Int J Gynaecol Obstet. 2017 Feb;136 Suppl 1:38-42. doi: 10.1002/ijgo.12049. Sexual counselling for treating or preventing sexual dysfunction in women living with female genital mutilation: A systematic review.
Okomo U, Ogugbue M, Inyang E, Meremikwu MM.
BACKGROUND: Female sexual dysfunction is the persistent or recurring decrease in sexual desire or arousal, the difficulty or inability to achieve an orgasm, and/or the feeling of pain during sexual intercourse. Impaired sexual function can occur with all types of female genital mutilation (FGM) owing to the structural changes, pain, or traumatic memories associated with the procedure. OBJECTIVES: To conduct a systematic review of randomized and nonrandomized studies into the effects of sexual counseling with or without genital lubricants on the sexual function of women living with FGM. SEARCH STRATEGY: Cochrane Central Register of Controlled Trials, MEDLINE, African Index Medicus, SCOPUS, LILACS, CINAHL, ClinicalTrials.gov, Pan African Clinical Trials Registry, and other databases were searched to August 2015. The reference lists of retrieved studies were checked for reports of additional studies, and lead authors contacted for additional data. SELECTION CRITERIA: Studies of girls and women living with any type of FGM who received counselling interventions for sexual dysfunction were included. DATA COLLECTION AND ANALYSIS: No relevant studies that addressed the objective of the review were identified. CONCLUSIONS: Despite a comprehensive search, the authors could not find evidence of the effects of sexual counseling on the sexual function of women living with FGM. Studies assessing this intervention are needed.
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Glob Public Health. 2008;3 Suppl 1:42-57. doi: 10.1080/17441690801892307.
Changing gendered norms about women and girls at the level of household and community: a review of the evidence.
Keleher H, Franklin L.
Department of Health Science, Monash University, Peninsula Campus, Australia. Helen.Keleher@med.monash.edu.au
Gendered norms are embedded in social structures, operating to restrict the rights, opportunities, and capabilities, of women and girls, causing significant burdens, discrimination, subordination, and exploitation. This review, developed for the Women and Gender Equity Knowledge Network of the WHO Commission on the Social Determinants of Health, sought to identify the best available research evidence about programmatic interventions, at the level of household and community, that have been effective for changing gender norms to increase the status of women. The focus was on developing countries. A wide range of single and multiple databases were searched, utilizing database specific keywords such as: women and girls; men and boys; household and community; intervention; and gender norms. Key themes were identified: education of women and girls; economic empowerment of women; violence against women, including female genital mutilation/cutting; and men and boys. Types of interventions, levels of action, populations of interest, and key outcomes from evaluations are identified. Evaluations are limited, with little evidence or measurement of changes in gender equity and women’s empowerment. A key finding is, that targeting women and girls is a sound investment, but outcomes are dependent on integrated approaches and the protective umbrella of policy and legislative actions.
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Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH.
Country Fact Sheet: Female Genital Mutilation in Benin
… According to the 2006 Demographic and Health Survey (DHS), which assesses the health of the country‘s population, 13 per cent of women between the ages of 15 and 49 have been subjected to FGM. This is a clear decline in numbers from the time of the 2001 survey, which showed an overall prevalence of nearly 17 per cent. The marked regional disparities in the prevalence of FGM are primarily the result of ethnic differences. The women most frequently cut are Bariba (74 per cent), followed by the Fulbe (72 per cent) and the Yoa and Lokpa (53 per cent)…
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J Paediatr Child Health. 2009 Oct;45(10):610-3. doi:10.1111/j.1440-1754.2009.01574.x. Epub 2009 Sep 14.
Lower genital tract lesions requiring surgical intervention in girls: perspective from a developing country.
Ekenze SO, Mbadiwe OM, Ezegwui HU.
Sub-Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. email@example.com
AIM: To determine the spectrum, outcome of treatment and the challenges of managing surgical lesions of lower genital tract in girls in a low-resource setting. METHOD: Retrospective study of 87 girls aged 13-years and younger, with lower genital tract lesions managed between February 2002 and January 2007 at the University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Clinical charts were reviewed to determine the types, management, outcome of treatment and management difficulties. RESULTS: The median age at presentation was 1 year (range 2 days-13 years). Congenital lesions comprised 67.8% and acquired lesions 32.2%. The lesions included: masculinized external genitalia (24), vestibular fistula from anorectal malformation (23), post-circumcision labial fusion (12), post-circumcision vulval cyst (6), low vaginal malformations (6), labial adhesion (5), cloacal malformation (3), bifid clitoris (3) urethral prolapse (3), and acquired rectovaginal fistula (2). Seventy-eight (89.7%) had operative treatment. Procedure related complications occurred in 19 cases (24.4%) and consisted of surgical wound infection (13 cases), labial adhesion (4 cases) and urinary retention (2 cases). There was no mortality. Overall, 14 (16.1%) abandoned treatment at one stage or another. Challenges encountered in management were inadequate diagnostic facilities, poor multidisciplinary collaboration and poor patient follow up. CONCLUSION: There is a wide spectrum of lower genital lesion among girls in our setting. Treatment of these lesions may be challenging, but the outcome in most cases is good. High incidence of post-circumcision complications and poor treatment compliance may require more efforts at public enlightenment.
