CAIS is also associated with an increased risk for gonadal tumors (. germ cell malignancy) in adulthood if gonadectomy is not performed.     The risk of malignant germ cell tumors in women with CAIS increases with age and has been estimated to be % at 25 years and 33% at 50 years.  The incidence of gonadal tumors in childhood is thought to be relatively low; a recent review of the medical literature  found that only three cases of malignant germ cell tumors in prepubescent girls have been reported in association with CAIS in the last 100 years. Some have estimated the incidence of germ cell malignancy to be as low as % before puberty. 
In addition to these symptoms, see your gyno if you have sudden, extreme pain along with foul-smelling vaginal discharge or fever—or you’re more than a week late. Pain that occurs before your period or comes after your period has ended is also a sign you need to visit your doctor. He or she will do a pelvic exam and talk through your menstrual cycle and symptoms. From there, an ultrasound or laparoscopy may be ordered to look inside your pelvic area. Treatment will depend on whether or not there are underlying health issues, but anti-inflammatory medications and certain birth control methods can help relieve cramping.
Primary hypogonadism (indicating an intrinsic problem with the testes in males) leads to decreased testosterone synthesis and increased conversion of testosterone to estradiol potentially leading to a gynecomastic appearance.  Klinefelter syndrome is a notable example of a disorder that causes hypogonadism, gynecomastia, and has a higher risk of breast cancer in males (20–50 times higher than males without the disorder).  Central hypogonadism (indicating a problem with the brain) leads to decreased production and release of luteinizing hormone (LH) (a stimulatory signal for endogenous steroid hormone synthesis) which leads to decreased production of testosterone and estradiol in the testes.