May 2011.

Introduction The exact prevalence of female sexual dysfunction (FSD) in the Middle East is exceptionally difficult to measure in light of its sensitive nature and the conservative tinge of the population. Aim The Global Online Sexuality Survey-Arabic-Females (GOSS-AR-F) is a community-based study of female sexuality in the Middle East through an online survey. Main Outcome Measures Prevalence of risk for female sexual dysfunction (rFSD) in the reproductive age group and its vulnerability to various risk factors. Methods GOSS-AR-F was offered via online advertising. The survey is comprised of the Female Sexual Function Index (FSFI) questionnaire among other questions. Results Out of 2,920 participants, 344 participants completed all survey questions. Average total FSFI score was 23 ± 6.5, with 59.1% of participants suffering rFSD. Age adjusted prevalence of rFSD was 59.5%, standardized to World Health Organization World Standard Population. There was a statistically significant higher prevalence of rFSD among cases with subjectively reported depression and male partner-related shortcomings such as erectile dysfunction and premature ejaculation as reported by the female participant, in addition to dissatisfaction with partner’s penile size, insufficient foreplay, and practice of masturbation. This was not the case with advancing age, diabetes mellitus, hypertension, smoking, ongoing pregnancy, mode of previous child delivery, infertility, menstrual irregularities, dysmenorrhea, interpersonal distress, subjectively reported hirsutism, and female genital cutting. Participants were found to require longer duration of coitus and better ejaculatory control but not necessarily a higher coital frequency. Conclusion Female sexual function in the reproductive age appears to be adversely affected by psychological factors and shortcomings in male sexual function more than anything. These findings point to the possibility that many cases of FSD can be managed with the focus on male partner’s ailments and attitudes that are relatively easier to manage.

Background: Breast-milk is the optimum form of nutrition for the first 6 months of life. Breastfeeding and its impact on child survival in developing countries have been well documented. The aim of the present study was to identify causes of failed breastfeeding reported by women who attended their one month postpartum follow up.

Introduction Female genital cutting (FGC) is a ritual involving cutting part or all of the female external genitalia, performed primarily in Africa. Understanding the motivation behind FGC whether religious or otherwise is important for formulating the anti-FGC messages in prevention and awareness campaigns. Aim The study aims to provide an investigation of opinion over FGC, the root motive/s behind it, in addition to the current prevalence of FGC among Internet users in the Middle East. Methods The Global Online Sexuality Survey was undertaken in the Middle East via paid advertising on Facebook®, comprising 146 questions. Main Outcome Measures The main outcomes are the prevalence of and public opinion on FGC among Internet users. Results 31.6% of 992 participants experienced FGC at an average age of 9.6 ± 3.5 years, mostly in Egypt (50.2%). FGC was performed among both Muslims (36.9%) and Christians (18.8%), more in rural areas (78.7%) than urban (47.4%), and was performed primarily by doctors (54.7%) and nurses (9.5%). Whether or not it is necessary for female chastity, FGC was reported as highly necessary (22.5%), and necessary (21.6%). This was more among males, particularly among those with rural origin, with no difference as per educational level. This is in contrast to only 3.7% regarding FGC as a mandate of Islam. Religious opinion among Muslims was: 55.4% anti-FGC and 44.6% pro-FGC. Conclusion An important motivation driving FGC seems to be males seeking female chastity rather than religion, especially with FGC not being an Islamic mandate, not to undermine the importance of religion among other motives. School and university education were void of an effective anti-FGC message, which should be addressed. There is a shift toward doctors and nurses for performing FGC, which is both a threat and an opportunity. We propose that the primary message against FGC should be delivered by medical and paramedical personnel who can deliver a balanced and confidential message.

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