 | ||
|
| |    Absence of the Uterus (Vaginal Agenesis) by Marjorie Greenfield, M.D. reviewed by Laura Jana, M.D., F.A.A.P. Many girls and women have never heard of vaginal agenesis, a condition in which a girl is born without a uterus. And yet it's fairly common, affecting 1 out of every 4,000 girls. The condition can be traced to the fetal stage of development, when the uterus and upper vagina do not form properly. Abnormalities of the kidneys or bones may occur as well. Girls with vaginal agenesis (also referred to as mullerian agenesis, Rokitansky syndrome, and Mayer-Rokitansky-Kuster-Hauser--or MRKH--syndrome) usually experience normal puberty--including breast development, the appearance of pubic hair, and a growth spurt--but they never get a period. The external, visible genital area of girls with this condition looks totally normal; it's only upon closer examination that a healthcare practitioner will discover a very shallow vagina and, after further testing, the absence of a cervix and uterus. Occasionally there is a small, nonfunctional "remnant uterus." Ultrasound or magnetic resonance imaging (MRI) scan is usually needed to be certain about this diagnosis. Sexual intercourse Before sexual intercourse is possible, most girls with vaginal agenesis must undergo a procedure to lengthen the vagina. This generally is best accomplished with the dilation method, where a young woman is taught how to put pressure on the inside of her vagina with a dilator, as instructed by a doctor or nurse. Most girls feel ready to take on this responsibility between the ages of 15 and 20. Gradually, after a few months of daily exercises, the vagina becomes deeper and wider, to make intercourse possible. While there are surgical procedures to lengthen the vagina, they present more complications than dilation does and are not the best choice for the majority of young women. To find an expert on vaginal agenesis in your area, ask your doctor or contact one of the support groups listed at the end of this article. Having children Since a girl with vaginal agenesis doesn't have a uterus, she won't get periods and can't give birth. She does, however, have eggs. So if and when a woman with vaginal agenesis wants to have a baby, her own eggs can be used, together with her partner's sperm, for in vitro fertilization. Once the egg is fertilized, the embryo(s) can then be implanted in the uterus of a gestational carrier (surrogate mother) to carry the pregnancy to term. Emotional issues Understandably, most girls are very distressed at the time they find out their diagnosis and often continue to feel that way for years afterward. There are layers of issues, from frustration at being different to grief over the prospect of never being able to give birth. Routine occurrences, like being asked for the date of her last menstrual period at the doctor's office or overhearing friends talk about birth control, can serve as painful reminders to a girl who has vaginal agenesis and can in some cases be devastating. Parents, too, go through a grieving process as they adjust to what this diagnosis means for their daughter. Most young women and their families benefit from psychological counseling to help with this adjustment. Certainly, distress over the diagnosis can affect a girl's romantic relationships, but there is no physical reason why those with vaginal agenesis can't have satisfying sex lives, including vaginal intercourse. The value of support groups Support from others with the same or a similar condition, as well as psychological counseling with a professional who has an understanding of the diagnosis, can greatly boost a young woman's comfort and confidence levels in developing an intimate relationship. For a terrific website for girls and women with a condition similar to vaginal agenesis, operated by an international support group, visit www.medhelp.org/www/ais. Some newer sites for MRKH include www.surrogacy.com/online_support/mrkh/; www.mrkh.org; and http://www.egroups.com/group/mrkh-grrls.
| |  | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About Us |
Contact Us |
Our Partners Privacy Policy | Ethics | Advertising Policy | Terms of Service © Copyright 2004 The Dr. Spock Company. All Rights Reserved. THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com
provides is for educational purposes only and is not a substitute for
professional medical advice. Always seek the advice of your health care
professional if you have a specific health concern. Mention or advertisement
of any product, service, or brand does not constitute endorsement, guarantee,
or recommendation by The Dr. Spock Company. Please read our full
Terms of Service. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
