment groups at 6 or 12 months.
Results
No changes were detected in stature-specific quality of life or enjoyment of physical activity following testosterone treatment.
Stature-specific quality of life and enjoyment of physical activity were assessed as secondary outcomes using standardized self-report questionnaires.
Neither treatment regimen produced significant changes in stature-specific quality of life.
Neither treatment regimen produced significant changes in enjoyment of physical activity.
This contrasts with the significant improvements seen in generic quality of life and depressive symptoms.
Results
Baseline testosterone serum levels were modestly associated with changes in social functioning, whereas later serum levels showed no such relationship.
This finding emerged from exploratory analyses.
The association was described as 'modest.'
Serum testosterone levels measured after treatment initiation did not show a similar association with social functioning changes.
This finding suggests that baseline pubertal status may influence certain psychosocial outcomes of treatment.
Results
The two testosterone treatment regimens (enanthate and undecanoate) produced no statistically significant differences in psychosocial outcomes.
Testosterone enanthate was administered at 75 mg/month for 6 months (n=12).
Testosterone undecanoate was administered at 250 mg every 3 months (n=15).
No statistical differences were found between treatment groups at either the 6-month or 12-month assessments across all psychosocial outcomes measured.
What This Means
This research suggests that giving low doses of testosterone to teenage boys (aged 14-16) who are experiencing delayed puberty can meaningfully improve their emotional wellbeing and overall quality of life. The study followed 27 boys who received one of two forms of testosterone treatment for up to 12 months and found that both general wellbeing and symptoms of depression improved significantly—and these improvements lasted throughout the study period. The boys also grew an average of about 9.3 cm (roughly 3.7 inches) over the 12 months.
Interestingly, the improvements in wellbeing appeared to be linked to the overall process of puberty progressing normally, rather than just to how much testosterone was in the bloodstream at any given time. The type of testosterone used (two different formulations were tested) did not make a significant difference in psychosocial outcomes, suggesting either approach may be similarly effective for emotional wellbeing. However, the treatment did not appear to change how boys felt about their height specifically, or their enjoyment of physical activity.
This research suggests that when doctors assess whether treatment for delayed puberty is working, they should consider emotional and social wellbeing as important measures of success—not just physical growth. Delayed puberty can cause real emotional and social difficulties for teenagers, and this study indicates that treating the delay may help address those challenges. The authors also emphasize the importance of structured follow-up care to support the emotional needs of adolescents going through delayed puberty.
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Österbrand M, Fors H, Norjavaara E, Chaplin J. (2026). Puberty promoting low dose testosterone treatment improved wellbeing and emotional state in boys with self-limited delayed puberty.. Journal of pediatric endocrinology & metabolism : JPEM. https://doi.org/10.1515/jpem-2025-0719