Sexual Satisfaction and Self-Concept of Women With Mayer-Rokitansky-Küster-Hauser (MRKH) After Vaginoplasty Surgery: A Case Control Study
Abstract
Women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome do not have proper performance and sexual satisfaction because of physical problems. MRKH syndrome leads to psychological and identity problems and has a negative effect on self-concept. This study aimed to compare the sexual satisfaction and self-concept of women with MRKH syndrome before and after vaginoplasty with normal women. The current study was a case study with a pre-test, post-test design and a control group. Fifteen people were selected using the purposeful sampling method, and 15 normal newly married women were also selected as a control sample group. In both groups, sexual satisfaction and self-concept questionnaires were administered; after the relevant vaginoplasty surgery, only in the test group, and after six months, both groups completed the sexual satisfaction and self-concept questionnaires as a post-test. Hudson's sexual satisfaction questionnaire and Rogers' self-concept questionnaire were used to collect the data. Data were analyzed using multivariate covariance analysis. The results indicated that the average levels of sexual satisfaction and self-concept in women with MRKH syndrome significantly increased after vaginoplasty in comparison to their preoperative scores; but compared to the women of the control group, it is lower. To increase sexual satisfaction and improve the self-concept of women with MRKH syndrome, vaginoplasty surgery can be used as an effective treatment and an efficient program.
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8. Spence J. Military sexual trauma in female veterans: Psychoeducation and treatment approaches; 2017.
9. Ghafarnejad M, Darvish S, Izadi-Mood N, Samimi-Sade S, Esmaeili S. Vaginal reconstruction using no grafts with evidence of squamous epithelialization in neovaginal vault: A simple approach. J Obstet Gynaecol Res 2011;37:195-201.
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13. Zhang Q, Miao L, He L, Wang H. The relationship between self-concept and negative emotion: a moderated mediation model. Int J Environ Res Public Health 2022;19:10377.
14. Gielkens EMJ, Sobczak S, Rossi G, Rosowsky E. EMDR as a treatment approach of PTSD complicated by comorbid psychiatric, somatic, and cognitive disorders: A case report of an older woman with a borderline and avoidant personality disorder. Clin Case Stud 2018;17:328-47.
15. Slotema CW, van den Berg DPG, Driessen A, Wilhelmus B. Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study. Eur J Psychotraumatol 2019;10:1614822.
16. Cash TF, Theriault J, Milkewicz Annis N. Body image in an interpersonal context: Adult attachment, fear of intimacy, and social anxiety. J Soc Clin Psychol 2004;23:89-103.
17. Aramats CA, Moran L, Sands RT. Gender differences in body image concerns and depression amongst Australian adolescents. The Abstracts of the 38th Conference of the Australian Psychological Society; 2003.
18. Eftekhar T, Ghanbari Z, Foroughifar T, Hagh Elahi F. Comparing sexual function in normal women and women having undergone vaginoplasty for Rokitansky syndrome. J Reprod Infertil 2011;11:269-73.
19. Hudson WW, Harrison DF, Crosscup PC. A short-form scale to measure sexual discord in dyadic relationships. J Sex Res 1981;17:157-74.
20. Khajeh F, Khezri Moghadam N. The relationship between emotional awareness, interpersonal problems, and marital satisfaction in married female nurses. Sci Mon J Fac Nurs Midwifery Urmia 2016;14:630-8.
21. Pour Akbar S. Investigating the role of personality traits in explaining the relationship between sexual satisfaction and marital satisfaction [Master's thesis]. Tehran: Faculty of Psychology, Tarbiat Modares University; 2012.
22. Mokundi B, Shahani Yilagh M, Najarian B. Comparing alexithymia and emotional intelligence between male and female students of Islamic Azad University, Ahvaz branch. New Findings Psychol 2011;6:47-57.
23. Lyubomirsky S, King L, Diener E. The benefits of frequent positive effect: Does happiness lead to success? Psychol Bull 2005;137:803-55.
24. Emami Meybodi E, Ahadi B, Farah Bijari A. Development and testing of a causal model of adolescent self-esteem based on parent-child relationships and fundamental psychological needs: with mediation of self-concept. Clin Psychol Personal 2023;21:103-20.
