Spondylolisthesis – a bit more about the signs and symptoms of Spondylolisthesis?

Spondylolisthesis
Spondylolisthesis

Spondylolisthesis

Spondylolisthesis is where a bone in the spine (vertebra) slips out of position, either forwards or backwards.

It’s most common in the lower back (lumbar spine), but it can also occur in the mid to upper back (thoracic spine) or the neck (cervical spine).

Spondylolisthesis isn’t the same as a slipped disc, which is where one of the spinal discs between the vertebrae ruptures.

Symptoms of spondylolisthesis

Many people may not realise they have spondylolisthesis because it doesn’t always cause symptoms.

Symptoms can include:

lower back pain – which is usually worse during activity and when standing, and is often relieved by lying down

pain, numbness or a tingling sensation radiating from your lower back down your legs (sciatica) – this occurs if the slipped vertebra presses on a nerve

tight hamstring muscles

stiffness or tenderness in your back

excessive curvature of the spine (kyphosis)

The severity of these symptoms can vary considerably from person to person.

What causes spondylolisthesis?

There are five main types of spondylolisthesis, each with a different cause. Spondylolisthesis can be caused by:

a birth defect in part of the vertebra – this can cause it to slip forward (dysplastic spondylolisthesis)

repetitive trauma to the spine – this results in a defect developing in the vertebra, which can cause it to slip; this is known as isthmic spondylolisthesis and is more common in athletes such as gymnasts and weightlifters

the joints of the vertebrae becoming worn and arthritic – this is known as degenerative spondylolisthesis and is more common in older people

a sudden injury or trauma to the spine – such as a fracture, which can result in the vertebra slipping forward (traumatic spondylolisthesis)

a bone abnormality – this could be caused by a tumour, for example (pathologic spondylolisthesis)

When to see your GP

You should see your GP if:

you have persistent back pain or stiffness

you have persistent pain in your thighs or buttocks

your back curves outwards excessively

Your GP may examine your back, although there aren’t usually any visible signs of spondylolisthesis.

Your GP may ask you to do a straight leg raise test, where you lie on your back while your GP holds your foot and lifts your leg up, keeping your knee straight. This is often painful if you have spondylolisthesis.

Spondylolisthesis can easily be confirmed by taking an X-ray of your spine from the side while you’re standing. This will show whether a vertebra has slipped out of position or if you have a fracture.

If you have pain, numbness, tingling or weakness in your legs, you may need additional imaging tests, such as a computerised tomography (CT) scan or magnetic resonance imaging (MRI) scan. These more detailed scans will be able to help determine whether you have a compressed nerve in your back.

Treating spondylolisthesis

The way spondylolisthesis is treated will depend on your symptoms and how severe they are. In most cases non-surgical treatments will be recommended first.

Non-surgical treatments

Initial treatments for spondylolisthesis may include:

a short period of rest, avoiding activities such as bending, lifting, contact sports and athletics

anti-inflammatory painkillers, such as ibuprofen, or stronger painkillers available on prescription can help reduce pain and inflammation

physiotherapy – simple stretching and strengthening exercises may help increase the range of motion in your lower back and hamstrings

if you have pain, numbness and tingling in your legs, corticosteroid injections around the compressed nerve and into the spinal canal may be recommended

These measures will only provide temporary symptom relief, but your symptoms may disappear completely with time.

Back braces sometimes used to be recommended for some people with spondylolisthesis. However, there are concerns that bracing may actually weaken the spine and fail to improve symptoms.

Surgery

Surgery may be recommended if non-surgical treatments are ineffective and your symptoms are severe, persistent, or suggest you have a compressed nerve in your spine.

The exact surgical procedure you need will depend on the type of spondylolisthesis you have.

It usually involves fusing the slipped vertebra to the neighbouring vertebrae using metal screws and rods, and a piece of your own bone taken from an area nearby. The screws and rods are usually left in place permanently.

In some cases the spinal disc being compressed between your vertebrae may also be removed. It will be replaced by a small “cage” containing a bone graft to hold your vertebrae apart.

The operation is performed under general anaesthetic, which means you’ll be unconscious while it’s carried out.

Surgery is often effective at relieving many of the symptoms of spondylolisthesis, particularly pain and numbness in the legs.

However, it’s a major operation that involves up to a week-long stay in hospital and a recovery period lasting months, where you have to limit your activities.

