Sexual experience before treatment for vaginal agenesis: a retrospective review of 137 women.

J Pediatr Adolesc Gynecol. 2018 Dec 21. pii: S1083-3188(18)30387-5. doi: 10.1016/j.jpag.2018.12.005. [Epub ahead of print]

Sexual experience before treatment for vaginal agenesis: a retrospective review of 137 women.

Dear J1, Creighton SM1, Conway GS1, Williams L1, Liao LM2.

Author information イギリス
1Women's Health Division, University College London Hospitals NHS Foundation Trust, Second Floor North, 250 Euston Road, London NW1 2PG, UK.
2Women's Health Division, University College London Hospitals NHS Foundation Trust, Second Floor North, 250 Euston Road, London NW1 2PG, UK. Electronic address: lih-mei.liao@nhs.net.

Abstract

STUDY OBJECTIVE:

To summarise the self-reported sexual experiences of women with vaginal agenesis before treatment and interpret the clinical implications.

DESIGN:

A retrospective review of pre-treatment baseline sexuality data and medical records of women with vaginal agenesis seeking vaginal construction.

SETTING:

A specialist multidisciplinary centre for women with complex congenital genital anomalies.

PARTICIPANTS:

137 women with untreated vaginal agenesis associated with Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) aged 15 to 41 years (mean 20 years).

METHODS:

Gynecological examination and completion of questionnaires.

OUTCOME MEASURES:

1) Sexual Experiences Questionnaire (SEQ); 2) Multi-dimensional Sexuality Questionnaire (MSQ); 3) Vaginal Self-Perceptions; 4) Vaginal length.

RESULTS:

A sizable proportion of women reported having had sexually intimate experiences before any intervention on the vagina. Vaginal length, which ranged from dimple to 7 cm and averaged 2.7cm for the cohort, was unrelated to the range of sexual experiences. Although most women perceived their vagina as being too small, less than half felt that a sexual partner would notice. Two thirds subsequently completed the dilation programme, which was not predicted by pre-treatment vaginal length or sexual experience.

CONCLUSION:

Contrary to the assumption that a vagina of certain dimensions is a pre-requisite for women to 'have sex,' many women with MRKHS and CAIS reported having experienced genital and non-genital sexual activities without treatment. Treatment providers could helpfully affirm women's capacity for sexual intimacy, relationships and enjoyment before introducing the topic of vaginal construction as a non-urgent choice.

Copyright © 2018. Published by Elsevier Inc.

KEYWORDS:
CAIS; Clinical psychology; DSD; Intersex; MRKHS; Multi-dimensional Sexuality Questionnaire; Sexual Experience Questionnaire; Sexual Health; Vaginal Agenesis; Vaginal Dilation