Dihydrotestosterone (DHT) (referred to as androstanolone or stanolone when used medically) can also be used in place of testosterone as an androgen. The availability of DHT is limited; it is not available in the United States or Canada, for instance, but it is available in certain European countries, including the United Kingdom , France , Spain , Belgium , Italy , and Luxembourg .  DHT is available in formulations including topical gel, buccal or sublingual tablets, and as esters in oil for intramuscular injection.  Relative to testosterone, and similarly to many synthetic AAS, DHT has the potential advantages of not being locally potentiated in so-called androgenic tissues that express 5α-reductase (as DHT is already 5α-reduced) and of not being aromatized into an estrogen (it is not a substrate for aromatase).
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If testosterone deficiency occurs during foetal development, then masculinisation of the foetus will fail to occur normally and this may give rise to disorders of sex development. If testosterone deficiency occurs during puberty, a boy’s growth may slow and no growth spurt will be seen. The child may also fail to develop full sexual characteristics (hypogonadism) associated with men undergoing puberty, including development of pubic hair, growth of the penis and testes and deepening of the voice. Around the time of puberty, boys with too little testosterone may also have less than normal strength and endurance, and their arms and legs may continue to grow out of proportion with the rest of their body.