BACKGROUND: Women with complete androgen insensitivity syndrome (CAIS) have always been presented as unequivocally feminine women with normal sexual function. However they have both physical and psychological factors that might predispose them to suffer sexual dysfunction, eg: shorter than average vaginas, an inability to respond to androgens and anxieties or concerns about their condition, which could impact on self esteem, body image, sensuality and sexual function.

METHODS: This was a questionnaire study and retrospective hospital notes review, looking at sexual function in XY females with a diagnosis of CAIS. The questionnaire comprised details on diagnosis and treatment and a modified sexual function inventory (GRISS) which provided scores encompassing seven areas of female sexual function. All respondents were invited for a clinical examination and all hospital notes were collected and analysed for details of diagnosis and treatments.

RESULTS: 62 women with a current diagnosis and clinical features compatible with CAIS completed and returned the questionnaire. 21/62 (34%) were examined. 17/62 (27%) were patients and 45/62 (73%) were recruited through the AISSG (Androgen Insensitivity Syndrome Support Group). 6/62 (10%) had never been sexually active, and 2/62 did not complete the sexual function questionnaire, leaving sexual function data on 54 women. Global mean sexual function scores were worse than the population average. Mean scores were worst for infrequent sexual activity, non-communication with partner about sexual activity and difficulty with vaginal penetration.

CONCLUSIONS: Sexual dysfunction is common in CAIS, most significantly in the areas of difficulty with vaginal penetration, infrequency and non-communication.