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When Willie Wet the Bed
Fathering poetry about a classic problem.

When adult control fails, the resulting power vacuum is filled by gangs and bullies. By Clyde Verner.

Teaching Children the Importance of Winning
Encouraging in our children the drive to win can be just as important as teaching them to lose gracefully. By Chris Call.

Suggestions for the New Single Father
Russel Wayne provides some immensely practical childcare tips for the man who has to go it alone.

Promoting Your Child's Balanced Development
Giving your children the opportunity to develop a special talent can provide them with a sense of their uniqueness and be a healthy enhancement to their self esteem. By Gerald Alpern.

Classical Fathering versus the Judeo-Christian Model
We interview historian Frederick Hodges about raising children with classical Western values by avoiding the methods imposed on the West by Middle-Eastern religions.

What Fathers Do
by Jack Kammer.

The Fathering Advisor
Selected Reader Mail Gets Our Response

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Home > Puberty > Adrenarche CAH

congenital adrenal hyperplasia (CAH)

Masculinization of children caused by excessive androgens from the adrenal glands, often resulting in extreme height velocity, acne, pubarche, and virilization. If left untreated, true central puberty results.

Adrenal attempts to compensate for low levels of aldosterone cause an overproduction of adrenal androgens, resulting in premature puberty in males.

Early appearance of pubic and axillary hair

In boys, early development of masculine characteristics:

  • Well-developed musculature
  • Enlarged penis
  • Small testes until HPG activation
  • In various forms of CAH, both boys and girls will be tall as children, but if left untreated will be significantly shorter than normal as adults.

    In a newborn boy no obvious abnormality is present, but long before puberty normally occurs, the child becomes increasingly muscular, the penis enlarges, pubic hair appears, and the voice deepens. Affected males may appear to enter puberty as early as 2-3 years of age. The testes are small. Left untreated, the excess level of sex hormones often triggers true precocious puberty, which will require separate treatment.

    Treatment for CAH:
    Currently, standard medical treatment consists of giving a glucocorticoid (a cortisol-like steroid medication, e.g., oral hydrocortisone) in children. A known complication of high dose glucocorticoids is growth inhibition.

    The goal of treatment is to return hormone levels to normal. This is achieved by daily administration of forms of cortisol: dexamethasone, fludrocortisone, or hydrocortisone. Additional doses of medicine are required during times of stress such as severe illness or surgery.

    Back to puberty index page

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