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Definition

Androgen insensitivity syndrome (AIS) is when a person who is genetically male (has one X and one Y chromosome) is resistant to male hormones called androgens. As a result, the person has some or all of the physical characteristics of a woman, despite having the genetic makeup of a man.

Alternative Names

Testicular feminization

Causes, incidence, and risk factors

Androgen insensitivity syndrome (AIS) is caused by various genetic defects on the X chromosome that make the body unable to respond to the hormones responsible for the male appearance.

The syndrome is divided into two main categories:

  • Complete AIS
  • Incomplete AIS

Complete androgen insensitivity prevents the development of the penis and other male body parts. The child born appears to be a girl. The complete form of the syndrome occurs in as many as 1 in 20,000 live births.

The degree of sexual ambiguity varies widely in persons with incomplete AIS. Incomplete AIS can include other disorders such as Reifenstein syndrome (also known as Gilbert-Dreyfus syndrome or Lubs syndrome), which is associated with breast development in men, failure of one or both testes fail to descend into the scrotum after birth, and hypospadias, a condition where the opening of the urethra is on the underside, rather than at the tip, of the penis.

Also included in the broad category of incomplete AIS is infertile male syndrome, which is sometimes due to an androgen receptor disorder.

Symptoms

A person with complete AIS appears to be female but has no uterus, and has very little armpit and pubic hair. At puberty, female secondary sex characteristics (such as breasts) develop, but menstruation and fertility do not.

Persons with incomplete AIS may have both male and female physical characteristics. Many have partial closing of the outer vaginal lips, an enlarged clitoris, and a short vagina.

There may be:

  • A vagina but no cervix or uterus
  • Inguinal herniawith a testis that can be felt during a physical exam
  • Normal female breast development
  • Testes in the abdomen or other unusual places in the body
Signs and tests

Complete AIS is rarely discovered during childhood, unless a mass is felt in the abdomen or groin that turns out to be a testicle when it is explored surgically. Most people with this condition are not diagnosed until they fail to menstruate or have difficulties becoming pregnant.

Incomplete AIS, however, is often discovered during childhood because the person may have both male and female physical characteristics.

Tests used to diagnose this condition may include:

  • Blood work to check levels of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH)
  • Genetic testing (karyotyping)
  • Pelvic ultrasound

Other blood tests may be done to help tell the difference between AIS and androgen deficiency.

Treatment

Unusually located testicular tissue may not be removed until a child completes puberty and growth is complete. At this time, the testis may be removed because they can develop cancer like any undescended testicle.

Estrogen replacement is prescribed after puberty.

Treatment and gender assignment can be a very complex issue, and must be individualized with great care.

Expectations (prognosis)

The outlook for complete AIS is good if at-risk testicular tissue is removed at the proper time. The outlook for incomplete AIS depends on the presence and severity of ambiguous genitalia.

Complications

Complications include testicular cancer, infertility, and complex psychosocial issues.

Calling your health care provider

Call your health care provider if you or your child have signs or symptoms of the syndrome.

References

Wysolmerski JJ. Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap 266.

Bringhurst FR, Demay MB, Kronenberg HM. Disorders of mineral metabolism. In: Kronenberg HM, Schlomo M, Polansky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. St. Louis, Mo: WB Saunders; 2008:chap 27.

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Related Questions

Do people with Androgen insensitivity syndrome have ovaries?

Yes, people with Androgen Insensitivity Syndrome (AIS) typically have undescended or underdeveloped testes instead of ovaries due to their genetic makeup. AIS is a condition where individuals with XY chromosomes are partially or completely insensitive to androgens, resulting in atypical development of the reproductive organs.


Can animals have androgen insensitivity syndrome?

Yes, it has been observed in many species like horses, dogs and cats. Those animals are born with apparent normal female genitalia, but fail to come into season as they dont have ovaries but testicles inside. It is very rare, and like in humans its an x linked disorder, so it is passed through the maternal line. However it is not called androgen insensitivity syndrom but testicular feminization or male pseudo-hermaphroditism.


A human individual is phenotypically female but her interphase somatic nuclei do not show the presence of Barr bodies what concerning her is probably true?

