🦍Testosterone Levels Alone Mean NOTHING: CAIS Explained

🦍Testosterone
Written By Team3DAlpha

The women in these pictures you often see related to CAIS are genetic XY men, not women.

They have normal male levels of Testosterone, free Testosterone, DHT (Dihydrotestosterone), and other androgen levels.

But due to genetic mutations on the Androgen Receptor (AR) gene, they have non-functioning Androgen Receptors.

The condition is therefore conveniently called “Complete Androgen Insensitivity Syndrome”, or CAIS for short.

They are genetic males, but due to the body’s inability to “recognize” testosterone and DHT, they develop as females externally, despite being males internally.

Outside, they have breasts, hips, and even a vagina. But inside, they have undescended testicles, no uterus, no ovaries, and therefore have no menstrual periods and cannot get pregnant.

Most people don’t know this, but every human being’s default state in the womb is actually female, not male. We all start off as “soon to be females” in the womb, but around the 8th week mark or so, the SRY gene from your father’s Y-chromosome activates, and turns your “would-be” ovaries into testes instead.

This then causes your testes to secrete testosterone (from your Leydig cells) and Anti-Mullerian hormone (from your Sertolli cells).

Those hormones then go on to prevent your body from continuing its path of developing as a female, and thus turns you into a male instead.

Testosterone (via DHT and the androgen receptor) is what creates your external genitalia (penis, scrotum, descended testicles etc.), and Anti-Mullerian hormone is what stops your uterus and internal female structures from forming.

Therefore, the body’s inability to respond to testosterone and DHT in CAIS men leads to an external female phenotype, while the inside remains male.

There’s more to this, but again, as I always say, it’s not all about total Testosterone levels in the blood, it’s about Androgen Receptor signaling and what I like to call your “Net Androgen Status”, which I define as the net action of all of your androgens minus the action of all of your anti-androgens.

You can have all of the testosterone in the world, but if you dont’ balance the other parts of the equation, it means absolutely nothing.






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SOURCES

Guo M, Huang JC, Li CF, Liu YY. Complete androgen insensitivity syndrome: a case report and literature review. J Int Med Res. 2023 Feb;51(2):3000605231154413. doi: 10.1177/03000605231154413. PMID: 36851849; PMCID: PMC9983103.

Team3DAlpha
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