Clinical summary guide

Klinefelter syndrome

6 min

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The GP’s role

Clinical notes

Some features of Klinefelter syndrome are related to the syndrome (e.g. behavioural and cognitive) and some features relate to androgen deficiency (e.g. osteoporosis).

Condition overview

Image 1 – 30mL (normal)(left)/4mL (Klinefelter syndrome)(right)

Image 2 – Clinical features of Klinefelter syndrome. Features present may be few, some or all.

Image 3 – Prevalence of Klinefelter syndrome characteristics


T formulationUsual (starting) dosageDosage rangeComment
Injections (IM)
Testosterone undecanoate1000mg every 12 weeks following loading dose at 6 weeks (i.e., 0, 6, 18, 30 weeks)Longer term: typically 500-100mg at 8 to 16-week intervals
Combined testosterone propionate
Testosterone phenylpropionate
Testosterone isocaproate
Testosterone decanoate*
Testosterone enantate*
250mg every 2 weeks10- to 21-day intervalsThese preparations are not typically prescribed in adult men
Transdermal gel
(1% as 50 mg in 5 g sachet OR 12.5 mg/ actuation pump pack dispenser; applied daily)
50mg daily25-100mg daily
(2% as pump dispenser; applied daily)
50mg daily25-100mg daily
Transdermal cream
Testosterone 5% cream25mg (0.5mL) daily applied to scrotumUp to 50mg (1mL) daily (to scrotum)PBS listing now requires scrotal application
Transdermal patch
Testosterone*5mg applied nightly2.5 to 5mg daily
Oral undecanoate
Testosterone undecanoate*40mg capsule 160-240mg in 2 to 3 doses daily80 to 240mg daily
*Not available on the Australian Pharmaceutical Benefits Scheme (PBS)





Learning and behaviour difficulties

Clinical review

Dr Rita Upreti, Endocrinologist, Monash Health and Hudson Institute of Medical Research
Klinefelter syndrome

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