FGM significantly reduces sexual quality of life, suggests new study

Women who have undergone female genital mutilation (FGM) have a significantly lower sexual quality of life finds a new study published today (10 October) in BJOG: An International Journal of Obstetrics and Gynaecology.

FGM is defined as any procedure 'involving partial or total removal of the external female genitalia without medical reasons'.

This study, carried out by researchers at King's College London, looks at the impact of FGM on the of life of who have undergone this procedure and compares them to a similar group of women who have not undergone FGM.

Seventy three women who had undergone FGM were compared to 37 women from a similar cultural background. Criteria for inclusion in the study included, women aged 16 or older, women who have undergone FGM, or to be from a cultural background where FGM is frequently practiced but not undergone FGM.

Sixty-three out of seventy-three (86.3 %) of the women whom had undergone FGM were from Somalia, , Nigeria and Eritrea, whereas of the women who had not undergone FGM thirty-two out of thirty-seven (86.49%) were from Nigeria and Ghana.

The women completed a questionnaire containing the Sexual Quality of Life–Female (SQOL-F) questionnaire. This was divided into two parts: part one of the questionnaire asking demographic questions and the second part containing the SQOL-F questionnaire, previously used for measuring sexual quality of life in women with female sexual dysfunction aged over 18 years.

Demographics measured included, age, country of birth, civil status, number of children, smoking status, , self-reported history of depression and type of FGM.

Overall the study found that women who have undergone FGM have a significantly lower overall SQOL-F score. Using the self reported questionnaire, with the highest score being 100, women who had undergone FGM rated their sexual quality of life on average 26.4 points lower than women who had not undergone FGM.

The researchers also conducted further analysis by dividing the total number of women into those who were sexually active and those who were not sexually active. They found that in sexually active women FGM type III is associated with the lowest sexual quality of life scores.

Professor Janice Rymer, Dean of Undergraduate Medicine and Professor of Gynaecology, King's College London and co-author of the paper said:

"FGM is abuse of women and we need to do all we can to eradicate the practice. We can help to do this by educating people about the harm that it causes and this study adds to our knowledge as we show, not surprisingly, that FGM has a detrimental effect on a woman's sexual life.

"FGM is always traumatic and has no known health benefits, and the complications range from bleeding and infection to death. Although the physical complications have previously been reported, the effects on sexual function and satisfaction were poorly understood.

"As a result of high rates of migration of women from nations where this practice is considered commonplace, to areas where it is not, it is important to all multidisciplinary practitioners to have an understanding of the impact of this practice on the women that we provide care for. The effect of a reduced or poor sexual quality of life is likely to have an effect on the general well being of women. It is important to raise the profile of the damage that is caused with regards to sexual function in the hope that this may go some way to eradicating the procedure for future generations."

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added: "FGM is a harmful and unacceptable practice. This study highlights that it has a lasting impact not only physically but emotionally. It is important that healthcare workers are aware of FGM and with an expansion of the migrant population they may see increasing numbers of women affected."

More information: Andersson S, Rymer J, Joyce D, Momoh C, Gayle C. Sexual quality of life in women who have undergone female genital mutilation: a case–control study. BJOG 2012; DOI: 10.1111/1471-0528.12004

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