Figure 5. An investigational approach to the treatment of classic congenital adrenal hyperplasia. Fludrocortisone is given in the usual manner. The hydrocortisone dose is reduced to physiologic levels, resulting in elevated androgen production. An antiandrogen agent is administered to block the effect of the elevated androgen levels, and an inhibitor of androgen-to-estrogen conversion is given to block conversion of the increased amount of androgen to estrogen.