View Full Version : What is the BIG difference between AIS and SS?
Ok, so this got into my head just a little while ago..
What is the Root difference Between AIS and Swyer syndrome? Why is it that a woman with Swyer's has a womb, but someone with AIS dose not? Unless I misunderstand, both have issues with the sex-determining gene on the Y chromosome?
So why will one woman have a womb, and one won't? I've dome some reading, and I must be missing something important, but most of the sites all sound like mumbo-jumbo to me :dunno:
Also, and this might be off topic for the tread, What would I have to do to go about getting my Dx Double confirmed by a different doctor? I want to be sure there was no screw ups with my DX and Surgery last year and if there was, there will be hell to pay.
I wonder because I am still hung up on the "The gonads are found to be partially non-functional streaks." part of Swyer's and all the doctor's who looked at me, never thought they looked odd. I dunno... Im going through one pf my funky periods :dunno: :dunno:
Note: I reserve the right be wrong and/or Misinformed about any and all of the above points!
I could be wrong but I thought AIS was maternally inherited and due to problems on the X chromosome?... For AIS the problem is with androgen receptors not chromosomal "abnormalities" per se
plus I think....
Note: I reserve the right be wrong and/or Misinformed about any and all of the above points!
:razz:
.... it might have something to do with MIS... I think that with CAIS our testes produce this as we're forming and it stops us developing a uterus and fallopian tubes and is why we have shorter than average vagina's.
whereas with Swyer's your testes are "streaks" so your body doesn't produce enough hormones and consequently you have a uterus and normal vagina... I think people with Swyer's syndrome could get pregnant with a donor egg whereas that wouldn't be possible for me :)
essentially, CAIS have dodgy receptors that means even though they produce loads of T, they don't have a cellular response to it.... whereas SS respond to hormones just they don't make much themselves
hope this helps, and that I haven't got it all mixed up myself
jos xy (= xx lol)
spacegirl
11-22-09, 06:45 PM
Hi Jos,
You sounded right, it was like the things I've read on the subject.
And here's a link where they're talking about a successful Swyer's pregnancy
http://www.endocrine-abstracts.org/ea/0013/ea0013p253.htm
Something you said had me a little curious, what would it take for a woman with ais to give birth herself? Just the uterus, or is there more to it? I found an article about uterus transplants.
http://www.washingtonpost.com/wp-dyn/content/article/2007/01/14/AR2007011401091_pf.html
mmm my knowledge of pregnancy isn't soooo good
I don't have a cervix.... but I guess I could have a C-section
I'd need hormones to make sure the development of the baby was good
a compatible donor of both womb and eggs
a big wad of dosh!! (although that's a given anyway, who doesn't :) )
and probably to be born a couple of decades later
I had heard about this and I must admit that in some ways it seems a bit.... manipulative. It strikes me as another one of those "doctors trying to FIX the problem" situations... and we know where that can lead.
maybe we should (as a society) learn to alter our perception of what is "normal" and stick to fixing stuff with a knife that should be fixed.
I'm not meaning to be judgemental of someone who would want this, just saying that it probably wouldn't be for me... I don't really trust most doctors THAT much.
plus there is the very obvious point about adoption and providing homes for those children
AIS means the testes develop normally but the body cannot use the testosterowen tyhey make so they develop female, with the exception of no uterus or upper vagina or cervix. At puberty the testes release large amounts of testosteroen but since the body cannot use it, it converts to estradiol and "normal" development occurs except a period never occurs. This is how many CAIS wonen are diagnosed.
Swyer syndrome is the testes do not develop at all, so they do not release MIS or any other hormones of enough quantity, so they do develop a uterus and cervix and a normal vagina. The do not have ovaries or testes, only streaks or nothing at all if the body absorbs them. At puberty nothing happens because they do not make any hormones or so little that it doesn't matter. To have normal development they must take hormones.
