Reversal of Idiopathic hypogonadotropic hypogonadism triggered by testosterone therapy

A 21-year-old male presented to us with delayed development of secondary sexual characteristics. Based on examination and investigations, a diagnosis of idiopathic hypogonadotropic hypogonadism was made and the patient was started on testosterone therapy. After around a year of therapy the patient had an increase in bilateral testicular volume with increased serum luteinizing hormone (LH) values. The patient was advised to stop treatment. On follow-up there was persistence of increase in LH values with maintenance of normal serum testosterone values. Thus the case highlights the importance of regular follow-up in cases of idiopathic hypogonadotropic hypogonadism to watch for reversal.   Key words: Puberty, hypogonadism, reversal.