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A Cognitive Behavioural Model and Therapy for Utero-Vaginal Agenesis (Mayer-Rokitansky-Küster-Hauser Syndrome: MRKH)

Published online by Cambridge University Press:  10 June 2009

Jacoline G. Heller-Boersma ,
D. Keith Edmonds  and
Ulrike H. Schmidt
Jacoline G. Heller-Boersma*
Affiliation:
Queen Charlotte's and Chelsea Hospital and City University, London, UK.
D. Keith Edmonds
Affiliation:
Queen Charlotte's and Chelsea Hospital, London, UK.
Ulrike H. Schmidt
Affiliation:
Institute of Psychiatry, London, UK
*
Reprint requests to Jacoline G. Heller-Boersma, “Scaling Your Mountains” Therapeutic Practice, The Attic Room, Sandy Bay Holistic Veterinary Centre, 11 Gregory Street, Sandy Bay, Hobart 7005, Tasmania, Australia. E-mail: scalingyourmountains@bigpond.com
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Abstract

Background: Utero-vaginal agenesis, also called the Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), is a congenital abnormality of the female genital tract, characterized by the non-formation of the vagina and the uterus. It is a common cause of primary amenorrhoea. Little is known about the psychological impact and management of this condition. Method: We describe a specific model of the core negative psychological impact of diagnosis and medical treatment of MRKH and a cognitive-behavioural therapy of MRKH based on the model (CBT-MRKH). The Medical Research Council's (2002) framework for the development and evaluation of complex health interventions was used for intervention development and evaluation. Results: Evidence from a recent cross-sectional study and a small randomized controlled trial (RCT) provides preliminary support for the model and treatment (Heller-Boersma, Schmidt and Edmonds, in press; Heller-Boersma, Schmidt and Edmonds, 2007), and this is further validated by extensive qualitative material gathered over the course of the RCT from participants. Conclusions: The model and treatment described may also be applicable to a number of other congenital or acquired gynaecological conditions such as premature ovarian failure, breast cancer, early onset endometrial cancer, female genital mutilation, Turner's Syndrome, ovarian dys/agenesis or, Complete Androgen Insensitivity Syndrome, all of which have a psychological impact not dissimilar to MRKH in terms of these women's sense of self and femininity.

Keywords

Utero-vaginal agenesisMayer-Rokitansky-Küster-Hauser Syndromecognitive-behavioural therapypsychological management of MRKHadjustment to diagnosis and treatment of MRKH
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 37 , Issue 4 , July 2009 , pp. 449 - 467
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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