Painful gynecologic and obstetric complications of female genital mutilation/cutting: A systematic review and meta-analysis

Lurie, Jacob; Weidman, Alessandra; Huynh, Samantha; Delgado, Diana; Easthausen, Imaani; Kaur, Gunisha

doi:10.1371/journal.pmed.1003088

Cited by 65 publications

(68 citation statements)

References 56 publications

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“…It causes bleeding, swelling, urine retention, pain, abscess, and infection. It also leads to adverse obstetric related complications, including fistula, urethral damage, inability to deliver by spontaneous vaginal delivery, severe bleeding during childbirth, infertility, and hemorrhagic shock [ 12 , 13 , 14 , 15 , 16 ]. Furthermore, sexual experience and function of married women are negatively affected.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

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Hanfore

Lake

et al. 2020

Heliyon

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Background Female genital mutilation affects the social, psychological, spiritual and physical well-being of women. In Ethiopia, studies regarding the female genital mutilation were conducted in various settings and years. Objective This systematic review and meta-analysis was aimed to summarize the prevalence of female Genital Mutilation in Ethiopia. Methods A systematic search of articles was conducted in PubMed, African Journals Online (AJOL), Excerpta Medica database (EMBASE), SCOPUS, Web of Science, and JSTOR. Data were extracted using a standardized data extraction format prepared in Microsoft Excel. The data were analyzed using STATA version 11 software. Cochrane Q statistic was used to assess the presence of significant between-study heterogeneity. I 2 was used to quantify between-study heterogeneity. A leave-one-out sensitivity analysis and subgroup analysis based on a study period and setting were done. The funnel plot and Egger's regression tests were used to measure the presence of substantial publication bias. The pooled estimated prevalence of female genital mutilation was conducted using a DerSimonian and Laird random effects model. Results The pooled prevalence estimate of FGM was 77.28% (95% CI: 55.81, 98.76). The pooled prevalence was higher in studies conducted from 2013-2017 (78.39%, 95%CI: 48.24, 108.54) and studies conducted in Hospital (92.02: 95%CI: 55.81, 98.76). Conclusion The prevalence of Female Genital Mutilation is high. Therefore, interventions that are focused on health education, social support and advocacy are recommended.

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Section: Introductionmentioning

confidence: 99%

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

Fite

Hanfore

Lake

et al. 2020

Heliyon

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“…It has already been shown that women with FGM/C have higher risks of experiencing dyspareunia than women without FGM/C. 29 In our study, we aimed to assess the prevalence and possible etiologies of chronic vulvar pain, by retrospectively analyzing the records of 506 women who attended our specialized FGM/C outpatient clinic between 2010 and 2017.…”

Section: Discussionmentioning

confidence: 99%

Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study

2021

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Introduction Chronic vulvar pain is a condition that affects many women during their lifetime, including women with Female Genital Mutilation/Cutting (FGM/C). Aim To study the prevalence and possible etiologies of chronic vulvar pain among women living with FGM/C. Methods We conducted a retrospective review of consecutive medical files of 506 women who consulted our specialized clinic for women with FGM/C between April 1, 2010 and December 31, 2017. We collected sociodemographic and clinical data including information on the type of FGM/C and its complications. We focused on studying the prevalence, etiologies and characteristics of chronic vulvar pain. Main outcome measures Prevalence and etiologies of vulvar pain in women with FGM/C. Results Chronic vulvar pain was present in 14 women (2.8%). Pain was unprovoked in one case (7.1%) and provoked in the 13 other cases (92.9%). In most of the cases, women presented vulvar pain related to scar complications such as clitoral or peri-clitoral adhesions or scar tissue (n = 3, 21.4%), bridle scars (n = 1, 7.1%), post-traumatic neuromas (n = 2, 14.3%) and vulvar cysts (n = 6, 42.9%), the latter being found more frequently in women with FGM/C type III. In 2 cases (14.3%) of chronic vulvar pain, no lesions other than FGM/C were visible at clinical examination. Among these 14 women, 12 suffered from superficial dyspareunia as well. The remaining ones had not had any sexual contact for several years. Dyspareunia was present in 126 women (24.9%), among which 75 patients (14.8%) suffered from superficial dyspareunia and 25 patients (4.9%) complained of deep dyspareunia. Fourteen women (2.8%) reported both superficial and deep dyspareunia. Twelve women (2.3%) reported dyspareunia with no specified localization documented in the medical charts. Dyspareunia was significantly more frequent among infibulated women compared to women with FGM/C different from type III ( P = .014). Conclusion Chronic vulvar pain after FGM/C is probably associated with scar complications and FGM/C type III (infibulation). Dyspareunia is more frequent in women with FGM/C type III. Bazzoun Y, Aerts L, Abdulcadir J. Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study. Sex Med 2021;9:100425.