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Afr Popul Dev Bull. 1999 Jun-Jul:26-7.
Female genital cutting. Evidence from the Demographic and Health Surveys.
[No authors listed]
PIP: This article reports on the prevalence of female genital mutilation (FGM) in the Central African Republic (CAR), Cote d’Ivoire, Egypt, Eritrea, Mali, Tanzania and Yemen. Evidences from the Demographic and Health Surveys indicate that FGM is widely practiced in these countries. About 9 out of 10 women have had at least some part of their external genitalia removed in Egypt, Eritrea, Mali, and northern Sudan, while in Cote d’Ivoire and the CAR the practice is less common. A comparison of prevalence levels among age groups in women aged 15-49 years revealed little or no decline in FGM; however, the CAR displayed a slight, but continuous, decline in prevalence across age groups. Furthermore, educational level and religion were found to affect the prevalence rate. Also, the 1996 clinical study in Egypt found that more than 70% of the study population had at least part or all of their clitoris and labia minora excised. In Eritrea and Sudan, many women undergo infibulation, the most hazardous and extensive form of female genital cutting, which almost entirely closes off the vaginal opening. The study also showed that women who had undergone the operation had experienced adverse health effects like hemorrhage. Widespread and enduring support for FGM among women was noted in Egypt, Mali, and Sudan; only Eritrea appeared to have a critical mass of opposition to the procedure among the adult population, which suggests an openness to change.
No link found to consult this report online.
J Womens Health (Larchmt). 2010 Nov;19(11):2081-9. Epub 2010 Oct 28.
Global women’s health in 2010: facing the challenges.
Lester F, Benfield N, Fathalla MM.
Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts 02120, USA. firstname.lastname@example.org
Women’s health is closely linked to a nation’s level of development, with the leading causes of death in women in resource-poor nations attributable to preventable causes. Unlike many health problems in rich nations, the cure relies not only on the discovery of new medications or technology but also getting basic services to the people who need them most and addressing underlying injustice. In order to do this, political will and financial resources must be dedicated to developing and evaluating a scaleable approach to strengthen health systems, support community-based programs, and promote widespread campaigns to address gender inequality, including promoting girls’ education. The Millennium Development Goals (MDGs) have highlighted the importance of addressing maternal health and promoting gender equality for the overall development strategy of a nation. We must capitalize on the momentum created by this and other international campaigns and continue to advocate for comprehensive strategies to improve global women’s health.
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Arch Kriminol. 2011 Jan-Feb;227(1-2):1-22.
[Medical and legal aspects of genital mutilation and circumcision part I: female genital mutilation (FGM)].
[Article in German]
Dettmeyer R, Laux J, Friedl H, Zedler B, Bratzke H, Parzeller M.
Aus dem Institut für Rechtsmedizin der Universität Giessen.
Female genital mutilation (FGM) is considered to be against the law and against morality not only in Western countries, although a woman of age and able to consent may sometimes think differently. The procedure may have serious physical and emotional consequences for the girl or woman. Nevertheless there are attempts to justify the procedure with medical and hygienic pseudoarguments, ideology, freedom of religion, cultural identity and social adequacy. Outside the Western world, some people claim that religion and culture alone justify the practice. In Germany, parents can lose the right to determine the residence of their daughter, if she is faced with the risk of genital mutilation in order to prevent that the child or girl is taken to her home country. Genital mutilation as a gender-specific threat is recognized as a reason to grant asylum or prevent deportation. Proposals to make genital mutilation a separate punishable offence are presently discussed by the legislator.
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Lancet. 2000 Feb;356:S57
Female genital mutilation: What can be done?
Female genital mutilation, euphemistically and erroneously referred to as “female circumcision”, is practised worldwide and the victims exceed 135 million. Although attempts have been made to classify the extent of this barbaric practice, it has been suggested that anatomically, the perpetrators “know not what they do”. But they should not be forgiven. The identified types correlate with the extent of mutilation in increasing order of severiw from a subtotal clitoridectomy, through infibulation, to introcision in which the perineum is split with the finger or other implements.
The earliest record of female genital mutilation, as a sort of substitute for human sacrifice, was found in a Greek papyrus of 163 BC. In the past, it was also advocated as medical treatment in the UK and USA for various “female weaknesses”, such as hysteria, melancholy, epilepsy, lesbianism, excessive masturbation, achievement of orgasm, and control of sexual drive. We may never know whether the original champions were the “auld enemy” male chauvinists or the ancestors of contemporary cultist daughters of Jezebel. Ensuring perpetual virginity among the Scoptsi sect of Russia, securing economic and social future in Sudan, and reducing female sexual activity in tribal Africa and Asia are some of the spurious reasons for maintaining the ritual. This supports the view that, like male circumcision, female genital mutilation evolved spontaneously in Africa, Europe, Australia, and America…
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