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Assessment of Sexual Functioning, Mental Health, and Life Goals in Women with Vaginal Agenesis

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Abstract

Vaginal agenesis is a congenital disorder defined by the incomplete formation of the vagina and other reproductive organs, often including the cervix, uterus, and fallopian tubes. For the patient, this frequently means infertility and an underdeveloped vagina with the subsequent difficulty to have vaginal intercourse. The patient with vaginal agenesis and her family then encounter a variety of psychological concerns that must be addressed during diagnosis, including weighing treatment options, managing interventions, and coping with long-term issues following diagnosis and treatment, such as partnership concerns and infertility. In this study, seven patients between the ages of 18 and 34 completed questionnaires assessing demographic information, sexual functioning, mental health, self-esteem, and life goals. Sexual functioning results were highly variable. Participants reported significant emotional reactions at diagnosis as well as anxiety about the disorder, specifically its role in relationships. However, overall, the group showed average levels of mental health and self-esteem. Participants also showed positive coping techniques through conceptualization of life goals.

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Acknowledgments

This research was funded by the University of Michigan Health Systems, Department of Social Work. Most importantly, we thank the women who gave their time to take part in this study. We also thank Dr. Joseph Himle, Lisa Engel Evans, and Sallie Foley for their roles as consultants, the Editor, and the journal's anonymous referees for their helpful comments on the final revision of this article

Author information

Authors and Affiliations

  1. Department of Psychology, University of California, Room 277, Social Sciences 2, Santa Cruz, California, 95064, USA

    Elizabeth M. Morgan

  2. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA

    Elisabeth H. Quint

Authors
  1. Elizabeth M. Morgan
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Corresponding author

Correspondence to Elizabeth M. Morgan.

Appendices

Appendix A. Individual items in the female sexual health measure

  1. 1.

    How satisfied have you been with your overall sex life?

  2. 2.

    How enjoyable do you find sexual activity without sexual intercourse?

  3. 3.

    How enjoyable do you find sexual intercourse?

  4. 4.

    How would you rate your frequency of sexual intercourse?

  5. 5.

    How sexually attractive does your partner find you?

  6. 6.

    How sexually attracted are you to your sexual partner?

  7. 7.

    Do you have pain with intercourse?

  8. 8.

    Do you have pain after intercourse?

  9. 9.

    Do you have bleeding with intercourse?

  10. 10.

    Do you feel unable to have sex due to the size of your vagina?

  11. 11.

    Does sex cause you pain because your vagina is too small?

  12. 12.

    Do the muscles in your vagina contract so much as not to allow penetration or make penetration difficult?

  13. 13.

    Do the muscles in your vagina contract so much as to make pelvic exams at the doctor's office painful?

  14. 14.

    Are you worried that sex may hurt?

  15. 15.

    Do you feel anxious about having sex?

  16. 16.

    Have you had sexual intercourse? (yes/no response)

  17. 17.

    How old were you when you first had sexual intercourse?

  18. 18.

    If you have not had intercourse, when are you interested in having intercourse (check all that apply)

Options: have had intercourse, not interested in having intercourse, as soon as I can, when I am in a committed relationships, when I am married

Note. Questions have a 5- or 6-point Likert response option unless otherwise noted; all questions included a “not applicable” option. The measure included the following prompt: Below is a list of questions that ask about sexual issues in your life. Please read each one carefully and check the box below that best corresponds to your sexual experiences.

Appendix B. Individual items in the life goals measure

  1. 1.

    Do your future goals include being married?

  2. 2.

    Are you interested in raising children?

  3. 3.

    Do you feel that adoption is a good alternative to having your own children?

  4. 4.

    Do you feel that in vitro fertilization with a surrogate (using your eggs and your partner's sperm to create a baby that would grow in another woman's uterus) is a good alternative to having your own children?

  5. 5.

    How important is it to you to have children (1 = not at all; 5 = extremely)

  6. 6.

    Are you planning on pursuing a professional career?

  7. 7.

    What would you like to do for work/career? (open-ended response)

  8. 8.

    What are you education aspirations? (open-ended response)

  9. 9.

    Please rate the importance of these elements in your life from 1 to 6.

    Options: education, staying connected to family (parents, siblings), focus on career/work, marriage/partnership commitment, travel/leisure, physical health/mental health, financial matters, raising children.

  10. 10.

    Have any illnesses/medical issues influenced the way you see the course of your life? If yes, please explain.

Note. Questions have yes/no response options unless otherwise noted. The measure included the following prompt: Please read the questions carefully and circle the answer, check the answer, or fill in the answer that best describes your current expectations, desires, and goals for the next 10 years.

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Morgan, E.M., Quint, E.H. Assessment of Sexual Functioning, Mental Health, and Life Goals in Women with Vaginal Agenesis. Arch Sex Behav 35, 607–618 (2006). https://doi.org/10.1007/s10508-006-9054-2

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