Sexual Function in Women with Müllerian Anatomic Differences of the Genitourinary Tract-A Qualitative Evaluation

Müllerian anomalies are congenital anomalies of the female reproductive tract. Patients with Müllerian anomalies frequently report difficulty with sexual function, yet no standardized patient-reported sexual function tools exist specific to this population. This study aimed to explore sexual function, through qualitative interviews, in women with Müllerian anomalies to identify themes and develop a conceptual model to later be used in the development of a sexual function questionnaire.

We conducted semi-structured qualitative interviews with 11 female patients with Müllerian anomalies. The interview guide was developed based on expert consultation and extensive literature review to identify what current sexual function questionnaires address and what sexual function concerns related to Müllerian anomalies are reported. Questions explored topics such as sexual pleasure, interpersonal relationships, physical and emotional discomfort during sex, sex education received from healthcare providers, and treatment goals related to sexual function. Interviews were conducted with female-identifying patients with Müllerian anomalies over 4 months. Interviews were transcribed, and qualitative thematic analysis was performed in NVivo to identify themes.

Eleven participants were recruited with Müllerian anomalies affecting the uterus, cervix, and/or vagina. Six major themes affecting sexual function were identified from interview transcripts: symptoms, diagnosis, providers, treatment, self-concept, and social context. Major and minor themes were used to develop a conceptual model.

Women with Müllerian anomalies face unique sexual challenges due to their anatomy and socio-emotional interplay, in addition to those experienced by the general population. Patient education materials and screening tools specific to this population are needed.