Understanding the Diagnostic Odyssey of Women with Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome in Denmark: A Qualitative Interview Study

J Pediatr Adolesc Gynecol. 2024 Aug;37(4):412-418. doi: 10.1016/j.jpag.2024.03.003. Epub 2024 Mar 15.

Abstract

Study objective: The diagnosis of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is often a lengthy process that typically occurs during late adolescence. To support optimized and patient-centered care, this study aimed to investigate how women with MRKH syndrome experience the diagnostic process.

Methods: From January 2021 to March 2021, we conducted in-depth interviews with 18 Danish women (≥25 years) diagnosed with MRKH syndrome. The interviews lasted a median of 92 minutes (range: 67-117). Data were analyzed using thematic analysis.

Results: As teenagers or young women at the time, all women had experienced the diagnostic process in the nonspecialized healthcare sector as deeply upsetting due to distressing gynecological examinations, use of inappropriate language, and considerable diagnostic delay. When reaching the specialized health care sector, questions could finally be answered, but this information and support did not significantly alter their feelings of being "deviant" or "flawed". The women continued their diagnostic odyssey beyond the health care system and found online communities that gave them valuable support in living with MRKH syndrome.

Conclusion: Women experience the diagnostic odyssey of MRKH syndrome as upsetting and potentially traumatizing beyond the diagnosis. Healthcare professionals can influence young women's understanding and experience of MRKH syndrome by using inclusive language (eg, avoiding "deformity") and addressing all that is normal and functioning (eg, external genitalia and potential for sexual pleasure). In nonurgent conditions, young women should be given the choice to delay a genital examination.

Keywords: 46,XX DSD; MRKH; Mullerian aplasia; Qualitative research; Vaginal agenesis.

MeSH terms

  • 46, XX Disorders of Sex Development* / diagnosis
  • 46, XX Disorders of Sex Development* / psychology
  • Adolescent
  • Adult
  • Congenital Abnormalities* / diagnosis
  • Congenital Abnormalities* / psychology
  • Delayed Diagnosis
  • Denmark
  • Female
  • Gynecological Examination / psychology
  • Humans
  • Interviews as Topic
  • Mullerian Ducts* / abnormalities
  • Qualitative Research*
  • Young Adult

Supplementary concepts

  • Mullerian aplasia