Female pseudohermaphroditism
FEMALE PSEUDOHERMAPHRODITISM: HOW TO RETURN THE CHILD’S TRUE GENDER
Pseudohermaphroditism or, as it is also called, false hermaphroditism is a violation of the structure of the sexual system of the body, in which the external genitals are incorrectly formed and to one degree or another resemble the genitals of a person of the opposite sex. False hermaphroditism differs from true hermaphroditism in that the patient has only one type of gonadal matter: either ovaries or testicles.
Speaking of female pseudohermaphroditism, they mean the presence of ovaries and other internal organs of the female reproductive system, which is accompanied by an externally “male” structure of the genitals and secondary sexual characteristics characteristic of the male body.
SYMPTOMS OF FEMALE PSEUDOHERMAPHRODITISM
The symptomatology of female false pseudohermaphroditism consists in violations of the external structure of the body: starting from the male genitals and ending with the formation of secondary sexual characteristics characteristic of boys in adolescence.
The symptoms of female pseudohermaphroditism can be arranged in chronological order relative to the time of their manifestation.
Hypertrophy of the clitoris (as a result of which it becomes similar to the penis).
Displacement of the opening of the urethra towards the clitoris.
Fused labia majora (fusion can be partial and complete, in the latter case, the labia outwardly resemble the scrotum).
The closed opening of the vagina.
Rapid somatic maturation with the development of stunting.
Rapidly progressive virilization (the manifestation of male traits: a decrease in the timbre of the voice, an increase in muscle mass, male-type body hair, etc.).
Delayed puberty.
CAUSES OF FEMALE PSEUDOHERMAPHRODITISM
False (as well as true) hermaphroditism is based on genetic anomalies of various etiologies. Violation of differentiation of the external genitalia may be due to endocrine diseases of the mother of the child or the use of androgens and / or progesterones in the first trimester of pregnancy. The cause of false hermaphroditism can also be various intoxications during pregnancy (chemical, alcoholic, narcotic, etc.) or radiation exposure.
DIAGNOSIS OF FEMALE FALSE HERMAPHRODITISM
In case of suspicion of female pseudohermaphroditism, an early examination by a pediatric gynecologist and urologist is necessary, as well as an endocrinologist’s consultation. The examination should include both simple methods (for example, palpation of the scrotum for the detection of testicles, in which it is possible to detect the fusion of the labia), and more complex studies. Usually this is a laboratory analysis of urine and blood serum, X-ray examination and ultrasound of the pelvic organs, histological examination is also possible (during any operation).
In addition, the doctor should carefully study the anamnesis (including family history) and materials about the course of the mother’s pregnancy.
TREATMENT OF FEMALE PSEUDOHERMAPHRODITISM
The treatment of this disease is a combination of intimate plastic surgery (reduction clitoroplasty and vaginoplasty) with the connection of hormone therapy.
An important component of the treatment is the psychological support of the child and his parents. Special attention should be paid to the preservation of medical secrecy.
PROGNOSIS AND POSSIBLE CONSEQUENCES OF IMPROPER TREATMENT
The prognosis depends on the severity of the symptoms, but it is impossible to call false hermaphroditism an incurable disease. Only in the absence of treatment, this pathology can lead to infertility and serious psychological problems.
With timely diagnosis and adequate treatment, female pseudohermaphroditism can be corrected. Due to surgery, hormone therapy and consultations with a psychologist or psychotherapist, it is possible to achieve complete restoration of menstrual and reproductive function, as well as to provide the patient with normal social adaptation.
