VIII. Psychological Treatment

Many individuals with CAH report benefits as a result of discussing their medical situation with a person who is knowledgeable about their condition. Topics of particular concern to some CAH patients are gaining an understanding of their medical condition, and the life-long requirement of medication for normal growth, pubertal development, fertility (for women), genital surgery (for women) and sexuality. There is no absolute recommendation for how much counseling is needed by CAH patients. Counseling can be helpful once sexual development and activity begin, and also when it is time to start family planning. Additionally, for girls and women, a counselor can be tremendously helpful during times of genital surgery.

Like all treatment guidelines, counseling guidelines must be adapted to meet the needs of any particular person. Typically, however, it is helpful to establish a person (pediatric endocrinologist, counselor, psychologist, nurse) who is both knowledgeable about CAH and with whom the patient feels comfortable, to discuss these types of issues should the need arise.