Spinal surgery for spondylolisthesis also carries a risk of potentially serious complications, including:

infection at the site of the operation

blood clot developing in one of the veins in your leg – known as deep vein thrombosis (DVT)

damage to the spinal nerves or spinal cord, resulting in continuing symptoms, numbness or weakness in the legs, or, in rare cases, some degree of paralysis or loss of bowel or bladder control

Because of the possibility of complications, make sure you discuss the operation in detail with your doctor or surgeon before deciding to have surgery.

Read more about lumbar decompression surgery, a type of spinal surgery used to treat compressed nerves in the lower (lumbar) spine.

Devic’s disease – what are the signs of Devic’s disease?

Devic's disease
Devic’s disease

Neuromyelitis optica (NMO), also known as Devic’s disease, is a rare neurological condition.

Neurological conditions are caused by disease or damage to the brain, spinal cord or nerves.

NMO most commonly affects the optic nerves and spinal cord, which can lead to optic neuritis and transverse myelitis (see below).

Some people may only experience optic neuritis or myelitis but may have the aquaporin-4 antibody (also see below). In such cases, a person is said to have an NMO spectrum disorder (NMOSD).

Each person with NMO will experience different symptoms and require individually tailored care and support.

Some of the main symptoms of NMO include:

muscle weakness – reduced strength in one or more muscles that can affect mobility

impaired eyesight

nerve pain – which can be a sharp, burning, shooting or numbing pain

spasms and increased muscle tone – from nerve damage that affects muscle control

bladder, bowel and sexual problems

NMO UK has more information about the symptoms of NMO.

Optic neuritis

Optic neuritis is inflammation of the nerve that leads from the eye to the brain. It causes a reduction or loss of vision, and can affect both eyes at the same time.

Other symptoms of optic neuritis include eye pain, which is usually made worse by movement, and reduced colour vision where colours may appear ‘washed out’ or less vivid than usual.

Transverse myelitis

Transverse myelitis is inflammation of the spinal cord. It causes weakness in the arms and legs which can range from a mild ‘heavy’ feeling in one limb, to complete paralysis in all four limbs.

It may cause numbness, tingling or burning below the affected area of the spinal cord and increased sensitivity to touch, cold and heat. There may also be tight and painful muscle contractions (known as tonic muscle spasms).

Relapses in NMO

An attack or relapse of NMO results in the nervous system becoming inflamed. The inflammation usually occurs in the optic nerve and spinal cord, and causes new symptoms or the recurrence of previous symptoms.

Less common symptoms of NMO can include unexplained nausea and vomiting, unexplained itching and tonic spasms (painful muscle contractions). In someone with known NMO, these symptoms may signify a new relapse.

NMO symptoms can range from mild to severe. In some cases, there may only be one attack of optic neuritis or transverse myelitis, with good recovery and no further relapses for a long time.

However, in severe cases, there can be a number of attacks which lead to disability. Disability occurs because the body can’t always fully recover from damage caused by the attacks on the spinal cord and optic nerve.

NMO UK has more information about NMO relapses.

What causes NMO?

NMO is an autoimmune condition, which means a person’s immune system (the body’s natural defence against illness and infection) reacts abnormally and attacks the body’s tissues and organs.

An antibody against a protein called aquaporin-4 is present in the blood of up to 80% of people with NMO.

Antibodies are proteins produced by the body to destroy disease-carrying organisms and toxins.

In NMO, the immune system attacks aquaporin-4 which damages the myelin sheath (the protective layer that surrounds nerve cells in the brain and spinal cord and helps transmit nerve signals).

Who’s affected by NMO?

NMO is a rare condition. In Europe, it’s estimated that there’s one case of NMO for every 100,000 people. In the UK, it’s thought that NMO affects less than 1,000 people.

NMO can affect anyone but it’s more common in women than men, with about four females being affected for every male.

Although the condition is thought to be more common in people of Asian and African descent, an increasing number of white (Caucasian) people are also being diagnosed.

Diagnosing NMO

It’s important that NMO is correctly diagnosed. It can sometimes be confused with multiple sclerosis, which also affects the brain and spinal cord and has similar symptoms. However, the treatment is different.

A neurology specialist will discuss your symptoms and medical history with you.

You’ll have a magnetic resonance imaging (MRI) scan of your brain and spinal cord. Some people with NMO (up to 60%) have lesions on their brain and spine, which are different to the lesions of someone with MS.

