While often identified in childhood, adults with CAH need tailored treatments to regulate cortisol, aldosterone, and androgen levels. This condition presents unique challenges for both CAH girls and men, impacting growth, fertility, and overall health.

What is Congenital Adrenal Hyperplasia?

CAH results from genetic mutations disrupting adrenal enzyme function, leading to hormone imbalances. The classic form often causes severe symptoms like ambiguous genitalia (intersex traits) and salt-wasting crises, while the non-classic form may lead to milder issues such as early puberty or fertility struggles. CAH symptoms in adults can include fatigue, irregular menstrual cycles, excessive hair growth, and low bone density.

Treatment Approaches for Adults

Hormone replacement therapy is the cornerstone of CAH management:
Glucocorticoids (e.g., hydrocortisone) restore cortisol levels and suppress excess androgens.
Mineralocorticoids (e.g., fludrocortisone) help regulate electrolytes in salt-wasting CAH.
Fertility support may be needed for reproductive health, especially in women with irregular cycles.
Regular blood tests ensure proper dosing, preventing complications like osteoporosis or hypertension.

Gender-Specific Considerations

CAH in men may cause testicular adrenal rest tumors (TARTs) or reduced fertility. Monitoring testosterone levels and imaging scans can help detect issues early.

CAH girls and women often face menstrual irregularities, hirsutism, or polycystic ovary syndrome (PCOS). Anti-androgen therapies or contraceptives may be recommended.

Lifestyle and Long-Term Care

Adults with CAH benefit from:
✔ A balanced diet rich in calcium and vitamin D to support bone health.
✔ Regular exercise to maintain weight and cardiovascular fitness.
✔ Stress management, as physical or emotional stress can trigger adrenal crises.
✔ Support networks, including counseling or patient groups, to address emotional and social challenges.

Conclusion

Living with Congenital Adrenal Hyperplasia requires ongoing medical care, personalized hormone therapy, and lifestyle adjustments. Early intervention and consistent monitoring help adults with CAH lead healthy, fulfilling lives. Advances in treatment continue to improve outcomes, emphasizing the importance of specialized care.