Sexuality in Males with Congenital Adrenal Hyperplasia Resulting from 21-Hydroxylase Deficiency

Katharina Gehrmann*, Manon Engels, Elena Bennecke, Claire Bouvattier, Henrik Falhammar, Baudewijntje P.C. Kreukels, Anna Nordenstrom, Nicole Reisch, Nicole Gehrmann, Nike M.M.L. Stikkelbroeck, Marcus Quinkler, Hedi L. Claahsen-Van Der Grinten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose: Although sexuality has been reported to be impaired in females with congenital adrenal hyperplasia (CAH) resulting from 21-hydroxylase deficiency, sexuality in males with CAH so far has remained largely unconsidered. Patients: One of the largest European male cohorts of patients with CAH in which sexuality in male patients with CAH was assessed. Methods: Sexuality was evaluated in 91 sexually active male patients with CAH using questionnaires investigating sexual orientation, age at sexual initiation, sexual activity, satisfaction with sex life, and sexual problems, such as fears or dislike of sexual activity, lack or excessive sexual desire, difficulties getting aroused or reaching an orgasm, premature ejaculation, and no or incomplete erection. Results: Sexuality in male patients with CAH was similar to European reference populations. If sexuality problems were present, they were less frequently reported by the most severely affected CAH males. Adducing a holistic perspective, sexual problems showed substantial association to psychological problems, such as anxiety and depression. Conclusions: Sexuality in male patients with CAH in general was unaffected and sexuality problems seemed to be associated in particular with psychological problems. Because sexual health is a key factor of general health, we recommend that sexuality as well as psychological issues explicitly should be addressed in health care of patients with a CAH diagnosis, independent of sex.

Original languageEnglish
Pages (from-to)1445-1456
Number of pages12
JournalJournal of the Endocrine Society
Issue number8
Publication statusPublished - Aug 2019

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