Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 1999;59(5):1199

See related article on congenital adrenal hyerplasia.

What is congenital adrenal hyperplasia?

A person with congenital adrenal hyperplasia (or CAH) doesn't make enough cortisol. Cortisol is a hormone that helps your body in times of physical stress. If you have CAH, your body's adrenal gland tries to make cortisol, but it can't make enough.

What are the symptoms of CAH?

There are two forms of CAH. Severe CAH is usually diagnosed at birth or in early childhood. Female children with severe CAH might be born with genitals that look like a boy. All children with severe CAH have masculine features (such as excess facial hair), grow quickly but stop growing before they should, have difficulty fighting off even small infections and may have trouble keeping enough salt in their bodies.

However, people with mild CAH are sometimes never diagnosed. They may be shorter than either of their parents, yet still be of normal height when compared with people their age. They may have acne and blood pressure problems. The illnesses they get, such as colds and sinus infections, don't go away as easily as everyone else's. Women with mild CAH may have genitals that don't look like other women's genitals. They may have square shoulders and narrow hips. Sometimes they have too much hair on their faces. Women with mild CAH often have irregular periods. They often have trouble getting pregnant.

How does my doctor know I have CAH?

Based on your symptoms and the results of your physical exam, your doctor may order blood tests to see if you have CAH.

What treatment is available for CAH?

Right now, there is no cure for CAH, but there is treatment. Some people with mild CAH may not need to take medicine all the time. They may only need to take cortisol when they are sick. Other people need to take cortisol every day.

If I have CAH, will my children get it?

If you and your partner have any form of CAH, your children might also have it. Remember, some people can have mild CAH and not know it, so you should tell your doctor as soon as you think you or your partner may be pregnant. A baby can be treated before it's born if the mother takes the medicine. If your baby has CAH, treatment should begin as soon as you know you are pregnant.

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