Question

I have a question about my sexuality. I was born with Klinefelter's syndrome (XXY). I get a shot of testosterone every 3 weeks but it does not seem to do much for my libido or anything else. I'm 65, have diabetes mellitus, and am on blood thinners (to prevent clotting in my legs) and I have poor circulation.

I guess I should 'hang up my sexual hat', but I didn't find out about the XXY until I was 53, and I went through puberty at 54!

Answer

Even though you found out that you have Klinefelter's syndrome 11 years ago I'm wondering just how much your physician has explained to you. Here are a few remarks on it.

There are 23 pairs of chromosomes found in each cell of the body, and each contain genes that determine our coloring, our features, and our sex. Women inherit two X chromosomes - one from each parent, written XX. Men inherit an X chromosome from their mothers and a Y chromosome from their fathers, written XY.

The X chromosome determines whether a child is going to be a male or a female. X-chromosome mutations cause various human genetic disorders, such as Turner's syndrome and Klinefelter's syndrome.

In 1942, Dr. Harry Klinefelter published a report on 9 men who had enlarged breasts, sparse facial and body hair, small testes, and an inability to produce sperm. They were found to have an XXY chromosome configuration.

This XXY chromosome arrangement now appears to be one of the most common genetic abnormalities known, occurring as frequently as 1 in 500 to 1 in 1000 male births. Although the extra X chromosome is widespread, the syndrome itself - the set of symptoms and characteristics that may result - is uncommon. Many men live their lives without ever even suspecting that they have an additional chromosome. This is probably why it wasn't until you were in your 50's that you discovered that you had Klinefelter's syndrome.

In addition to the symptoms mentioned already, XXY males are more likely than others to be overweight, and tend to be taller than their fathers and brothers.

The symptoms are treatable. Surgery, when necessary, can reduce breast size. Regular injections of testosterone, beginning at puberty, can promote strength and facial hair growth as well a more muscular body type.

Adult XXYs are usually capable of normal erection and ejaculation. Though not able to manufacture enough sperm to father children, you should not automatically assume you are infertile without further testing. You will most likely be treated by an endocrinologist, a medical specialist who treats the endocrine (hormone-producing) glands.

Having diabetes could have a lot to do with your decreased sexual function, especially if it's not controlled. I would continue to receive your testosterone injections even though it doesn't seem to affect your libido at this time. The testosterone does work in unison with other circulating hormones to make you feel and function better on the whole.