title: Sexual life and sexual wellness in individuals with complete androgen insensitivity syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS).
abstract: BACKGROUND
  Sexual wellness depends on a person's physical and psychological constitution. Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) can compromise sexual well-being.
  
  
  OBJECTIVE
  To compare sexual well-being in CAIS and MRKHS using multiple measures: To assess sexual problems and perceived distress. To gain insight into participants' feelings of inadequacy in social and sexual situations, level of self-esteem and depression. To determine how these psychological factors relate to sexual (dys)function. To uncover what participants see as the source of their sexual problems.
  
  
  METHODS
  Data were collected using a paper-and-pencil questionnaire. Eleven individuals with CAIS and 49 with MRKHS with/without neovagina treatment were included. Rates of sexual dysfunctions, overall sexual function, feelings of inadequacy in social and sexual situations, self-esteem and depression scores were calculated. Categorizations were used to identify critical cases. Correlations between psychological variables and sexual function were computed. Sexually active subjects were compared with sexually not active participants. A qualitative content analysis was carried out to explore causes of sexual problems.
  
  
  METHODS
  An extended list of sexual problems based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, by the American Psychiatric Association and related distress. Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS social scale, FUSS sexual scale), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. Open question on alleged causes of sexual problems.
  
  
  RESULTS
  The results point to a far-reaching lack of sexual confidence and sexual satisfaction in CAIS. In MRKHS apprehension in sexual situations is a source of distress, but sexual problems seem to be more focused on issues of vaginal functioning. MRKHS women report being satisfied with their sex life.
  
  
  CONCLUSIONS
  Different conditions can affect individuals in diagnosis-specific ways despite some shared clinical features. Professionals should adopt an interdisciplinary approach and provide custom-made care in order to promote sexual well-being in patients.
authors.affiliation: Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Fliegner
authors.forename: Kerstin
authors.initials: K
authors.lastname: Krupp
authors.forename: Franziska
authors.initials: F
authors.lastname: Brunner
authors.forename: Katharina
authors.initials: K
authors.lastname: Rall
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Brucker
authors.forename: Peer
authors.initials: P
authors.lastname: Briken
authors.forename: Hertha
authors.initials: H
authors.lastname: Richter-Appelt
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D013734:Androgen-Insensitivity Syndrome / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D000013:Congenital Abnormalities / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D005783:Gender Identity; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009095:Mullerian Ducts / Q000002:abnormalities*; D010555:Personality Inventory; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D014621:Vagina
keywords: Complete Androgen Insensitivity Syndrome; Disorders of Sex Development; Mayer-Rokitansky-Küster-Hauser-Syndrome; Sexual Problems and Personal Distress; Sexual Quality of Life; Sexual Well-Being