Sexual function in women with complete androgen insensitivity syndrome.
OBJECTIVE
To investigate sexual function in women with complete androgen insensitivity syndrome (CAIS) and to investigate the prevalence of factors that might contribute to sexual difficulties.


METHODS
Cross sectional survey and clinical examination.


METHODS
Tertiary hospital multidisciplinary intersex clinic and an international peer support group for CAIS.


METHODS
Sixty-six adult women with CAIS.


METHODS
Self-completed survey of sexual function, genital normality perceptions, and compliance and satisfaction with vaginal hypoplasia treatments. Hospital case notes review, and genital examination for prevalence of vaginal and clitoral hypoplasia.


METHODS
Golombok-Rust Inventory of Sexual Satisfaction (GRISS) scores of study participants were compared against the scores of the test validation population (as control). In physical examination participants, anatomical dimensions were assessed against published normal values for clitoral and vaginal sizes.


RESULTS
We found that 90% of women with CAIS in this study had sexual difficulties when compared with the general female population, most commonly sexual infrequency and vaginal penetration difficulty; 77% perceived their vagina as small, but on genital examination only 35% had vaginal hypoplasia.


CONCLUSIONS
Androgen deficiency leads to sexual problems. Vaginal hypoplasia and negative psychological adaptation to living with an intersex condition are likely to have contributed to the high rates of sexual problems found in this study. Treatments for vaginal hypoplasia need to be evaluated with outcome studies of long-term sexual function, quality of life, and satisfaction. Clinical services for the management of intersex conditions need to be multidisciplinary and aim to optimize the patient's physical and psychological health.
Minto
Catherine L
CL
The Middlesex Clinic, Elizabeth Garrett Anderson Hospital, University College London Hospitals, London, United Kingdom.
Liao
K Lih-Mei
KL
Conway
Gerard S
GS
Creighton
Sarah M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D013734:Androgen-Insensitivity Syndrome / Q000503:physiopathology* / Q000523:psychology; D001828:Body Image; D002987:Clitoris / Q000033:anatomy & histology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D006061:Gonadal Dysgenesis, 46,XY / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000523:psychology; D019529:Sexuality / Q000502:physiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014621:Vagina / Q000033:anatomy & histology