Congenital Adrenal Hyperplasia - A Sexual Tale From A Dude Who Loves A Girl

[SuaSponte]

Good evening everyone,

You may be wondering, what is CAH and Addison's Disease and how does it relate to Sexual Health? Why is it in this forum? Good questions, and I'll explain.

One of my very close friends (who I'm hoping becomes my girlfriend, as we're "courting" now, but not exclusive) who I care deeply about has both these conditions. Both relate, in some way, to sexual health. I've needed a medium to express my concerns and feelings on, and writing it down seems healthy enough, in addition to talking to her about it.

What are these conditions? Addison's Disease is a endocrine disorder that affects the adrenal glands in not producing enough hormones. Because of this disease, this also caused another onset of another condition that she also has. Congenital Adrenal Hyperplasia is a condition that affects the adrenal glads (located just above your kidneys) in that the glands cannot produce enough cortisol, the main hormone produced in the glands. The adrenal glands produce various hormones, or chemical messengers, which are released into the bloodstream. The outer portion of the adrenal gland, the cortex, normally makes three different products: cortisol (hydrocortisone), aldosterone (salt-retaining hormone), and androgens (male-type sex hormones). The condition is that the enzymes (proteins) that relay messages from the brain to the adrenal glands are faulty, and therefore imbalances occur of the hormones, especially androgen. It can range from severe to manageable, to low, and most people with the conditions are able to live normal, healthy lives.

Ok, thanks for the science lesson doc, but how does this involve sex? It involves it in many ways.

Women who are born with the condition can have a multitude of adverse effects and varying cases of severity. In my "girlfriend's" case, she has several of the the defects but it does really not affect her daily function. She has to take pills by mouth every morning, but besides that there are no special things she has to do really. She's white, but the condition can cause a darkening of the skin, and in her case she's got an olive tint, but nothing severe. Other effects of the conditions include mood swings (well...normal for a girl lol), dehydration (this is why its important for her to salt her foods), and general tiredness and weakness.

Sexually, and regarding women specifically, it involves the formation and function of the vulva and vagina. In my girlfriend's case, the production of more androgens (male sex hormone) during her time in the womb caused whats called ambiguous genitalia. This condition varies based on severity. Her case is not severe. In her case, she has (and I have experienced) a normal functioning vagina, but her vulva looks a little different, and that is okay. She has an enlarged clitoris, and puffy "outer lips" of her labia majora. It makes her incredibly uncomfortable to discuss the topic, but in talking to her about something so private, I felt us grow as a couple (future couple) in discussing such a difficult topic. After eating her out for the first time, I always thought that she was just blessed with a larger clitoris (which is nothing to complain about, that is an asset! #itoldherthat). I had no idea until recently that it was a medical condition. I've told her time in and time out, she is beautiful just the way she is, physically, mentally and sexually. As a dude, making your woman feel 100% is part of the job description, and she deserves it. She's absolutely stunning.

Can you tell I want the boyfriend job?

So ladies, what do you think? Is there anyone out there who also has these conditions and wishes to share some stories? Looking to hear what you all think!

[Becky]

Sometimes. CAH can be asymptomatic and require no more than medication to balance hormone levels. Sometimes it’s so mild it’s not discovered until puberty or later. However, severe CAH—”salt-wasting” CAH (the body can’t hold on to sodium)—can throw off the electrolyte balance in the body, causing all kinds of problems and, untreated, can prove fatal. Depending on how well this type of CAH can be controlled, the person affected may or may not be disabled.

So in those cases where CAH causes chronic illness, yes, it can be categorized as a disability. Treatment is improving, however; most CAH patients are not disabled as long as they take the medication they need.

CAH also causes “masculinization” in females affected, because it’s a hormone imbalance, but this doesn’t generally cause disability. Both males and females might have fertility problems; this might be hard to deal with, but it isn’t a disability.

[Brett]

I'm not familiar with this disease, however, I will suggest you find out if this disease can be transmitted to you now that you're having sex with her. If the condition she is suffering from has no effect on you and you love her, then go ahead with the relationship. On the other hand, if you are going to be affected, then break it off with her.

[SuaSponte]

I'm not familiar with this disease, however, I will suggest you find out if this disease can be transmitted to you now that you're having sex with her. If the condition she is suffering from has no effect on you and you love her, then go ahead with the relationship. On the other hand, if you are going to be affected, then break it off with her.

Hi Brett! Thanks for your response.

CAH is not something like a STD - it is not transmitted between sexual partners. She was born with it. Like I outlined up top, despite a slightly darker skin complexion, taking daily pills, and a minor surgery when she was a child to correct the gender ambiguity problem, there seems like no adverse effects based on conversation and getting to know her. So, I plan to continue on with her. She's absolutely lovely.

[SuaSponte]

Sometimes. CAH can be asymptomatic and require no more than medication to balance hormone levels. Sometimes it’s so mild it’s not discovered until puberty or later. However, severe CAH—”salt-wasting” CAH (the body can’t hold on to sodium)—can throw off the electrolyte balance in the body, causing all kinds of problems and, untreated, can prove fatal. Depending on how well this type of CAH can be controlled, the person affected may or may not be disabled.

So in those cases where CAH causes chronic illness, yes, it can be categorized as a disability. Treatment is improving, however; most CAH patients are not disabled as long as they take the medication they need.

CAH also causes “masculinization” in females affected, because it’s a hormone imbalance, but this doesn’t generally cause disability. Both males and females might have fertility problems; this might be hard to deal with, but it isn’t a disability.

Hi Becky! Thank you for your response.

Her case is mild in comparison to some of the other cases I've read about, although in regards to "salt wasting," she does add a lot of salt to food when she eats. This may just be preemptive for the condition. She takes her medication, and she's good. She has told me, however, that her CAH is far worse than what her brother has (also CAH).

CAH can also have effects on mood and behaviour. This I have noticed. One day she could be totally fine, the next its like the worst day of her life. She's incredibly smart, but a lot of the times I worry.

As a woman, I was more curious for the female perspective on the gender ambiguity aspect at birth. As "not looking normal" down there, despite her genitalia being female and functioning female. I have read about the fertility problems encountered sometimes and I have yet the courage to speak up and ask her about it. I definitely want kids someday. She does too. In regards to myself, in an open forum, I only have one teste. One was removed because it never descended. So I've always been nervous about fertility even on my end, but now, if I stick with this woman, I'm concerned for our plans to have a family in the future. I'm not sure on how to approach this topic.

[Tina]

I once had a friend who had CAH, she revealed it to me because we were very close friends. What I observed in her is that she was absolutely normal and you won't detect it if she didn't tell you. So, I will advice you continue the relationship with her, she's absolutely perfect.

[John]

It's obvious you're really bothered about this condition of your girlfriend. If it bothers you so much, then it's best you let go of your emotions and work with your head. I'm not saying you should breakup with her, but it's something you might want to consider if it will make you happy again.