Sexual function in women with turner syndrome

Background: Turner syndrome (TS) (45,X) is associated with premature ovarian failure, usually occurring during childhood. Estrogen treatment is required for the development of secondary sexual characteristics and to maintain feminization. The present study aimed to determine the level of sexual activity in adult women with TS participating as volunteers in the NIH natural history study. Methods: The Derogatis Interview for Sexual Functioning was administered to 98 women, average age 37 +/- 10 years (range 18-59) with karyotype-proven TS. Results were compared to gender-based norms, expressed as standardized area T-scores. Results: The average total score was 32 +/- 12, approximately at the 10th centile, based on nonpatient community respondents. The survey included independent sections on fantasy, arousal, experience, orgasm, and relationship. Scores on sexual fantasy were in the normal range and were significantly greater than scores on all the other sections (p < 0.001). Approximately 30% of the study group were involved in a partner relationship, and this group scored within the average range on all sections. We examined factors that might influence sexual function, including age; parental origin of the single normal X chromosome; physical stigmata, such as neck webbing; estrogen use; testosterone levels; age of puberty; and hearing loss, but none of these appeared to contribute. Of all factors investigated, only height and years of education were positively correlated with partnership status and sexual function. In summary, women with TS in a partner relationship report relatively normal overall sexual function, but the majority of unpartnered women reported very low level sexual functioning. Conclusions: Further study is needed to elucidate the nature of psychosocial impediments affecting establishment of partner relations and sexual functioning in women with TS.