Genital and subjective sexual response in women with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with a non-surgically created neo-vagina
Both, S1; Kluivers, K2; ten Kate-Booij, M3; Weijenborg, P4
1: Leiden University Medical Center, Netherlands; 2: Radboud University Medical Centre; 3: Erasmus Medical Centre; 4: Leiden University Medical Center
Objectives: Women with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome are born without a uterus and vagina. For women affected with this uncommon congenital syndrome a neo-vagina can be created by surgical or non-surgical treatment to allow penile-vaginal intercourse. Nonsurgical treatment involves the dilation technique in which graduated dilators are pressed into the space of the introital dimple twice a day with most patients obtaining a normal sized vagina after 6 to 12 months of dilation. In general, studies on sexual functioning after treatment show lower sexual function in women with the MRKH syndrome compared with the standardization population in the domains of sexual arousal, vaginal lubrication, orgasm and pain during intercourse. It is unknown whether lower sexual functioning of women with the MRKH syndrome is associated with a reduced sexual response of their neo-vagina’s from a physiological point of view. In this study we tested whether women with the MRKH syndrome with a non-surgically created neo-vagina show lower vaginal blood flow or lower subjective sexual arousal in response to visual sexual stimulation compared to women without this condition.
Material and Method: Vaginal blood flow (measured as Vaginal Pulse Amplitude, VPA) and subjective sexual arousal responses to erotic film were assessed in pre-menopausal MRKH women with a non-surgically created neo-vagina (N = 15), and compared with responses of an age-matched control group (N = 21).
Results: Women with the MRKH syndrome showed significantly lower VPA during baseline and erotic film. The relative increase in VPA from baseline to erotic film was not significantly different between groups. Also, levels of subjective sexual arousal did not significantly differ between groups.
Conclusions: Blood flow of the non-surgically created neo-vagina in women with the MRKH syndrome is lower, possibly due to less innervation and vascularization of the neo-vagina. The neo-vagina does, however, show responsiveness to visual sexual stimulation. Also, women with the MRKH syndrome do not differ from women without the syndrome in their subjective sexual responsiveness.
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