16 Gynecology O B .GYN. NEWS • June 15, 2008 Neovagina May Not Provide Sexual Satisfaction

BY SHERRY BOSCHERT tionnaires to assess psychosocial and func- ported a mean score of 21 on the FSFI, sig- with vaginal agenesis because of androgen San Francisco Bureau tional outcomes after laparoscopic Davy- nificantly lower than a mean score of 30 insensitivity syndrome (AIS) but not in 18 dov, Dr. Kerith L. Lucco said at the annu- reported for control patients in the med- women with vaginal agenesis because of N EWPORT B EACH, CALIF. — Women al meeting of the North American Society ical literature, said Dr. Lucco of the de- Mayer-Rokitansky-Kuster-Hauser with vaginal agenesis who undergo lapa- for Pediatric and Adolescent Gynecology. partment of pediatric and adolescent gy- (MRKH) syndrome, Dr. Lucco noted roscopic Davydov surgery to create a neo- In that previous study, scores on the Fe- necology at the Hospital for Sick Children (Hum. Reprod. 2007;22:2020-4). vagina may have impaired sexual function, male Sexual Function Index (FSFI) did in Toronto. FSFI scores below 24 are con- Approximately 1 in every 4,000 female compared with controls, a study of six not differ significantly among 28 women sidered to represent poor sexual function. babies are born without a vagina because such patients found. who underwent vaginoplasty via laparo- In comparison, a separate recent study of MRKH and approximately 1 in 20,000 The findings of the small study contra- scopic Davydov and a control group found that vaginal dilation improved female babies lack a vagina at birth be- dict results from the only previous study (Hum. Reprod. 2005;20:2954-7). scores for sexual satisfaction and decreased cause of AIS. First-line treatment is vagi- that also used validated self-report ques- In the current study, the six women re- scores for “sexual depression” in 8 women nal dilation, but several surgical methods of creating a vagina have been tried, in- vaginal pain inability to orgasm intmacy and illness cluding the laparoscopic Davydov proce- embarassed decreased pleasure lack of dure, both in untreated patients and in stimulation vaginal discomfort disinterest in sex loss of desire slow response unable to reach orgasam some who have failed vaginal dilation. painful intercourse anxiety no libido cancer Women in the current study ranged in fertility and lubrications intimacy and aging age from 19 to 52 years. All underwent la- vaginal dryness embarassed what is normal low libido vaginal health breast paroscopic Davydov vaginoplasty in 2004- health menopause low sexual desire vaginal dryness 2006 at one of Examine. vaginal atrophy pain during intercourse vulvodynia vaginisums ‘This requires us two Toronto lack of lubrication vaginal pain inability to orgasm intmacy and illness embarassed decreased pleasure lack of stimulation hospitals, and vaginal discomfort disinterest in sex loss of desire slow response to reflect on the Educate. unable to reach orgasam painful intercourse the surgeries anxiety no libido cancer fertility and lubrications outcomes and to technically intimacy and aging what is normal low libido went very well. vaginal health breast health menopause low sexual desire consider whether vaginal dryness vaginal atrophy pain during intercourse Postoperatively, Empower. vulvodynia disinterest lack of lubrication vaginal pain [to revise] the all were provid- inability to orgasm intmacy and illness embarassed decreased pleasure lack of stimulation vaginal discomfort surgical ed with either a disinterest in sex loss of desire slow response vaginal stent or unable to reach orgasam painful intercourse anxiety technique, a dilator for an pain no libido cancer fertility and lubrications intimacy and aging urse vulvodynia disinterest in sex loss of desire slow response unable to reach orgasam vulvodyn potentially by average of 6.5 at is normal low libido vaginal health breast health menopause low sexual desire vaginal dryness vaginal a months, said ring intercourse vulvodynia vaginisums lack of lubrication vaginal pain inability to orgasm intmacy and illness e increasing the decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of desire slow response unable t Dr. Lucco. orgasam painful intercourse anxiety no libido cancer fertility and lubrications intimacy and aging what is normal low Two women vaginal health breast health menopause low sexual desire vaginal dryness vaginal atrophy pain during inter size of the stent.’ ulvodynia vaginisums lack of lubrication vaginal pain inability to orgasm intmacy and illness embarassed decreased reported that k of stimulation vaginal discomfort disinterest in sex loss of desire slow response unable to reach orgasam painful their vaginas now were “OK/normal,” oss of desire anxiety breast health menopa two said their vaginas were smaller than xiety no libido cancer fertility and lubr ications intimacy and aging what is normal low lib embarassed decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of desire slow re average, one patient each said their vagi- enopause low sexual desire vaginal dryness vaginal atrophy pain during intercourse vulvodynia vaginisums lack of na was short or narrow, and two described vaginal pain inability to orgasm intmacy and illness embarassed decreased pleasure lack of stimulation vaginal dis sinterest in sex loss of desire slow response unable to reach orgasam painful intercourse anxiety no libido cancer their vaginas as small. Three said they lubrications intimacy and aging what is nor low libido vaginal health breast health menopause low sexual desir would like their vaginas to be longer. yness vaginal atrophy pain during intercourse vulvodynia vaginisums lack of lubrication vaginal pain inability to orga “This requires us to reflect on the out- d illness embarassed decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of desire slo unable to reach orgasam painful intercourse anxiety no libido cancer fertility and lubrications intimacy and ag comes and to consider whether there is lubrication vaginal pain inability to orgasm intmacy and illness disinterest in sex los cause for revising the surgical technique, hat is normal low libido vaginal health breast health menopause loss of desire vaginal dryness vagin pain during intercourse vulvodynia vaginisums lack of lubrication vaginal pain inability to orgasm intmacy and ill potentially by increasing the size of the mbarassed decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of desire slow response stent that is placed postoperatively,” Dr. reach orgasam painful intercourse anxiety no libido cancer fertility and lubrications intimacy and aging what is normal low libido vaginal health breast health menopause low sexual desire vaginal dryness vaginal at Lucco said. pain during intercourse vulvodynia vaginisums lack of lubrication vaginal pain inability to orgasm intmacy and ill Women in the study scored significant- mbarassed decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of desire slow response reach orgasam painful intercourse anxiety no libido cancer fertility and lubrications intimacy and aging ly lower than controls on the FSFI, out of what is normal low libido vaginal health breast health menopause low sexual desire vaginal dryness vaginal atr a total of 6 points per category in mea- It’s whatpain you during do. intercourse It’s what vulvodynia we do. vaginisums lack of lubrication inability to orgasm intmacy and illness sures of arousal (mean scores of 4 vs. 5, embarassed decreased pleasure lack of stimulation vaginal discomfort disinterest in sex loss of response unable to reach orgasam painful intercourse anxiety no libido cancer fertility and lubrications intimacy an respectively), lubrication (4.4 vs. 5.5), or- Created with the well-beingwhat is normal of the lowfemale libido form vaginal in health breast health menopause low sexual desire vaginal drynes gasm (3.3 vs. 5), and comfort (1.9 vs. 5.5). mind, Mí by Arkadia is dedicated to improving vaginal the atrophy pain during intercourse vulvodynia vaginisums lack of lubrica The study also had women complete vaginal pain inability to orgasm intmacy and illness emb quality of women’s sexual health. decreased Sign up for pleasureour free lack of stimulation vaginal discomfort disinterest in sex loss of de the Golombok Rust Inventory of Sexual slow response unable 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Of the four women who’d had or call 866-440-3377 and enroll today. menopause low sexual desire vaginal dryness vaginal atrop pain during intercourse vulvodynia vaginisums lack of lubrication intercourse, two had FSFI scores in the vaginal pain inability to orgasm intmacy and illness embarassed decreased pleasure “good” or better range. ■