“I am 18 year old, and I’ve not menstruated throughout my life” Cynthia says to the doctor.
“I am sorry to hear this Cynthia, but why has it taken you up to this time to come to the hospital”
“It’s because at first, I thought it would till it didn’t come, maybe it was late for me since the time varies with different people. Now though, it has become a matter of concern to me and my parents”
“Do you have any other complaints other than these?”
After an hour
“Cynthia, can I please see your parents privately?”
“Doctor, is there a problem? You can tell me too”
“I will. Just give me a few minutes with your parents first”
“Okay. I’ll wait outside” she says with worry in her eyes
“Mr. and Mrs. Benson, the problem with your daughter is what has prevented her from having her periods. I would not want you to be too distressed over what I’m about to say. From the ultrasound and the MRI taken of her body, we have seen that she has MRKH syndrome”
“What does that mean?” Cynthia’s mum asks
“MRKH syndrome means…”
Mayer Rokitansky Kuster Hauser Syndrome [MRKH], named after the doctors that discovered it is a condition that occurs only in females. In the case of this syndrome, the vagina and the uterus are either underdeveloped or completely absent. Because they have no uterus, menstrual periods is not possible. Even though there is no uterus, there are functioning ovaries and in some cases fallopian tubes. They experience normal secondary sexual development such as development of breast and pubic hair development. The presence of functioning ovaries makes it possible to have babies through other means except carrying babies. It occurs in 1 in 4500 women at their birth
There are two types of MRK syndrome: type 1 and type 2
Type 1: it may not be diagnosed until late adolescence when a female is expected to have started menstruating and has not started. It affects only reproductive organs. People with this type do have fallopian tubes
Type 2: it may be diagnosed earlier than type 1 because other organs and parts of the body are affected. The kidneys may be abnormal, there might be heart problems, and fallopian tubes may not be present. The skeleton may not be formed correctly.
Intercourse may be painful for those with underdeveloped vagina. Many say that it is a genetic disorder, and others say it is because of environmental factors. The truth is that the cause of this syndrome is yet to be confirmed. Also, nothing a mother does during pregnancy can cause or prevent MRKH syndrome. In simple terms, there is no cause to MRKH syndrome.
Apart from the obvious signs of no periods, further diagnosis as MRI, ultrasound helps to detect if there are abnormalities with other organs.
Because vagina in many is underdeveloped, dilators are employed to cause the vagina to expand in length and depth. If expansion is not satisfactory with this method, vaginoplasty which is a surgery to create a functional vagina will be carried out, after which a dilator will still be used. It is possible for a female with MRKH syndrome to have children of her own. Her egg can be fertilized by her partner’s sperm and implanted in another woman’s uterus. The only seeming impossibility is carrying a child in a womb, though recently in some places, uterus transplant is already possible and there have been successful cases of this, even resulting in being able to carry a child in the transplanted uterus.
Many women diagnosed with this have been emotionally affected, and may need counselling because of how they feel. Because many have to undergo surgeries that has something to do with transgender, they have serious problems of low self-esteem. They seriously doubt their gender and may feel depressed. These females may need not only medical solutions, but emotional help.
Many in the world are happy despite this syndrome because they have found solutions with improving technology and improved healthcare. Another reason for their joy is that they have had listening hears to pour out their mind to when they need to. There is no reason to stigmatize or blame anyone for the MRKH syndrome, instead it is important to support anyone who needs it however we can.
Writer: Agboola Stella
Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria