Table 5.

Advantages and disadvantages of various hormonal therapies for microphallus

Hormonal therapy	Advantages	Disadvantages
Intramuscular testosterone	Promotes penile growth and development by addressing testosterone deficiencies. Enhances the development of secondary sexual characteristics. Improves muscle mass, bone density, and overall well-being	Potential side effects include acne, mood swings, increased aggression, and accelerated skeletal maturation. May suppress natural testosterone production if used long-term. Requires regular monitoring of hormone levels and administration through injections or topical applications
Topical	Non-invasive administration, more comfortable. Gradual absorption with more stable and consistent hormone levels. Less Pain and Discomfort. Easy Application and more convenient treatment option	Erratic absorption with hormonal fluctuations, limited efficacy, and uncertain outcomes. Risk of transfer to others, especially children and women, through close physical contact with the application site. Skin Sensitivity and allergic reactions to the topical product. Lack of Standardization
hCG	Stimulates the testes to produce testosterone, aiding in penile growth. Can be used in combination with other hormonal therapies for enhanced results. Administration via injections or subcutaneous pellets	Potential side effects may include fluid retention, breast tenderness, and mood swings. Requires careful monitoring and adjustment of dosages to avoid adverse effects
Aromatase inhibitors	Inhibit the conversion of androgens to estrogen, potentially increasing testosterone levels and aiding penile growth. May be considered for individuals with aromatase excess syndrome	Limited evidence on efficacy and safety for promoting penile growth. ‎Possible side effects include joint pain, mood swings, and bone density issues
GH therapy	Stimulates growth and may indirectly impact penile growth. Beneficial for children with growth hormone deficiencies or short stature	Limited evidence regarding the direct impact on penile growth in microphallus cases. Potential side effects include fluid retention, joint pain, and increased risk of diabetes
GH therapy	Combines multiple hormones (e.g., testosterone, hCG) to synergize and enhance penile growth potentially. May optimize hormonal treatment effectiveness for promoting penile growth	Increased complexity of treatment regimen with potential for elevated side effects due to multiple hormonal agents. Requires vigilant monitoring and management of potential adverse effects

hCG: Human chorionic gonadotropin; GH: Growth hormone.