25. Taghizadeh Z, Omani Samani R, Kazem-Nejad A, Riasi M. Self-concept and self-disconnection in two groups of women candidates for egg donation and donation. Hayat 2015;21:50-62.
26. Erdogan G, Genis B, Bingol TY, Gurhan N, Aksu MH. The effect of vaginoplasty on coping with stress, self-esteem, and sexual satisfaction in Turkish women: a cross-sectional controlled study. Eur J Plast Surg 2022;45:951-7.
27. Dejan B, Lotfi R, Mahdizadeh Z, Rahimzadeh M, Mohammadzadeh M, Karimzadeh M. Comparison of sexual self-concept in fertile and infertile women visiting community health and infertility centers in Karaj city in 2017. Sci Res J Alborz Univ Med Sci 2021;11:35-44.
28. Goodman MP, Placik OJ, Matlock DL, Simopoulos AF, Dalton TA, Veale D, et al. Evaluation of body image and sexual satisfaction in women undergoing female genital plastic/cosmetic surgery. Aesthet Surg J 2016;36:1048-57.
29. Vigl J, Strauß H, Talamini F, Zentner M. Trajectories of relationship and sexual satisfaction over two years in the Covid-19 pandemic. J Pers 2025;93:259-74.
30. Lotfollahi H, Riazi H, Omani Samani R, Maroufizadeh S, Montazeri A. Sexual self-concept in fertile and infertile women: A comparative study. Int J Fertil Steril 2021;15:1560-64.
2. Rajai F, Gorji Y. Investigation of the role of sexual issues in the marital lives of couples seeking divorce using thematic analysis. Interdiscip Res Women 2022;11:49.
3. Bancroft J. Sexual motivation and behaviour. In: Colman AM. Companion Encyclopedia of Psychology. Milton Park in Abingdon, Oxfordshire: Routledge; 2019:542-59.
4. Meyrs D. The friends, funds, and faith of happy people. Am Psychol 2009;55:56-67.
5. Zarei F, Asadpour I, Mohsenzadeh F. The effectiveness of motivational interviewing on marital satisfaction and self-efficacy of mothers with children suffering from cerebral palsy. J Psychol Sci 2024;23:305-22.
6. Bigdeli-Mojarad F, Entesar-Foomani G, Hajazi M. The effectiveness of cognitive-behavioral sex therapy on reducing marital boredom and increasing marital quality among married female nurses. Nurs Res 2020;15:1-9.
7. Liu E, Roloff ME. To avoid or not to avoid: When emotions overflow. Commun Res Rep 2015;32:332-9.
8. Spence J. Military sexual trauma in female veterans: Psychoeducation and treatment approaches; 2017.
9. Ghafarnejad M, Darvish S, Izadi-Mood N, Samimi-Sade S, Esmaeili S. Vaginal reconstruction using no grafts with evidence of squamous epithelialization in neovaginal vault: A simple approach. J Obstet Gynaecol Res 2011;37:195-201.
10. Carroll S, Laufer MR, Thomas-Kowal P, Lossie AC, Moss-Morris R. From engulfment to enrichment: Associations between illness representations, self-concept, and psychological adjustment in Mayer-Rokitansky-Küster-Hauser Syndrome. J Pediatr Adolesc Gynecol 2020;33:639-48.
11. Jensen AH, Herlin MK, Vogel I, Lou S. A life course perspective on Mayer-Rokitansky-Küster-Hauser syndrome: women’s experiences and negotiations of living with an underdeveloped uterus and vagina. Disabil Rehabil 2024;46:1130-40.
12. Pondeh-Najadan AA, Attari Y, Dardaneh H. Predicting quality of life based on mindful eating with mediation of body image and eating behaviors in married women with overweight and obesity. Couns Psychother Cult 2018;9:141-70.
13. Zhang Q, Miao L, He L, Wang H. The relationship between self-concept and negative emotion: a moderated mediation model. Int J Environ Res Public Health 2022;19:10377.
14. Gielkens EMJ, Sobczak S, Rossi G, Rosowsky E. EMDR as a treatment approach of PTSD complicated by comorbid psychiatric, somatic, and cognitive disorders: A case report of an older woman with a borderline and avoidant personality disorder. Clin Case Stud 2018;17:328-47.
