Other endocrine problems may include underproduction of thyroid hormone (hypothyroidism) or central adrenal insufficiency, which prevents the body from responding appropriately during stress or infections. Underproduction of growth hormone can result in short adult height, low muscle mass and high body fat. Without treatment, women may not start menstruating until their 30s or may never menstruate, and men may not have much facial hair and their voices may never fully deepen. This results in underdeveloped sex organs, incomplete or delayed puberty, and in nearly all cases, infertility. A condition called hypogonadism occurs when sex organs (testes in men and ovaries in women) produce little or no sex hormones. Unusual food-seeking behaviors, such as hoarding food, or eating frozen food or even garbage, may develop. Constant hunger leads to eating often and consuming large portions. A classic sign of Prader-Willi syndrome is a constant craving for food, resulting in rapid weight gain, starting around age 2 years. Other features of Prader-Willi syndrome appear during early childhood and remain throughout life, requiring careful management. In females, the clitoris and labia may be small. The testicles may be small or not descended from the abdomen into the scrotum (cryptorchidism). Males may have a small penis and scrotum. A baby may seem unusually tired, respond poorly to stimulation, have a hard time waking up or have a weak cry. Poor sucking makes feeding difficult and can result in failure to thrive. Infants may have a poor sucking reflex due to decreased muscle tone. ![]() Children may be born with almond-shaped eyes, a narrowing of the head at the temples, a turned-down mouth and a thin upper lip. Babies may rest with their elbows and knees loosely extended instead of fixed, and they may feel floppy or like rag dolls when they're held. A primary sign during infancy is poor muscle tone (hypotonia). Signs and symptoms that may be present from birth include: Symptoms may slowly change over time from childhood to adulthood. Signs and symptoms of Prader-Willi syndrome can vary among individuals.
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