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These physiological changes have a significant impact on patients with congenital adrenal hyperplasia (CAH). An essential treatment aim across the lifespan in patients with CAH is to replace glucocorticoids sufficiently to avoid excess adrenal androgen production but equally to avoid cardiometabolic risks associated with excess glucocorticoid intake. The changes to the hormonal milieu at puberty, combined with poor adherence to medical therapy, often result in unsatisfactory control exacerbating androgen excess and increasing the risk of metabolic complications due to steroid over\u2010replacement. With the physical and cognitive maturation of the adolescent with CAH, fertility issues and sexual function become a new focus of patient care in the paediatric clinic. This requires close surveillance for gonadal dysfunction, such as irregular periods\/hirsutism or genital surgery\u2010associated symptoms in girls and central hypogonadism or testicular adrenal rest tumours in boys. To ensure good health outcomes across the lifespan, the transition process from paediatric to adult care of patients with CAH must be planned carefully and early from the beginning of adolescence, spanning over many years into young adulthood. Its key aims are to empower the young person through education with full disclosure of their medical history, to ensure appropriate follow\u2010up with experienced physicians and facilitate access to multispecialist teams addressing the complex needs of patients with CAH.<\/jats:p>","DOI":"10.1111\/cen.14992","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T20:42:52Z","timestamp":1700080972000},"page":"332-345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Management aspects of congenital adrenal hyperplasia during adolescence and transition to adult care"],"prefix":"10.1111","volume":"101","author":[{"given":"Chamila","family":"Balagamage","sequence":"first","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners University of Birmingham Birmingham UK"},{"name":"Department of Endocrinology and Diabetes Birmingham Children's 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