What symptom might a teenage girl with congenital adrenal hyperplasia present with?

A teenage girl with congenital adrenal hyperplasia (CAH) might present with ambiguous genitalia at birth due to the excess production of androgens that occurs in this condition. CAH is primarily caused by adrenal enzyme deficiencies that affect steroid hormone production, leading to an overproduction of sex steroids, particularly in females. In female infants, this can manifest as masculinization of the external genitalia, resulting in ambiguous genitalia.

During adolescence, the symptoms may vary with some girls experiencing no notable issues regarding genital development due to medical management, but the initial presentation in infancy is key to diagnosing CAH. While other symptoms can occur in females with CAH, such as delayed menarche or excessive body hair growth, ambiguous genitalia at birth is the most significant and defining symptom directly related to the condition.