A blood sample will be taken and tested for aquaporin-4 antibodies.

A lumbar puncture is another test you may have. A sample of cerebrospinal fluid (CSF) is taken from the spine using a hollow needle that’s inserted into the lower part of the spine.

The fluid sample will be sent to a laboratory to be tested and to look for evidence of conditions affecting the brain, spinal cord or other parts of the nervous system.

In some cases of transverse myelitis, there’s an increase in the level of proteins or white cells.

NMO UK has more information about how NMO is diagnosed.

Treating NMO

There’s no cure for NMO, so treatment aims to manage attacks and symptoms, and prevent relapses.

Every person with NMO is affected differently and some may have much milder symptoms than others. However, early treatment is usually needed to prevent further episodes and permanent disability.

Medication is used to reduce nerve inflammation, suppress the immune system and treat any pain. Rehabilitation techniques, such as physiotherapy, can also help with any reduced mobility that the relapses cause.

At these centres, research is ongoing to find possible future treatments for NMO.

To be referred to one of these centres, a GP referral letter is all that’s needed. These specialist services are nationally funded, so GP practices won’t have any additional costs for referring.

NMO UK has more information about treatments for NMO.

Driving

Optic neuritis (inflammation of the optic nerve) could affect your ability to drive.

Stevens-Johnson syndrome – What are the signs and symptoms of Stevens-Johnson syndrome?

Stevens-Johnson syndrome is a rare but serious disorder that affects the skin, mucous membrane, genitals and eyes.

The mucous membrane is the soft layer of tissue that lines the digestive system from the mouth to the anus, as well as the genital tract (reproductive organs) and eyeballs.

Stevens-Johnson syndrome is usually caused by an unpredictable adverse reaction to certain medications. It can also sometimes be caused by an infection.

The syndrome often begins with flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off.

Stevens-Johnson syndrome is a medical emergency that requires treatment in hospital, often in intensive care or a burns unit.

Treatment aims to identify the underlying cause, control the symptoms and prevent complications.

Erythema multiforme is a similar, but less severe, skin reaction that’s usually caused by infection, particularly herpes viral infections, and a bacteria called mycoplasma that causes chest infections.

 

Symptoms of Stevens-Johnson syndrome

Skin pain is the most common symptom of Stevens-Johnson syndrome.

Flu-like symptoms are also usually present during the initial stages, and may include:

feeling generally unwell

a high temperature (fever) of 38C (100.4F) or above

headache

joint pain

cough

After a few days a rash appears, which may look like a target – darker in the middle and lighter around the outside (see below). The rash isn’t usually itchy, and spreads over a number of hours or days. Large blisters then develop on the skin, which after bursting leave painful sores.

Facial swelling and swollen lips covered in crusty sores are common features of Stevens-Johnson syndrome. The mucous membranes inside your mouth, throat, eyes and genital tract may also become blistered and ulcerated. This can make swallowing painful and lead to serious problems such as dehydration.

The surface of the eyes can also sometimes be affected, which if not treated quickly can cause corneal ulcers and vision problems

Causes of Stevens-Johnson syndrome

In children, Stevens-Johnson syndrome is usually triggered by a viral infection, such as

mumps

flu

herpes-simplex virus, which causes cold sores

Coxsackie virus, which causes Bornholm disease

Epstein-Barr virus, which causes glandular fever

Less commonly, bacterial infections can also trigger the syndrome.

In adults, Stevens-Johnson syndrome is often caused by an adverse reaction to medication. The medications associated with a high risk of Stevens-Johnson syndrome are:

allopurinol

carbamazepine

cotrimoxazole and other anti-infective sulfonamides – including sulfasalazine, sulfadiazine, sulfadoxine and sulfafurazole

lamotrigine

nevirapine

certain types of non-steroidal anti-inflammatory drugs (NSAIDs) – including meloxicam, piroxicam and tenoxicam

phenobarbital

phenytoin

sertraline

As a result of the associated risk, a thorough evaluation of the expected benefits of treatment is required when prescribing the above medications. Doctors are advised to carefully consider using these medications as first-line treatments, particularly if there are safer alternatives.

It’s important to emphasise that Stevens-Johnson syndrome is rare, and the overall risk of getting the syndrome is low, even for people using “high risk” medications (one in 1,000 to one in 100,000).