The individual likely has an intersex condition like Androgen Insensitivity Syndrome (AIS) where the body does not respond to androgens, and thus does not form Barr bodies in the nuclei. In AIS, the individual has XY chromosomes but develops female physical characteristics due to insensitivity to male hormones.


Is it possible to not have a cliterix?

Yes, it is possible for some individuals to be born without a clitoris due to congenital conditions, such as androgen insensitivity syndrome or differences in sexual development. Additionally, surgical removal or injury can also result in the absence of a clitoris. However, most individuals assigned female at birth typically have a clitoris.


What is an abnormal condition of excess androgen secretion observed primarily in woman?

Excess androgen secretion may be related to polycystic ovarian syndrome, which affects one in twenty women. Another cause may be congenital adrenal hyperplasia.


What are three sex-linked diseases?

Three examples of a sex-linked disease are; Hemophilia, Wiskott-Aldrich syndrome, and androgen insensitivity syndrome. HIV, gonorrhea, and syphilis are examples of sexually transmitted diseases, which is something totally different.


What does it mean when a human has two X chromosomes?

When a human has two X chromosomes, it typically indicates that they are female, as females usually have two X chromosomes (XX) while males have one X and one Y chromosome (XY). This chromosomal configuration is associated with the development of female secondary sexual characteristics and reproductive systems. However, variations can occur, such as in individuals with Turner syndrome (a single X chromosome) or Androgen Insensitivity Syndrome, where individuals may have XY chromosomes but develop female characteristics.


Is there some kind of disease that inhibits puberty?

There are many things that can inhibit or delay pubertal development: * Constitutional variance, normal delay caused by nothing other than genetics and various other factors. These kids are referred to as "late bloomers" and will eventually develope normally. * System diseases such as Inflammatory bowel disease, chronic renal failure, cystic fibrosis. * Endocrine disorders such as Cushing's disease, androgen insensitivity syndrome. * Hypopituitarism * Prader-Willi Syndrome, Kallmann Syndrome * Defects of the Gonads such as Turner's Syndrome, mumps orchitis, or damage from trauma or chemo therapy. * Malnutrition This is by no means an all-inclusive list. If you have any concerns about delayed puberty in a child, they should be seen and evaluated by their pediatrician and/or a pediatric endocrinologist.


What causes a hermaphrodite baby to be born?

uh, a few seconds on google is all that you needed. http://en.wikipedia.org/wiki/Intersexuality http://www.jax-inter.net/~help/sexdiff.html http://en.wikipedia.org/wiki/Androgen_insensitivity_syndrome


If a woman had the same type of cancer as Lance Armstrong what would it be called?

Ovarian cancer could be considered the female equivalent to testicular cancer, as they are essentially homologous organs. (that is, they share a "common ancestry" embyologically, and they are both gonads and endocrine glands) Depending on how one interprets it, it is theoretically possible for a woman to have to have testicular cancer. One suffering from intersexuality "disorders" like complete androgen insensitivity syndrome (CAIS) - genetically a male with undescended testes, but with a vagina and outward female appearance - or Klinefelter's syndrome - instead of XY (male) or XX (female) chromosomes, one has XXY - can get testicular cancer.


Is there a website for or about hermaphodites?

There are several resources for education and support about hermaphroditism. Intersex Society of North America (ISNA)P.O. Box 31791San Francisco, CA 94131Email: info@isna.orgWeb Site: http://www.isna.org/ Androgen Insensitivity SyndromeAIS Support Network US4203 Genessee #103-436San Diego, CA 92117-4950 Turner SyndromeTurner Syndrome Society US811 12 oaks court15500 Wayzata BlvdWayzata, MN 55391 Klinefelters SyndromeSupport and Educational Exchange for Klinefelters Syndrome (SEEKS)1417 25th Ave Dr WBradenton, FL 34205-6449941-750-8044


What abnormalities or defects during development can lead to a lack of sexual concordance at?

The abnormalities during developtment can lead to a lack of sexual concordance at the penis for an XY chromosome and the vagina for and XX chromosome. Thus causing you to have terrible intercourse during the time of your defects which occurs around teenage years.