15. Slotema CW, van den Berg DPG, Driessen A, Wilhelmus B. Feasibility of EMDR for posttraumatic stress disorder in patients with personality disorders: a pilot study. Eur J Psychotraumatol 2019;10:1614822.
16. Cash TF, Theriault J, Milkewicz Annis N. Body image in an interpersonal context: Adult attachment, fear of intimacy, and social anxiety. J Soc Clin Psychol 2004;23:89-103.
17. Aramats CA, Moran L, Sands RT. Gender differences in body image concerns and depression amongst Australian adolescents. The Abstracts of the 38th Conference of the Australian Psychological Society; 2003.
18. Eftekhar T, Ghanbari Z, Foroughifar T, Hagh Elahi F. Comparing sexual function in normal women and women having undergone vaginoplasty for Rokitansky syndrome. J Reprod Infertil 2011;11:269-73.
19. Hudson WW, Harrison DF, Crosscup PC. A short-form scale to measure sexual discord in dyadic relationships. J Sex Res 1981;17:157-74.
20. Khajeh F, Khezri Moghadam N. The relationship between emotional awareness, interpersonal problems, and marital satisfaction in married female nurses. Sci Mon J Fac Nurs Midwifery Urmia 2016;14:630-8.
21. Pour Akbar S. Investigating the role of personality traits in explaining the relationship between sexual satisfaction and marital satisfaction [Master's thesis]. Tehran: Faculty of Psychology, Tarbiat Modares University; 2012.
22. Mokundi B, Shahani Yilagh M, Najarian B. Comparing alexithymia and emotional intelligence between male and female students of Islamic Azad University, Ahvaz branch. New Findings Psychol 2011;6:47-57.
23. Lyubomirsky S, King L, Diener E. The benefits of frequent positive effect: Does happiness lead to success? Psychol Bull 2005;137:803-55.
24. Emami Meybodi E, Ahadi B, Farah Bijari A. Development and testing of a causal model of adolescent self-esteem based on parent-child relationships and fundamental psychological needs: with mediation of self-concept. Clin Psychol Personal 2023;21:103-20.
25. Taghizadeh Z, Omani Samani R, Kazem-Nejad A, Riasi M. Self-concept and self-disconnection in two groups of women candidates for egg donation and donation. Hayat 2015;21:50-62.
26. Erdogan G, Genis B, Bingol TY, Gurhan N, Aksu MH. The effect of vaginoplasty on coping with stress, self-esteem, and sexual satisfaction in Turkish women: a cross-sectional controlled study. Eur J Plast Surg 2022;45:951-7.
27. Dejan B, Lotfi R, Mahdizadeh Z, Rahimzadeh M, Mohammadzadeh M, Karimzadeh M. Comparison of sexual self-concept in fertile and infertile women visiting community health and infertility centers in Karaj city in 2017. Sci Res J Alborz Univ Med Sci 2021;11:35-44.
28. Goodman MP, Placik OJ, Matlock DL, Simopoulos AF, Dalton TA, Veale D, et al. Evaluation of body image and sexual satisfaction in women undergoing female genital plastic/cosmetic surgery. Aesthet Surg J 2016;36:1048-57.
29. Vigl J, Strauß H, Talamini F, Zentner M. Trajectories of relationship and sexual satisfaction over two years in the Covid-19 pandemic. J Pers 2025;93:259-74.
30. Lotfollahi H, Riazi H, Omani Samani R, Maroufizadeh S, Montazeri A. Sexual self-concept in fertile and infertile women: A comparative study. Int J Fertil Steril 2021;15:1560-64.
| Files | ||
| Issue | Vol 63 No 4 (2025) | |
| Section | Original Articles | |
| Keywords | ||
| Vaginoplasty Sexual satisfaction Self-concept Mayer-rokitansky-küster-hauser (MRKH) | ||
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How to Cite
1.
Mahmoud Alilou M, Bakhshipour Roudsari A, Adabi K, Ghanbari Z, Noureh F. Sexual Satisfaction and Self-Concept of Women With Mayer-Rokitansky-Küster-Hauser (MRKH) After Vaginoplasty Surgery: A Case Control Study. Acta Med Iran. 2025;63(4):214-220.
