Amenorrhea after puberty

Patients with bilateral congenital adrenal hyperplasia appear hairy, muscular, amenorrhea, and breast development. Male patients have unusually large reproductive organs. Too much androgen inhibits the secretion of gonadotropins, causing testicles to shrink. In extremely rare cases, a hyperplastic adrenal cortex in the testicles will enlarge and harden the testes, and most patients have no semen after puberty.