Risk factors

Risk factors for Stevens-Johnson syndrome may include:

viral infections – such as herpes, hepatitis, viral pneumonia or HIV

a weakened immune system – as a result of HIV or AIDS, autoimmune conditions, such as lupus, or certain treatments, such as chemotherapy and organ transplants

a previous history of Stevens-Johnson syndrome – if the syndrome was previously caused by medication, you’re at risk of it reoccurring if you take the same medication again, or medications from the same family of medications

a family history of Stevens-Johnson syndrome – if a close family member has had the syndrome, your risk of getting it may be increased

Specific genes have also been identified that increase the risk of Stevens-Johnson syndrome among certain groups of people.

For example, Chinese people with the HLA B1502 gene have experienced Stevens-Johnson syndrome after taking carbamazepine, and allopurinol has also triggered the syndrome in Chinese people with the HLA B1508 gene.

Diagnosing Stevens-Johnson syndrome

Stevens-Johnson syndrome should be diagnosed by a dermatologist (skin specialist). A diagnosis is often based on a combination of your:

symptoms

physical examination

medical history (including any medication you’ve recently taken)

To confirm the diagnosis, a small sample of skin may be removed (biopsy) so that it can be tested in a laboratory.

Treating Stevens-Johnson syndrome

If Stevens-Johnson syndrome is suspected, you or your child will be immediately referred to hospital for treatment. Without treatment, the symptoms can become very severe and be life-threatening.

Severe cases of Stevens-Johnson syndrome may need to be treated in an intensive care unit (ICU) or burns unit.

The first step is to stop taking any medications that may be causing Stevens-Johnson syndrome. However, it can sometimes be difficult to determine which medication is causing it, so stopping all non-essential medications may be recommended.

Treatment for relief of symptoms while in hospital may include:

cool, moist compresses held against the skin – dead skin may be gently removed and a sterile dressing placed over the affected area

regularly applying a plain (unscented) moisturiser to the skin

replacement fluids – you may receive fluids and nutrition through a tube that’s passed through your nose and into your stomach (a nasogastric tube)

mouthwashes containing anaesthetic and/or antiseptic – to temporarily numb your mouth and make swallowing easier

a short course of corticosteroid tablets (topical corticosteroids) to control skin inflammation (only on specialist advice)

antibiotics – if blood poisoning (sepsis) is suspected

eyedrops or eye ointment – for eye-related symptoms

Once the cause of Stevens-Johnson syndrome has been identified and successfully treated (in the case of an infection), or stopped (in the case of medication), the skin reaction will stop. New skin may start to grow after a few days.

However, the length of time it takes to recover from Stevens-Johnson syndrome will depend on how severe it is, and it can sometimes take many weeks or months to fully recover.

If the cause was an adverse reaction to medication, you’ll need to avoid that medication and possibly other similar medications for the rest of your life. The doctor treating you will be able to advise you further about this.

Complications of Stevens-Johnson syndrome

As Stevens-Johnson syndrome severely affects the skin and mucous membranes, it can cause a number of complications. These include:

skin changes – when your skin grows back it may be uneven in colour; less commonly, scarring may occur

secondary skin infection (cellulitis) – which can lead to further, serious problems such as blood poisoning (sepsis)

problems with internal organs – organs can become inflamed – for example, the lungs (pneumonia), heart (myocarditis), kidneys (nephritis) or liver (hepatitis); the oesophagus may also become narrowed and scarred (oesophageal stricture)

eye problems – the rash can cause problems with your eyes which, in mild cases, may be irritation and dry eyes, or in severe cases may result in corneal ulceration, uveitis (inflammation of the uvea, which is the middle layer of the eye) and, possibly, blindness

Problems with the sexual organs, such as vaginal stenosis (narrowing of the vagina caused by a build-up of scar tissue), and scarring of the penis, is also a possible complication of Stevens-Johnson syndrome.

Preventing Stevens-Johnson syndrome

If Stevens-Johnson syndrome has been caused by an adverse reaction to a medication, you’ll need to avoid taking this medication and other similar medications. Other family members may also want to avoid using the medication in case there’s a genetic susceptibility within your family.

If you’ve had Stevens-Johnson syndrome in the past, and your doctor thinks you’re at risk of getting it again in the future, you’ll be warned to look out for the symptoms.

