The most difficult management decisions are posed by the more ambiguous genetic (XY) males. Most who are severely undervirilized, looking more female than male, are raised as females with surgical removal of the nonfunctional testes. If raised as males, a brief course of testosterone can be given in infancy to induce growth of the penis. Surgery may be able to repair the hypospadias. The testes should be salvaged by orchiopexy if possible. Testosterone must be replaced in order for puberty to occur and continued throughout adult life.
Measurements of levels of 17α-OHP are useful in the evaluation of patients with suspected congenital adrenal hyperplasia as the typical enzymes that are defective, namely 21-hydroxylase and 11β-hydroxylase , lead to a build-up of 17α-OHP. In contrast, the rare patient with 17α-hydroxylase deficiency will have very low or undetectable levels of 17α-OHP. 17α-OHP levels can also be used to measure contribution of progestational activity of the corpus luteum during pregnancy as progesterone but not 17α-OHP is also contributed by the placenta .
The Mesterolone hormone is not estrogenic. It does not aromatize and it carries no progestin nature. As a result, the side effects of Proviron will not include any related effects such as gynecomastia or excess water retention. Such adverse effects are impossible with this steroid. This will also greatly reduce the risk of high blood pressure as high blood pressure associated with anabolic steroid use is often due to extreme water retention. In fact, Proviron should provide an anti-estrogenic effect by preventing testosterone to estrogen conversion or at least tremendously slow it down.