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Early Testis Examination Stated Early Stage Of Puberty. Chances Of Fake Report?

Posted on Mon, 21 Oct 2013

Question: hi there. I have some notes of when i was 14.5 years old my testis examination. Note says i was in 'early stage of puberty' . what if the doctor lied when she noted this down? Is it possible ??

Answered by Dr. Polash Sannigrahi (49 minutes later)

Brief Answer:
Kindly attach the examination notes

Detailed Answer:
Dear XXXXX,

Thanks for your query.

In your post you have mentioned your gender as Female & you are concerned regarding notes on testis examination.
Testis is a primary reproductive organ in Males & it is not present in Females.

So, there is obviously some mistake in the examination report.
Kindly attach the report with your post using the option provided on this query page. You have a feature for the same.

It will help us in understanding your concern in a better way.

Wishing you a good health.
Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Polash Sannigrahi (18 hours later)

Hello. At the moment i cannot upload. Sorry for misunderstanding, but i am MALE.

I experienced rapid pubertal progress during 15.2 years of age ( XXXXXXX stage 3/4)

I understand hormonal activity must be present prior to stage 3/4 by several years....is this correct? (Because this would then PROVE i had hormones)

and prior to onset of puberty XXXXXXX stage (4ml testis) , hormone is present prior to this landmark by 2 years? Is this correct? Thanks

Answered by Dr. Polash Sannigrahi (7 hours later)

Brief Answer:
Neuro-hormonal response starts 1-2 yrs before

Detailed Answer:
Hello XXXXX,

Thanks for your follow up query.

The XXXXXXX staging is used only to measure an individual’s maturity status & not for age estimation.
The testis are formed during the intra-uterine stage but when a male reaches the Pubertal age (begins by 11-12 yrs & completes by 16-17 yrs) the brain gives signal for the production of Hormones, which in turn results in appearance of secondary sexual characters like hoarseness of voice, male pattern of body & facial hair, musculature, increase in size of testes & penis, etc.

This neuro-hormonal response starts 1-2 yrs before the appearance of any noticeable change in the body.
So, if you were in XXXXXXX stage 3/4 at 15.2 yrs of age, then it is obvious that hormone production has already started prior to it for the bodily changes to occur.

Hope I have been able to answer your query.
If you have additional questions or follow up queries then please do not hesitate in writing to us.
I will be happy to answer them.

Wishing you a Good Health.
Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Polash Sannigrahi (2 days later)

Thank you Dr Polash for answer.

One final question relating to this subject, if i may ask.

I understand around puberty time, testosterone and androgens interact with pitutary gland and various other areas in body, via the androgen receptor.

Does testosterone interact with pituitary gland in baby boy after birth, when test levels are said to be high??

kind Regards

Answered by Dr. Polash Sannigrahi (10 hours later)

Brief Answer:
Kindly view the details

Detailed Answer:
Dear XXXXX,

Thanks for your follow up query.

You are correct regarding the fact that around puberty time, testosterone and androgen interact with pituitary gland and various other areas in body, via the androgen receptor.

The testosterone levels rise in the first weeks of life for male infants, but the reason or function of such a rise is not known.
Studies done on animal models have revealed effects on brain development- brain masculinization, negative feedback effects on pituitary gland (that is inhibition of pituitary gland to secrete hormones), effects on bones & overall growth.

But, most of these effects have been poorly understood as their mechanisms are still not clear.

Hope I have been able to answer your query.
Please let me know if I need to clarify further.

Regards,
Dr. Polash

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Polash Sannigrahi (10 hours later)

Thanks Dr. Polash for the answer.

In healthy subjects, does circulating androgens within baby boys always lead to binding to androgen receptors of ALL sites where they are found (in pituitary, bones, brain, gonads etc) ??

Or is it when they are baby it doesnt bind, but if teenager/man it does?

Hope you can clarify this final question as its important for me.

Wishing you all the best

Regards,
XXXXX

Answered by Dr. Polash Sannigrahi (14 hours later)

Brief Answer:
Kindly view the details

Detailed Answer:
Dear XXXXX,

Thanks for your follow up query.

Neonatal testis produces testosterone, which gains access to the brain and is further metabolized into active androgens and estrogens, which modify brain development.
No significant changes have been identified in other parts of the human body.
So, it can be assumed that it does not bind to all the available androgen receptors or even if it binds, it does not produce any noticeable significant effect.

By 4-6 months of age, the levels of Testosterone is not detectable in the body.
As I have already mentioned in my previous answer, the various mechanisms of action of Testosterone are poorly understood & most of the studies have been carried in animal models.
However, studies have shown increased levels of androgen as the pubertal age approaches.
During this time, androgen binding occurs at all the receptors & results in respective changes in the body, which are measured on XXXXXXX scale.

Hope I have been able to answer your query.
Please let me know if I need to clarify further.

Regards,
Dr. Polash

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Polash Sannigrahi (12 hours later)

Thank you for great answer.

I want to make picture in my mind if possible.

In the case it doesnt bind, does the testosterone enter the cell and then exit again with out binding?

Or, does it just brush against the cell?

The reason i ask is i would be very happy, if proven that binds to all cells in early stages of life, even if no significant action takes place.

Thank you Dr Polash, wishing you all the best

Answered by Dr. Polash Sannigrahi (18 hours later)

Brief Answer:
Kindly view the details

Detailed Answer:
Dear XXXXX,

Thanks for your follow up query.

Testosterone being a steroid hormone, its receptor is present within the cell.
Once it attaches with the receptor, it is carried inside the nucleus of the cell where it demonstrates its effect by DNA synthesis & protein formation.
If testosterone does not bind to the receptor, there is no possibility of any subsequent effect.
However, even if it binds to the receptor & then does not enter the nucleus or fails to synthesize the DNA & proteins, then also no effects can be appreciated.

But the studies do not provide evidence on whether it binds to all cells in early stages of life of a healthy subject, even if no significant action takes place.
Studies suggest that the elevation of male serum Testosterone during the first months of life lacks biological significance.
Most of the Testosterone gets bound with albumin or hormone-binding globulin & degraded into inactive products that are subsequently excreted.

Regards,
Dr. Polash

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Polash Sannigrahi (32 hours later)

Thank you Dr Polash for the advice.

Are testosterone receptors present in the usual target cells at all ages (birth to old age) ?

or is there any reason at birth for it to only be present in gonads (to allow genital development) and only in subsequent years become present in other sites such as pituitary gland?

Wishing you all the best

Regards

Answered by Dr. Polash Sannigrahi (27 hours later)

Brief Answer:
Kindly view the details

Detailed Answer:
Dear XXXXX,

Thanks for your follow up query.

Testosterone receptors were detected in the male embryonic cartilaginous tissue. The increase in receptor levels seems to reflect the maturation and growth of the fetal skeleton.

Non-genital fetal tissues (bladder, lung, great vessel, trachea, muscle, scalp skin, kidney, thyroid, intestine, thymus, stomach and rectum) also show the presence of androgen receptor.

Based on the above studies, we can conclude that the receptors are present from embryonic life itself.
Regarding their function, as I have already mentioned in my previous answers, they are regulated by the higher centers in brain & are fully functional only during pubertal age group.

Regards,
Dr. Polash

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Above answer was peer-reviewed by : Dr. Vaishalee Punj