AIS means the testes develop normally but the body cannot use the testosterone they make so they develop female, with the exception of no uterus or upper vagina or cervix. At puberty the testes release large amounts of testosterone but since the body cannot use it, it converts to estradiol and "normal" development occurs except a period never occurs. This is how many CAIS women are diagnosed.
Hrm.. So then with AIS its an Issue with Receptors? The body is making the Testosterone but the body can not use it. With Sweyer there is low to No Hormones at all? I suppose that means the Testosterone somehow inhibits the development of a uterus and cervix and vagina.?
At puberty nothing happens because they do not make any hormones or so little that it doesn't matter. To have normal development they must take hormones.
This is another one of those things that worries me. I have a breasts, I developed them at the correct time too. Is there some kind of test that can be done to tell me if they are "boobs" or something else (like fatty tissue as opposed to breast tissue)
spacegirl
11-23-09, 12:00 AM
Hrm.. So then with AIS its an Issue with Receptors? The body is making the Testosterone but the body can not use it. With Sweyer there is low to No Hormones at all? I suppose that means the Testosterone somehow inhibits the development of a uterus and cervix and vagina.?
As Jos explained in an earlier post, testes produce both hormones (mostly androgens) and m.i.s (mullerian inhibiting substance) Every embryo starts out with mullerian ducts and cells to make a uterus. If there is mis, all that disappears. Ais gonads make both, the androgens don't count but the mis does. Swyers gonads makes neither, so no mis means your uterus doesn't disappear.
This is another one of those things that worries me. I have a breasts, I developed them at the correct time too. Is there some kind of test that can be done to tell me if they are "boobs" or something else (like fatty tissue as opposed to breast tissue)
A mammogram would show all the details.
Hi Zaora, et. al.,
You wrote,
This is another one of those things that worries me. [...about my diagnosis of Swyer syndrome...] I have a breasts, I developed them at the correct time too...
There is actually one variant of Swyer Syndrome (the one that is carried on the X chromosome) where there is some ovarian development, although the ovarian tissue degenerates very early by a process similar to menopause - it is already starting to happen by the age of puberty. An affected girl might have the beginning of breast development and even a few menstrual periods, but a few years later, when she gets diagnosed by a physician, the ovarian tissue has already degenerated into the non-functioning "streak gonads" typical of Swyer syndrome.
If you e-mail me through the forum or send me an e-mail address through a PM, I can send you some literature on this form of Swyer syndrome.
...Is there some kind of test that can be done to tell me if they are "boobs" or something else (like fatty tissue as opposed to breast tissue)
If you palpate breast tissue, it feels different from body fat - it has a knotty texture. Breasts also have a distinctively different shape from fat in the chest area. I think these are the first observations a physician would make to answer your question.
Friendly greetings to all,
Peggy
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Hrm.. So then with AIS its an Issue with Receptors? The body is making the Testosterone but the body can not use it. With Sweyer there is low to No Hormones at all? I suppose that means the Testosterone somehow inhibits the development of a uterus and cervix and vagina.?
Right AIS is a defect in the recptors, so the boddy cannot use testosterone at all.
In development two things control the development. MIS/AMH ( Mullerian inhibiting substabce or Anti Mullerian hormone ) and testosterone levels. All babies start off the same, with wolffian and mullerian ducts and a undifferentiated gonad that can become either a teste or a ovary. Depending on your genetic programming and the right hormonal cues it turns into one or the other.
If it something goes wrong and it doesn't differentiate, you end up with gonadal dysgenesis, swyer syndrome for XY. Since there are no androgen levels and no testes to make MIS you develop female and develop all the female organs the uterus etc.
If you have AIS, your testes produce testosterone and MIS. The MIS prevetns the uterus and other parts from forming, but because the testosterone cannot be used, the rest of the male anatomy does not, so no prostate or penis develops and the result is default female.
If you have CAH there may be enough testosterone to cause the development of a penis and a prostate. Since there is no MIS the normal female organs will develop, so there will be ovaries and a uterus and a vagina that may or may not have a external opening.
