1. Look for Signs of Congenital Adrenal Hyperplasia at Birth
Congenital adrenal hyperplasia, also known as CAH, occurs in the fetal stage of development due to an imbalance of hormones. With CAH, hormones such as cortisol and aldesterol are in short supply, causing male hormones, called androgens, to increase. Female infants are usually born with an enlarged clitoris, causing them to occasionally be mistaken for males. No signs of congenital adrenal hyperplasia are obvious in male infants, making it difficult to diagnose this condition until the child is two or three years old.
2. Check for Abnormal Secondary Sexual Characteristics in Very Young Children
Masculine secondary sexual characteristics are usually identified in male and female children with CAH by the time they reach 2 or 3 years of age. Girls may develop pubic hair at an early age. Boys will also develop pubic hair, along with an enlarged penis and a deepening of the voice. In other words, CAH can trigger the onset of puberty while children are still in preschool.
3. Notice Further Complications as Children Enter Puberty
Since the secondary sexual characteristics that normally emerge during puberty are already present in children with congenital adrenal hyperplasia, further complications may develop to complicate normal growth patterns. Females may develop facial hair and experience a deepening of the voice. Menstruation cycles may fail to start as well. Males with CAH may fail to produce sperm since their testicles do not function properly.
4. Note Problems With Normal Growth Patterns in Children With CAH
Since hormones are stimulated at such an early age with congenital adrenal hyperplasia, the ends of longer bones such as the femur, tibia and humerus may close off prematurely, stunting growth. Therefore, children with congenital adrenal hyperplasia usually grow to a shorter height than if hormonal balance had been achieved at an earlier age.
