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FOR IMMEDIATE RELEASE: 8 AUGUST 2000 Johns Hopkins Medical Institutions
http://hopkins.med.jhu.edu/ Children's center researchers question
role of androgens in female sex drive and function
Researchers from the Johns Hopkins Children's Center have determined
that over the course of their lives, women who possess the same
sex chromosomes as men -- by virtue of a genetic mutation that
leaves them completely insensitive to male sex hormones called
androgens -- can still lead active, normal sex lives. The study,
which appears in the August 2000 issue of The Journal of Clinical
Endocrinology & Metabolism, suggests that androgens, long
thought to enable women to experience orgasm and heighten their
sex drive, may not be essential after all.
"Our current ideas about hormone-to-behavior interactions may
not generalize to humans," says Amy Wisniewski, Ph.D., lead author
of the study. "The women reported that they had a good libido
and normal sexual activity -- without sensitivity to androgens."
The research team, led by pediatric endocrinologist Claude Migeon,
M.D., studied 14 women with Complete Androgen Insensitivity Syndrome
(CAIS). Unlike previous studies of CAIS, Migeon and his research
team followed the women's medical history well into their adult
years. By the end of the study, most subjects were between the
ages of 30 and 60 years of age.
CAIS results from a gene mutation on the X-chromosome that makes
women unresponsive to androgens. Among androgens' many roles are
guiding normal male development and, later in life, influencing
male and female sex drives. If sensitive to androgens, normal
fetuses with the XY sex chromosomes develop into boys and those
with XX sex chromosomes develop into girls. Without sensitivity
to androgens, XY fetuses develop into girls. A woman with CAIS
is physically female, but with an underdeveloped uterus and fallopian
tubes. In addition, she has latent testes unconnected and embedded
in her lower body cavity. Since there are no outward signs of
CAIS, women don't usually learn of their condition until puberty,
when they fail to menstruate and visit a physician or specialist
to find out why. The news is often a complete surprise, Wisniewski
says.
Women in the long-term study knew they had a condition called
CAIS, though many did not fully understand what the term meant.
They were assessed for physical and gender development from childhood
to adulthood, their knowledge about CAIS and their responsiveness
to treatment options. Overall, they reported satisfaction with
their gender development, sexual function, body image and femininity.
Eight of the 14 women exhibited no understanding of CAIS and most
desired more information about their condition. Women in the study
requested that their identities remain confidential.
"These women were well-adjusted, psychologically and sexually,"
says Wisniewski. "But a lot of the women had some psychological
counseling, and we believe it helped them."
The two most common problems associated with CAIS that require
treatment are the psychological impact of perceived or real social
stigma and an unusually high incidence of bone diseases such as
osteoporosis. Although a majority of the women said they were
satisfied with the counseling and surgical treatment they received,
estrogen therapy designed to thwart bone disease -- prescribed
soon after their CAIS diagnosis -- was often resisted by the women,
Migeon says.
"The women can't understand why they need to take it, so there
is a lack of compliance with estrogen," Migeon says. "But these
women live well into adulthood, so treatment is very important."
Researchers from Columbia University, the University of Miami
in Florida, and The Johns Hopkins School of Public Health also
contributed to the study, which was funded by a grant from The
Genentech Foundation for Growth and Development. Additional funding
was made available by the National Institutes of Health. To learn
more about sexual development syndromes online, visit: http://www.med.jhu.edu/pedendo/intersex/index.html |
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