In a true hermaphrodite what happens is that the undifferentiated organ either doesn't differentiate and you get a bit of both, or it can divide and you can have a testis and a ovary, or one side can become and ovary and one side a testis or any combination of them along with any combination of internal organs and external genitalia. It just depends on what happens in development and if the levels were high enough to stimulate or supress the development of whatever.
Of course those are the main ones. There are many many things that can affect development, chemicals, other defects on receptors or hormones or genetics. Progestins or hormones taken by the mother can cause masculinization or feminization. Enzyme defects can cause problems like 5AR deficinency http://www.usrf.org/news/010308-guevedoces.html
Lots of things can happen and go wrong. I'm sure many many people have some form of intersex issue they are not even aware of, not unless they have a real problem. Many are discovered by accident.
This is another one of those things that worries me. I have a breasts, I developed them at the correct time too. Is there some kind of test that can be done to tell me if they are "boobs" or something else (like fatty tissue as opposed to breast tissue)
Well breasts develop because of estrogen, or they are just fat. Real breasts are glandular. They are firm and nodular. They develop from the nipple out. If you have a mound under your nipple that spreads out and doesn't compress much, you have breasts. Even men can develop breasts if estrogen levels are high enough.
If you have AIS, your testes produce testosterone and MIS. The MIS prevetns the uterus and other parts from forming, but because the testosterone cannot be used, the rest of the male anatomy does not, so no prostate or penis develops and the result is default female.
The way you said this, you seem to imply women with AIS don't have a prostate gland. Probably you meant to say women with AIS have a very under-developed prostate.
The mere fact that we have a (kind of) prostate gland and a (kind of) penis has nothing to do with AIS. As you said before: all babies start off the same. That means man and woman share some body parts that are more or less the same and yet have different names because in adults we don't recognize them anymore as being the same.
Don't tell this to the bartender bloke at the local pub: he has a vagina masculina and somewhere near his prostate gland this poor eternal virgin even has a hymen. The Skene gland (female prostate homologue) in women is the equivalent to the males prostate gland and the clitoris is homologous to the the penis. (A penis is a clitoris on steroids. :D )
Just like a clitoris needs androgens to grow, the basic version of a prostate needs androgens to become a 'real' prostate. This means women who are really, really 100% CAIS have a prostate so small nobody can find it. Women with PAIS have a prostate of which the size ranges from extremely small to near normal.
That being said, I want to emphasize the amount of androgens in XY-women without testes is extremely low. That means that even in women with PAIS the chance of getting prostate cancer is near zero. I guess - hey, I'm not a doctor! ;)
Groeten, Miriam
I was trying to make things as simple as possible without writing a whole book on it. Maybe I should, we really need a definitive one that actually explains things they way it really is.
Everyone has some kind of vestigial leftovers more or less due to how human development works. We all start off with the basic both sets of parts and usually one or the other takes over and the other regresses and doesn;t develop, but it is still there in some ways. You are right, there is a vagina and uterus masculinus. The inside of the scrotum is called the vagina actually in medical literature.
That's exactly the point, that the whole process of development is checks and balances that make things differentiate one way or another, and without the right cues, things don't happen properly or develop at all. It's why I think intersex is much more common than anyone knows and it's just cultural and social taboo to point out that the gender binary doesnt really exist.
Well breasts develop because of estrogen, or they are just fat. Real breasts are glandular. They are firm and nodular. They develop from the nipple out. If you have a mound under your nipple that spreads out and doesn't compress much, you have breasts. Even men can develop breasts if estrogen levels are high enough.
I don't think they are "firm" but then I don't have much of a reference (I don't go squeezin many boobs you know :mrgreen:)
I'm probably just going to have to ask at my next doctor's Visit. Geeze when I think about it, I'm really uninformed about the human body :???:
fraulein_Maria
11-25-09, 06:17 PM
[QUOTE=Zaora;21781]IGeeze when I think about it, I'm really uninformed about the human body :???:
>>> its ok hon. go to the library and check out "the new our bodies, ourselves" it contains a weath of info on norm-born females and males..... aswell as a new section that talks a little about US. :)
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