Talk:Müllerian agenesis

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Self-reference?

The Vecchietti procedure is a laparoscopic procedure that has been shown to result in a vagina that is comparable to a normal vagina in patients with Mullerian agenesis.

The article is *about* Mullerian agenesis. I believe perhaps this section was taken from a section concerning MTF SRS, as it is common to mention that post-vaginoplasty an MTF will typically have anatomy that is indistinguishable from a female with Mullerian agenesis. --Puellanivis 03:13, 13 March 2007 (UTC)[reply]

Causes of primary amenorrhea

Apparently, myself and an anonymous editor are in dispute as to whether Müllerian agenesis is the most, or the second-most common cause of primary amenorrhea. I believe it to be the most common cause, while they don't, citing hypergonadotropic hypogonadism. So which is correct? Here are the cites that I used;

  • Parikh, R.; Nakum, K.; Kadikar, G.; Gokhle, A. (2013). "Mullerian anomalies: A cause of primary amenorrhea". International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2 (3): 393. doi:10.5455/2320-1770.ijrcog20130926.
  • Welt, Corinne K.; Barbieri, Robert L. "Etiology, diagnosis, and treatment of primary amenorrhea". Retrieved 1 February 2015.

Thoughts / comments? - Alison ❤ 07:39, 2 February 2015 (UTC)[reply]

I am said user. I am currently taking a reproductive physiology class, and so I guess that would be my source. The most common cause of primary amenorrhea is Gonadal Failure (or hypergonadotropic-hypogonadism) and causes 50% of cases. It is a genetic disorder resulting in a gonadal streak instead of full gonads. This results in less estrogen which in turn lowers the the inhibitory feedback on the pituitary, leading to high gonadotropic levels, which is the cause of amenorrhea. Uterine agenesis is the second most common cause (15% of primary amenorrhea patients, 1 in 4500 births). It is a congenital absence of the uterus (Rokitansky-Kuster-Hauser syndrome), but the female still has ovaries, a cyclic ovulation, pubic/axillary hair and a normal range of hormones. I believe what you are referring to in the Mullerian Agenesis article is androgen resistance. This is not the same as R-K-H syndrome, nor would it be the first or second most common cause of primary amenorrhea (So my correction would actually be wrong). It is the lack of internal genitalia and the presence of female external genitalia in genetic males. It is due to a resistance of androgens (testosterone) which causes breast development and small, rudimentary male gonads which are often removed. The lack of internal genitalia (the uterus) is due to Mullerian Inhibitory Substance, which is normal for males, and causes the vaginal pouch to be short (it doesn't lead to anything). Because it is a genetic male, the estrogen levels are in the male range, however there is little to no testosterone due to the androgen resistance. The lack of female gonads and a uterus leads to the amenorrhea.

Removing the vaginal agenesis image

The MRKH community objects to the use of the current image on the Muellerian Agenesis/MRKH Syndrome page. We feel that this image is unnecessarily graphic and shows a poor representation of our syndrome. MRKH is a condition that primarily affects the development of internal organs, so we feel that a diagram would be a much more useful visual aid. If no such image is available we would prefer this page to be image-free as it was a couple of years ago. Some members of our community feel uncomfortable "coming out" to family and friends out of fear that they will google MRKH and have this graphic image be the first thing they see. — Preceding unsigned comment added by Spw94 (talk • contribs)

The MRKH community finds this image extremely offensive. The image is very graphic and is not required to explain the MRKH Syndrome. For someone, searching for MRKH information, this image is not the correct representation as this condition is related to the internal organs. Clearly, the user who is uploading this image again and again has no idea what this condition is about. This image should be removed immediately.— Preceding unsigned comment added by 2601:2c3:8202:77f0:3592:4f82:a447:b319 (talk • contribs)

  • Hi there. Thanks for posting your valuable opinion here as a person with MRKH - it's appreciated. It's a difficult situation and I can understand where people are coming from, though I don't personally have MRKH Syndrome. Due to the way Wikipedia works, it will likely be allowed stay as Wikipedia has a policy on what they see as 'censorship'. This can be harsh on those who are personally involved. What might work would be if the image could be placed lower down on the page, so it's not the exact-first thing you get to see when you land on the page. Would this be a good compromise? I'd personally prefer a diagram and I know that complete vaginal agenesis isn't always the case. Let's see what others say - Alison ❤ 05:05, 21 October 2015 (UTC)[reply]
  • In a bold move, I've gone ahead and moved the image way further down the page. I've also clarified the caption to state that complete vaginal agenesis isn't the default setting. Hope this helps a bit - Alison ❤ 05:10, 21 October 2015 (UTC)[reply]
  • Thank you for moving the image down. But is that image needed at all? I think the description of the syndrome is enough. That image depicts a symptom that some women with MRKH do not even have. It's un-necessary. The narrative is enough. Thank you. — Preceding unsigned comment added by 12.158.89.4 (talk) 11:52, 21 October 2015 (UTC)[reply]
    Definitely not, imagines of medical conditions and anatomy are crutials for understanding the condition. What a nonsens, when I was a student the images were still on. Now I want to explain somone the condition and I can't do it well. One image speaks a 1000 worlds. 190.63.236.15 (talk) 00:23, 21 May 2023 (UTC)[reply]

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