Candace is a normal-looking 15-year-old girl but has never had a menstrual period, though she has other signs of puberty such as breasts and pubic and axillary hair. During a pelvic exam her physician determines that she has no uterus. Blood tests reveal that she has elevated amounts of testosterone in her blood, similar to that expected in young adult males. Name two typical sources of

Question

testosterone. Given the lack of a uterus, what is the likely source of testosterone in this case? What may be wrong with her? (Hint: Consider general principles of hormone secretion and action.) Why is there no uterus? What genetic test may confirm this suspicion?

What will be an ideal response?

Answer 1

Testosterone is produced by adrenal glands and testes. The presence of elevated testosterone combined with absence of a uterus suggests that she has testes rather than ovaries. The lack of masculinization indicates that her tissues do not respond to the testosterone that is present. There is no uterus because she is genetically male. This can be confirmed by examining her chromosomes. Such individuals have "androgen insensitivity syndrome."