We provide an in-depth review of the role of androgens in male maturation and development from the fetal stage through adolescence into emerging adulthood and discuss the treatment of disorders of androgen production throughout these time periods. Testosterone, the primary androgen produced by males, has both anabolic and androgenic effects. Androgen exposure induces virilization and anabolic body composition changes during fetal development, influences growth and virilization during infancy and stimulates development of secondary sexual characteristics, growth acceleration, bone mass accrual, and alterations of body composition during puberty. Disorders of androgen production may be subdivided into hypo- or hypergonadotropic hypogonadism. Hypogonadotropic hypogonadism may be congenital or acquired, resulting from cranial radiation or trauma, although there are many less common causes. Hypergonadotropic hypogonadism occurs in males with Klinefelter syndrome and may occur in response to pelvic radiation, certain chemotherapeutic agents, and other less common causes. These disorders all require testosterone replacement therapy during pubertal maturation and many require life-long replacement. Androgen (or gonadotropin) therapy is clearly beneficial in those with persistent hypogonadism and self-limited delayed puberty and is now widely used in transgender male adolescents. With more widespread use and newer formulations approved for adults, data from long-term randomized placebo-controlled trials are needed to enable pediatricians to identify the optimal age of initiation, route of administration and dosing frequency to address the unique needs of their patients.

中文翻译：

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婴儿期，儿童期和青春期的雄激素：生理学和临床实践中的用途。

我们提供了从胎儿期到青春期再到成年期的雄激素在男性成熟和发育中的作用的深入综述，并讨论了在这些时间段内雄激素产生障碍的治疗方法。睾丸激素是男性产生的主要雄激素，具有同化作用和雄激素作用。雄激素暴露会在胎儿发育过程中引起男性化和合成代谢的身体成分变化，在婴儿期影响生长和男性化，并刺激青春期继发性特征，生长加速，骨量增加和身体成分改变。雄激素产生障碍可细分为性腺机能减退或性腺机能减退。促性腺激素减退性性腺功能减退可能是先天性的或后天性的，是由于颅骨放射或创伤引起的，尽管有很多不常见的原因。促性腺激素性性腺功能低下症发生在患有克氏综合征的男性中，可能是由于盆腔辐射，某些化学治疗药物和其他较不常见的原因而发生。这些疾病在青春期成熟期间都需要睾丸激素替代疗法，许多疾病需要终生替代。雄激素（或促性腺激素）疗法对于患有持续性腺功能低下和自我限制的青春期延迟者显然是有益的，现在已广泛用于跨性别的男性青少年中。随着成人的更广泛使用和更新制剂的批准，需要长期随机安慰剂对照试验的数据，以使儿科医生能够确定最佳的起始年龄，给药途径和给药频率，以满足患者的独特需求。