The effect of sex hormone replacement therapy on behavior problems and moods in adolescents with delayed puberty

Objective: The objective of this clinical study was to determine the effects of sex steroids on behavior and mood in adolescents with hypogonadism. Study design: The experimental design consisted of a randomized, double-blind, placebo-controlled, crossover trial lasting for 21 months. The study group consisted of 39 boys and 16 girls recruited from a pediatric endocrine clinic for delayed puberty. Depo-testosterone (to boys) or conjugated estrogens (to girls) was administered in 3-month blocks, alternating with placebo, at 3 dose levels approximating early, middle, and late pubertal amounts. The Child Behavior Checklist, Youth Self Report, Differential Emotion Scale, and Daily Mood Diary were administered after each placebo and treatment period to ascertain the effect of sex steroids on self- and parent-reported behavior problems and moods. Results: The data demonstrated only one significant treatment effect, namely, an increase in withdrawn behavior problems during administration of low-dose estrogen in girls. There were no consistent sex differences. Conclusion: These results demonstrate that administered testosterone or estrogen has minimal effects on behavior problems or mood in adolescents. (J Pediatr 1998;133:521-5)