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Sexual functioning of women with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and its predictors

Weijenborg, P1; Kluivers, K 2; Dessens, A3; Both, S1

1: Leiden University Medical Centre, Netherlands; 2: Radboud University Medical Centre, Netherlands; 3: Erasmus Medical Centre, Netherlands

Objective: Women with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome are born without a uterus and vagina. For women affected with this uncommon condition, surgical as well as non-surgical treatment is offered to create a neovagina. In general, studies on sexual functioning after treatment show lower sexual function in MRKHwomen compared with the standardization population. However, the prevalence of sexual dysfunctions remains unclear as sexual distress is not assessed in most studies - a criterion essential to diagnose a sexual dysfunction. Also, to what extent sexual functioning is associated with (sexual) self-esteem and other psychosocial variables is unknown. In this study, sexual function and distress in women with the MRKH syndrome was compared to an age-matched healthy control group. Associations of sexual function with sexual self-esteem, psychological, and relational functioning were examined.

Material and Methods: Women with the MRKH syndrome were recruited via the Dutch MRK foundation, and gynaecologists of 3 University Medical Centres. Participants completed validated questionnaires assessing sexual problems (the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS)) and questionnaires assessing (sexual) self-esteem, genital self-image, anxiety and depression, and relational functioning.

Results: Fifty four MRKH women (37 (68.5%) had created their neovagina themselves) and 79 controls participated. FSFI Total score and FSDS score did not differ significantly between MRKH women and controls. However, MRKH women scored significantly lower on the FSFI pain scale. Relatively more MRKH women scored within the clinical range of sexual dysfunction. MRKH women reported significantly lower sexual self-esteem, and a more negative genital self-image. No significant differences were found between groups on the other variables. Sexual dysfunction in MRKH women, was significantly predicted by sexual self-esteem.

Conclusion: Compared to controls, more MRKH women report a sexual dysfunction.  Sexual self-esteem seems to be an important predictor of sexual dysfunction.


Work supported by industry: no.

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