21-hydroxylase deficiency secondary prevention

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Secondary Prevention

Preventing hyperandrogenism and optimizing fertility

As growth ends, management in girls with CAH changes focus to optimizing reproductive function. Both excessive testosterone from the adrenals and excessive glucocorticoid treatment can disrupt ovulation, resulting in irregularity of menses or amenorrhea, as well as infertility. Continued monitoring of hormone balance and careful readjustment of glucocorticoid dose can usually restore fertility, but as a group, women with CAH have a lower fertility rate than a comparable population.

CAH has little effect on male fertility unless an adult stops taking his glucocorticoid medication entirely for an extended period of time, in which case excessive adrenal testosterone may reduce testicular production as well as spermatogenesis.