If you’re of Chinese, southeast Asian or Indian descent, genetic testing may be recommended before taking medications, such as carbamazepine and allopurinol, that are known to have an associated risk of causing Stevens-Johnson syndrome. Testing will help determine whether you carry the genes (HLA B1502 and HLA B1508) that have been associated with the syndrome when taking these medications.

Bell’s palsy – what are the signs of Bell’s palsy?

Bell's palsy
Bell’s palsy

Introduction

Bell’s palsy is a condition that causes temporary weakness or paralysis of the muscles in one side of the face. It is the most common cause of facial paralysis.

Other causes of facial paralysis include:

  • congenital facial palsy – children born with facial weakness
  • injury to the facial nerve in an accident – such as a cut to the cheek or skull base fracture
  • injury from surgery – which is most common during surgery of the parotid gland and neck

What are the symptoms?

The symptoms of Bell’s palsy vary from person to person. The weakness on one side of the face can be described as either:

  • partial palsy, which is mild muscle weakness
  • complete palsy, which is no movement at all (paralysis) – although this is very rare

Bell’s palsy can also affect the eyelid and mouth, making it difficult to close and open them. In rare cases, it can affect both sides of a person’s face.

Read more about the symptoms of Bell’s palsy

When to seek medical advice

As well as being a symptom of Bell’s palsy, facial weakness or paralysis can also be a sign of a more serious condition – such as a stroke.

Visit your nearest A&E department immediately or call 999 for an ambulance if you or someone you are with develops sudden facial paralysis, so a doctor can determine the cause.

Bell’s palsy is only diagnosed if other possible causes of your symptoms are ruled out.

Read more about diagnosing Bell’s palsy.

Why does it happen?

Bell’s palsy is believed to occur when the nerve that controls the muscles in your face becomes compressed.

The exact cause is unknown, although it’s thought to be because the facial nerve becomes inflamed, possibly due to a viral infection.

The herpes virus is thought to be the most common cause but other viruses may also be responsible.

Read more about the causes of Bell’s palsy

Who is affected?

Bell’s palsy is a rare condition that affects about one in 5,000 people a year. It’s most common in people aged 15-60, but people outside this age group can also suffer from the condition. Both men and women are affected equally.

Bell’s palsy is more common in pregnant women and those with diabetes and HIV, for reasons that are not yet fully understood.

Treating Bell’s palsy

Around seven out of 10 people with Bell’s palsy make a complete recovery, with or without treatment.

Most people notice an improvement in their symptoms after about two to three weeks but a complete recovery can take up to nine months. The recovery time varies from person to person and will depend on the amount of nerve damage.

Prednisolone, a type of corticosteroid, is used to reduce the swelling of the facial nerve.

Eye drops may be required to prevent problems if you are unable to close your eye. Tape may also be used to close the eye while sleeping.

Read more about treatments for Bell’s palsy.

Complications

Around three in 10 people with Bell’s palsy will continue to experience weakness in their facial muscles, and two in 10 will be left with a more serious long-term problem.

Complications include:

  • persistent facial weakness
  • eye problems
  • difficulty with speech, eating and drinking
  • reduced sense of taste
  • facial muscle twitching

Bell’s palsy may reoccur in up to 14% of people, especially if there is a family history of the condition.

Read more about the complications of Bell’s palsy.

Klinefelter syndrome – what is Klinefelter syndrome and what are the signs and symptoms of the condition!

Klinefelter syndrome
Klinefelter syndrome

Introduction

Klinefelter syndrome (sometimes called Klinefelter’s, KS or XXY) is where boys and men are born with an extra X chromosome.

Chromosomes are packages of genes found in every cell in the body. Two types of chromosome, called the sex chromosomes, determine the genetic sex of a baby. These are named either X or Y.

Usually, a female baby has two X chromosomes (XX) and a male has one X and one Y (XY). But in Klinefelter syndrome, a boy is born with an extra copy of the X chromosome (XXY).

The X chromosome is not a “female” chromosome and is present in everyone. The presence of a Y chromosome denotes male sex.

Boys and men with Klinefelter syndrome are still genetically male, and often will not realise they have this extra chromosome, but occasionally it can cause problems that may require treatment.

Klinefelter syndrome is quite common, affecting around 1 in every 660 males.

 

Symptoms of Klinefelter syndrome

Klinefelter syndrome doesn’t usually cause any obvious symptoms early in childhood, and even the later symptoms may be difficult to spot.

