Symptoms, Causes, Diagnosis, and More

Medication Options

• Mineralocorticoids (fludrocortisone) to replace aldosterone, which helps counter sodium loss, prevent adrenal crises, and boost growth and development in children
• Glucocorticoids (dexamethasone, hydrocortisone, prednisolone, prednisone) to replace cortisol, which helps manage adrenal insufficiency, control androgens, and manage growth and development in childhood
• Salt supplements (sodium chloride) to help retain salt in the body

People with CAH may need to take more glucocorticoids during stressful times, such as when sick, injured, or getting surgery. These are called “stress doses” and are given to reduce the risk of adrenal crisis. Occasionally, people with nonclassic CAH may also need stress doses, for childbirth, major surgery, or trauma.

Some women with nonclassic CAH may also be given other treatments, including:

• Corticosteroids, to help with fertility or decrease the risk of miscarriage
• Oral contraceptives, to help regulate periods and treat acne and facial hair
• spironolactone (Aldactone), to help treat acne and facial hair

Surgery

Parents of girls born with ambiguous genitalia may opt for surgery, especially if the genitals interfere with the ability to urinate. There’s not always a “best” time to have this procedure: Some parents schedule the surgery during the first 2 to 6 months of their child’s life. But many are encouraged to delay the decision about surgery and/or observation until the child is older and can be involved in the decision.