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“…A contrasting approach in the clinical encounter, as suggested by some interviewees in this study, is to start with an unbiased clinical assessment before giving recommendations, bearing in mind that FGC can, but does not necessarily have to, play a part in the person's illness (Johnsdotter & Essén, 2020). This is pertinent not the least in the context of uncertain evidence as regards menstrual pain and FGC (Lurie et al, 2020;Obermeyer, 2005). In such a context, the intention to proceed from young women's real-life experiences of FGC, seems misplaced.…”

Section: Implications For Practicementioning

confidence: 99%

“…The finding suggests that professionals had adopted messages from FGC training even though research on menstrual pain and FGC has not been able to prove the correlation (e.g. Lurie et al 2020;Obermeyer, 2005). Medical professionals also supported their understanding on knowledge based in medical training on physiological processes associated with primary and secondary dysmenorrhoea.…”

Section: Menstrual Pain As Physiology and Culturementioning

confidence: 99%

“…In many cases, evidence of sexual and reproductive health outcomes is inconsistent (see reviews by Berg & Denison, 2012;Johnsdotter, 2018;Obermeyer, 2005). Whereas many studies highlight increased health risks and, for example, have found a higher likelihood of reportings of genital pain (Lurie et al, 2020) or less sexual satisfaction (Berg & Denison, 2012), other studies on sexuality document frequent reports of orgasm, desire and satisfaction (Abdulcadir et al, 2016;Catania et al, 2007;Obermeyer, 2005) and no statistically significant differences on genital pain between women with or without FGC (Alsibiani & Rouzi, 2010). This great variation underscores the challenges in conducting research on sexual health outcomes related to FGC.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent Sexual and Reproductive Health Counselling in Relation to Female Genital Cutting: Swedish Professionals’ Approach to Menstrual Pain as an Empirical Example

Palm

Johnsdotter

Elmerstig

et al. 2021

Sexuality & Culture

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In Sweden, as well as in an international context, professionals are urged to acquire knowledge about possible health effects of female genital cutting (FGC) in order to tackle prevention and care in relation to the practice. While professionals are guided by policies and interventions focusing on medical effects of FGC, some scholars have cautioned that many popular beliefs about health risks rest on inconclusive evidence. The way professionals understand and respond to health information about FGC has in this context largely been left unexamined. This article aims to provide a qualitative exploration of how professionals in Sweden approach adolescent sexual and reproductive healthcare encounters in relation to acquired knowledge about FGC, using menstrual pain as an empirical example. The analysis shows that there was a tendency in counselling to differentiate young migrant women’s menstrual complaints from ordinary menstrual pain, with professionals understanding pain complaints either in terms of FGC or as culturally influenced. The study shows how professionals navigated their various sources of knowledge where FGC awareness worked as a lens through which young women’s health complaints were understood. Biomedical knowledge and culture-specific expectations and assumptions regarding menstrual pain also informed counselling. Finally, the article discusses how FGC awareness about health risks was used constructively as a tool to establish rapport and take a history on both menstrual pain and FGC. The analysis also recognises potential pitfalls of the approaches used, if not based in well-informed policies and interventions in the first place.

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Painful gynecologic and obstetric complications of female genital mutilation/cutting: A systematic review and meta-analysis

Cited by 65 publications

References 56 publications

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

Chronic Vulvar Pain After Female Genital Mutilation/Cutting: A Retrospective Study

Adolescent Sexual and Reproductive Health Counselling in Relation to Female Genital Cutting: Swedish Professionals’ Approach to Menstrual Pain as an Empirical Example

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