Many boys and men don’t realise they have it.

  • in babies and toddlers – learning to sit up, crawl, walk and talk later than usual, being weaker, quieter and more passive than usual

     

    in childhood – shyness and low self-confidence, problems with reading, writing, spelling and paying attention, mild dyslexia and/or dyspraxia, low energy levels, difficulty socialising or expressing feelings

    in teenagers – growing taller than expected for the family (with long arms and legs), broad hips, poor muscle tone and slower than usual muscle growth, reduced facial and body hair that starts growing later than usual, a small penis and testicles, enlarged breasts (gynaecomastia)

    in adulthood – inability to have children naturally (infertility) and a low sex drive, in addition to the physical characteristics mentioned above

Health issues in Klinefelter syndrome

Most boys and men with Klinefelter syndrome will not be significantly affected and can live normal, healthy lives.

Infertility tends to be the main problem, although there are treatments that can help (see Treatments below).

However, men with Klinefelter syndrome are at a slightly increased risk of developing other health problems, including:

type 2 diabetes

weak and fragile bones (osteoporosis)

cardiovascular disease and blood clots

autoimmune disorders (where the immune system mistakenly attacks the body), such as lupus

an underactive thyroid gland (hypothyroidism)

anxiety, learning difficulties and depression – although intelligence is usually unaffected

male breast cancer – although this is very rare

These problems can usually be treated if they do occur and testosterone replacement therapy may help reduce the risk of some of them.

Causes of Klinefelter syndrome

Klinefelter syndrome is caused by an additional X chromosome.

This chromosome carries extra copies of genes, which interfere with the development of the testicles and mean they produce less testosterone (male sex hormone) than usual.

The extra genetic information may either be carried in every cell in the body or it may only affect some cells (known as mosaic Klinefelter syndrome).

Klinefelter syndrome isn’t directly inherited – the additional X chromosome occurs as a result of either the mother’s egg or the father’s sperm having the extra X chromosome (an equal chance of this happening in either), so after conception the chromosome pattern is XXY rather than XY.

This change in the egg or sperm seems to happen randomly. If you have a son with the condition, the chances of this happening again are very small.

However, the risk of a woman having a son with Klinefelter syndrome may be slightly higher if the mother is over 35 years of age.

Testing for Klinefelter syndrome

See your GP if you have concerns about your son’s development or you notice any troubling symptoms of Klinefelter syndrome in yourself or your son.

Klinefelter syndrome isn’t necessarily anything serious, but treatment can help reduce some of the symptoms if necessary.

In many cases, it’s only detected if a man with the condition undergoes fertility tests.

Your GP may suspect Klinefelter syndrome after a physical examination and they may suggest sending off a sample of blood to check reproductive hormone levels.

The diagnosis can be confirmed by checking a sample of blood for the presence of the extra X chromosome.

Treatments for Klinefelter syndrome

There’s no cure for Klinefelter syndrome, but some of the problems associated with the condition can be treated if necessary.

Possible treatments include:

testosterone replacement therapy (see below)

speech and language therapy during childhood to help with speech development

educational and behavioural support at school to help with any learning difficulties or behaviour problems

occupational therapy to help with any co-ordination problems associated with dyspraxia

physiotherapy to help build muscle and increase strength

psychological support for any mental health issues

fertility treatment – options include artificial insemination using donor sperm or possibly intra-cytoplasmic sperm injection (ICSI), where sperm removed during a small operation are used to fertilise an egg in a laboratory

breast reduction surgery to remove excess breast tissue

Testosterone replacement therapy

TRT involves taking medication containing testosterone. It can be taken in the form of gels or tablets in teenagers, or given as gel or injections in adult men.

TRT may be considered once puberty begins and may help with the development of a deep voice, facial and body hair, an increase in muscle mass, reduction in body fat, and improvement in energy. You should see a specialist in children’s hormones (a paediatric endocrinologist) at this time.

Long-term treatment during adulthood may also help with several other problems associated with Klinefelter syndrome – including osteoporosis, low mood, reduced sex drive, low self-esteem and low energy levels – although it can’t reverse infertility.

More information and support

If you or your son has been diagnosed with Klinefelter syndrome, you might find it useful to find out more about it and get in touch with others affected by it.

The following websites may be able to help:

Klinefelter’s Syndrome Association UK

Klinefelter Organisation

Contact a Family