Research
Reproductive endocrinology and infertility
Turner's syndrome and other forms of congenital hypogonadism impair quality of life and sexual function

https://doi.org/10.1016/j.ajog.2013.01.011Get rights and content

Objective

We sought to assess the burden of Turner's syndrome (TS) and other congenital hypogonadisms (OCH) on quality of life (QOL) and sexual function.

Study Design

An observational study was undertaken in a gynecological endocrinology unit of a teaching hospital. Three cohorts of women aged 20-50 years were compared: 26 TS patients, 21 women with OCH and wild-type karyotype, and 41 healthy age-matched women who were included as controls. All subjects filled out the Medical Outcome Study Short Form (SF-36) and the Female Sexual Function Index.

Results

TS subjects had significantly worse QOL scores in physical functioning (P = .026) and role physical functioning (P = .032) whereas OCH showed significantly worse scores in physical functioning (P = .027) and bodily pain (P = .025) compared to controls. In all, 80% of OCH and 50% of TS patients declared sexual activity. Sexually active TS patients had poorer arousal outcomes (P = .009) and OCH women showed significantly worse scores in arousal (P = .002), orgasm (P = .007), pain (P = .001), and Female Sexual Function Index total score (P = .004) compared with healthy controls. No differences between sexually active and inactive TS women were found in SF-36 scores, clinical characteristics, or anthropomorphic characteristics.

Conclusion

TS and OCH subjects presented impaired physical domains in QOL. Women with TS are less likely to be involved in sexual activity, arousal dysfunctions being their main symptom. Conversely, arousal, orgasm, pain, and total score were significantly affected in OCH subjects.

Section snippets

Patients

A total of 47 women aged 20-50 years presenting primary amenorrhea were included in this prospective cohort study from June 2010 through July 2011. According to the American Society for Reproductive Medicine criteria,15 patients had TS or OCH.

TS women (n = 26) were included as the first cohort. TS diagnosis was done by blood sample karyotype showing total or partial absence of X chromosome in, at least, >10% of leukocytes. All women were receiving hormone replacement therapy (HRT) for the

Results

Clinical and anthropometrical characteristics of the subjects are shown in Table 1. As expected, controls and OCH patients were taller than TS patients, and only 13 women with TS had spontaneous menarche. All women with TS who presented spontaneous menarche developed ovarian failure at age <30 years (mean time of spontaneous menses 7.1 ± 6.4 years). All controls had menarche at age <16 years, whereas the mean age of spontaneous or induced menarche among TS subjects was 18.2 years. Finally, up

Comment

The main findings of the present study are: (1) women with congenital hypogonadisms (either TS or OCH) presented worse QOL than age-matched healthy women; and (2) hypogonadism is related to poor sexual functioning.

Data from previous studies suggest that TS women presented normal health-related QOL.9, 10 However, TS patients in our study scored worse QOL in 2 physical subscales of SF-36: physical functioning and role physical functioning. These results are in accordance with a recent study using

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    • Cited by (0)

    C.R. is the recipient of a fellowship (HB-10-EL-RC-C) from Hospital Clinic i Provincial de Barcelona. The author's work was independent of the funder, which had no role in the study design, analysis of data, writing of the manuscript, or decision to submit for publication.

    The authors report no conflict of interest.

    Cite this article as: Ros C, Alobid I, Balasch J, et al. Turner's syndrome and other forms of congenital hypogonadism impair quality of life and sexual function. Am J Obstet Gynecol 2013;208:484.e1-6.

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