Abstract
Study Objective
To summarize the self-reported sexual experiences of women with vaginal agenesis before
treatment and discuss the clinical implications.
Design
A retrospective review of pretreatment baseline sexuality data and medical records
of women with vaginal agenesis seeking vaginal construction.
Setting
A specialist multidisciplinary center for women with genital differences associated
with diverse sex development.
Participants
One hundred thirty-seven women with untreated vaginal agenesis associated with Mayer-Rokitansky-Küster-Hauser
Syndrome and complete androgen insensitivity syndrome aged 15 to 41 years (mean age,
20 years).
Interventions
Gynecological examination and completion of questionnaires.
Main Outcome Measures
(1) Sexual Experiences Questionnaire; (2) Multidimensional Sexuality Questionnaire;
(3) Vaginal Self-Perceptions; and (4) vaginal length.
Results
A sizable proportion of women reported having had sexually intimate experiences before
any medical intervention on the vagina. Vaginal length, which ranged from dimple to
7 cm and averaged 2.7 cm for the cohort, was unrelated to the range of sexual experiences.
Most women perceived their vagina as being too small, but less than half believed
that a sexual partner would notice this. Two-thirds of the cohort subsequently completed
the dilation program, which was not predicted by pretreatment vaginal length or sexual
experience.
Conclusion
Contrary to the assumption that a vagina of certain dimensions is a prerequisite for
women to “have sex,” many women with Mayer-Rokitansky-Küster-Hauser syndrome and complete
androgen insensitivity syndrome reported having experienced genital and nongenital
sexual activities with no medical interventions. It is recommended that treatment
providers affirm women's capacity for sexual intimacy, relationships, and enjoyment
before they introduce the topic of vaginal construction as a non-urgent choice.
Key Words
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Article info
Publication history
Published online: December 21, 2018
Footnotes
The authors indicate no conflicts of interest.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
