Question for the Doctors... (Endocrinologists especially welcome)

In the condition Congenital Adrenal Hyperplasia, one of the side effects is, apparently, penile enlargement (when it happens to boys).

My question: is the endocrinal imbalance responsible for that particular symptom due to a sympathetic effect from the overall condition or a specific blockage/excess/metabolic interaction?

Anybody?

The adrenal glands have cortex (responsible for production of mineralocorticoid, glucocorticoids and some androgenic products) and the medulla which is (responsible for output of epinephrine/norepinephrine).

In CAH it is the adrenal cortex that is overdeveloped and over produces its products resulting in a tendency to hypertension, glucose intolerance, virulism in females, but I’m not to sure what it does to males (early developement ie too big for the age would seem logical).

Because of an enzyme deficiency the adrenal glands of affected fetuses cannot produce enough cortisol, a hormone important in energy production and the regulation of blood sugar levels. The pituitary gland senses a low cortisol level and sends chemical messages to the adrenals to make more. They grow larger trying to produce enough cortisol (thus "hyperplasia"). The adrenals also produce aldosterone (salt regulating hormone) and androgen. As they enlarge they produce increasing amounts of all three, but the pituitary isn’t sensitive to excess levels of androgen so it continues to produce the chemical message that more work is needed from the adrenals. Eventually this excess androgen is what causes virilization (ambiguous genitals or male sexual characteristics) in females and enlarged penises in males.

See:
Congenital Adrenal Hyperplasia: A Handbook for Parents
and
congenitaladrenalhyperplasia.org

Many thanks fellas- as always.

God, this board rules!