Psychosocial Development, Sexuality and Quality of Life in Congenital Adrenal Hyperplasia

Abstract

Exposure of the developing brain to androgens during fetal life is known to affect sexual development, including postnatal sex and sexual orientation. However, these relationships are both multifactorial and unpredictable. It is generally assumed that congenital adrenal hyperplasia (CAH) has greater effects in women than in men due to non-physiological adrenal androgen excess. Outcome information on patients with CAH often indicates poor quality of life, general maladjustment, problems with sexuality, and decreased fertility. With advances in medical treatment and surgery and changes in societal perspectives on gender and sexuality, there is a need for greater consideration of quality of life factors, including socialization and sexuality.