Congenital Adrenal Hyperplasia Women Research Articles

General intelligence and cognitive profile in women with congenital adrenal hyperplasia (CAH)

To investigate possible effects of prenatal androgen exposure on cognitive functions, general intelligence and cognitive profile were studied in 22 women, 17–34 years old, with prenatal virilization due to congenital adrenal hyperplasia (CAH) (21-hydroxylase deficiency) and 22 healthy controls matched for region and date of birth. The tests were selected to measure abilities where gender differences repeatedly had been observed or that had earlier shown differences between CAH subjects and controls. The following cognitive functions were tested: Verbal, Visuo-Spatial, Visuo-Motor, Arithmetical, Logical Inductive abilities, and Field Dependence. Contrary to earlier reports, the mean general intelligence level of the CAH (22) group was significantly lower than the controls' and the earlier observed inferiority for calculation abilities in female CAH subjects was not supported by the results of the present study. A possible verbal disadvantage with significantly inferior results was noted for the two verbal tests for the CAH (22) group. For the 13 CAH/control pairs with equal general intelligence levels, the discrepancy between the inferior verbal vs. visual, arithmetic, and logical category scores was significantly larger for the CAH group than the controls. These results may suggest that CAH women develop a more masculine cognitive pattern under the influence of increased prenatal androgen exposure.

Sexual behavior in adolescent and adult females with congenital adrenal hyperplasia

As part of a comprehensive interview study, 34 female patients with congenital adrenal hyperplasia (CAH) plus 14 control sisters (ages 11–41 yr.) reported on their psychosexual development and sexual orientation (90 items). Fewer patients than sisters had ever experienced love relationships and sexual activities with male partners ( p<0.05 to 0.001). Twenty percent of the patients and none of the sisters wished for and/or had had homosexual relationships; in the patients >21 yr 44% expressed this interest ( p<0.07). For most items, patients with the salt-wasting variant of CAH (SW) differed more clearly from the sisters than the simple-virilizing patients (SV). For two scales “indicating” homosexual (HOM) and heterosexual orientation (HET) and for two indices of HOM/HET differences), the patients also revealed relatively stronger homosexual and/or weaker heterosexual interests than the sisters ( p<0.05 to 0.001). Here, too, the SW/sister differences were more clear-cut. These results corroborate earlier reports on both delays in reaching psychosexual milestones and increased rates of bisexual/homosexual fantasies and experiences in CAH women.