Tag Archives: Reproductive Health

The status of one’s reproductive system and its function.

Awareness and predictors of female genital mutilation/cutting among young health advocates

FREEInt J Womens Health. 2015 Feb 20;7:259-69. doi: 10.2147/IJWH.S78664. eCollection 2015.

Awareness and predictors of female genital mutilation/cutting among young health advocates

Abolfotouh SM, Ebrahim AZ, Abolfotouh MA


The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases) associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical medical phase of education. The low level of knowledge among even future health professions in our study suggests that communication, rather than passive learning, is needed to convey the potentially negative consequences of FGM/C and to drive a change in attitude toward discontinuation of this harmful practice.

This article can be accessed in this LINK

Female genital mutilation: Consequences for reproductive and sexual health

Sexual and Marital Therapy. 1995, 10(2):189-200.

Female genital mutilation: consequences for reproductive and sexual health

McCaffrey, M


World-wide, female genital mutilation affects more than 80 million women and it is estimated that at least two million girls are mutilated each year. This paper describes the types of female genital mutilation performed and their effects on women’s physical and psychological health. Individual case histories are cited to illustrate these effects. A model of medical care, as provided at Northwick Park Hospital, Harrow in response to a growing problem, is outlined.

This article can be accessed in this LINK

[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain).] [Article in Spanish]

Gac Sanit. 2014 Mar 24. pii: S0213-9111(14)00047-8. doi: 10.1016/j.gaceta.2014.02.006. [Epub ahead of print]

[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain).] [Article in Spanish]

Ballesteros Meseguer C, Almansa Martínez P, Pastor Bravo MD, Jiménez Ruiz I.


OBJECTIVE: To explore the perceptions of a group of women who underwent female genital mutilation on the impact of this practice on their sexual and reproductive health.

METHODS: We performed a phenomenological qualitative study in a sample of 9 sub-Saharan Africa women, whose mean age was 30 years old and who had lived in Spain for 1 to 14 years. These women underwent genital mutilation in their countries of origin. Data was collected using a socio-demographic survey and an in-depth, structured personal interview. Subsequently, we performed a thematic discourse analysis.

RESULTS: The discourses were grouped into four categories related to participants’ perceptions of female genital mutilation. These categories were intimate relationships, pregnancy, childbirth, and social impact.

CONCLUSIONS: The practice of female genital mutilation is maintained due to social and family pressure, transmitted from generation to generation and silenced by women themselves. This practice affects their sexual and reproductive health, as demonstrated by anorgasmia and dyspareunia. The women were satisfied with the healthcare received during pregnancy and childbirth. Nevertheless, most of them were not satisfied with family planning.

This article can be accessed in this LINK

Adolescent sexual and reproductive health in the Niger Delta region of Nigeria–issues and challenges.

Afr J Reprod Health. 2007 Apr;11(1):113-24. FREE

Adolescent sexual and reproductive health in the Niger Delta region of Nigeria–issues and challenges.

Okonta PI.

Department of Obstetrics and Gynaecology, College of Health Sciences, Delta State University, Abraka, Delta State. Patrickokonta@Yahoo.com


There has been an increasing awareness of the need to pay special focus on the adolescent and their sexual and reproductive h
ealth. This article reviews the sexual and reproductive health of adolescents in the Niger Delta region (NDR) of Nigeria. The objective is to bring to focus these important issues in the region. Adolescents in the NDR engage in unhealthy sexual behaviour characterized by early age at sexual initiation, unsafe sex and multiple sexual partners. The local socioeconomic condition exerts extra pressure on the adolescent with negative reproductive health consequences. There is urgent need to develop a time bound strategic framework and plan to redress this situation. This will require the participation of all stake holders.

This article can be accessed in this LINK.

Female Genital Cutting Practices in Burkina Faso and Mali and Their Negative Health Outcomes

Stud Fam Plann. Sept 1999 30(3): 219–230

Female Genital Cutting Practices in Burkina Faso and Mali and Their Negative Health Outcomes

Jones H, Diop N, Askew I, Kaboré I


Observations of the types of female genital cutting and possible associated gynecological and delivery complications were undertaken in 21 clinics in rural Burkina Faso and in four rural and four urban clinics in Mali. Women who came to the clinics for services that included a pelvic exam were included in the study, and trained clinic staff observed the presence and type of cut and any associated complications. Ninety-three percent of the women in the Burkina Faso clinics and 94 percent of the women in the Mali clinics had undergone genital cutting. In Burkina Faso, type 1 (clitoridectomy) was the most prevalent (56 percent), whereas in Mali the more severe type 2 cut (excision) was the most prevalent (74 percent); 5 percent of both samples had undergone type 3 cutting (infibulation). Logistic regression analyses show significant positive relationships between the severity of genital cutting and the probability that a woman would have gynecological and obstetric complications.

This article can be purchased in this LINK

Clitoral cyst: not a very rare complication of female genital mutilation

Fertil Steril. 2009 92(3): S118

Clitoral cyst: not a very rare complication of female genital mutilation

Rouzi AA


No abstract is available for this article

This article can be purchased in this LINK

Infertility from female circumcision

Fertil Steril. 2004 81(6): 1692-1694

Infertility from female circumcision

Chen G, Dharia SP, Steinkampf MP, Callison S


OBJECTIVE: To present a case report of a patient with primary infertility from female circumcision, the management of the patient, and a review of the literature. DESIGN:Case report and literature review. SETTING: University hospital. PATIENT(S): A 31-year-old woman referred for a history of primary infertility. INTERVENTION(S): Complete history and physical exam of the patient and subsequent deinfibulation. MAIN OUTCOME MEASURE(S): Diagnosis, surgical management, and postoperative sexual function and pregnancy. RESULT(S)Resolution of dyspareunia, satisfactory postoperative sexual function, and pregnancy. CONCLUSION(S): Awareness of this type of female circumcision and familiarity with its surgical management may prevent delays and any subsequent complications.

This article can be purchased in this LINK

The effects of type of female circumcision on infertility and fertility in Sudan

J Biosoc Sci. July 2002 34(03): 363-377

The effects of type of female circumcision on infertility and fertility in Sudan

Larsen U


This study explores the association between type of female circumcision and infertility and fertility in Sudan using the 1989–90 Demographic and Health Survey. It is hypothesized that women with either Pharaonic or Intermediate circumcision would have higher infertility and lower fertility compared with women with Sunna circumcision, and that uncircumcised women would have the lowest infertility and highest fertility of the three groups. This hypothesis, a widely held assumption, proved to be largely incorrect. Though women with Pharaonic or Intermediate circumcision did have a higher prevalence of primary infertility than uncircumcised women, women with Sunna circumcision had even lower rates of primary infertility compared with uncircumcised women. This pattern prevailed in multivariate models controlling for confounding variables, where women with Pharaonic or Intermediate circumcision had significantly higher primary infertility. Moreover, though women with Pharaonic or Intermediate circumcision also had the highest prevalence of secondary infertility, once confounding covariates were controlled in multivariate models, there was no significant difference among the three groups of women. With respect to fertility, the total fertility rate was 7·6 for women with Pharaonic or Intermediate circumcision, 8·1 for women with Sunna circumcision and 8·3 for uncircumcised women. Differences in fertility were found to be insignificant when covariates were controlled. The multivariate models were estimated using logistic regression. In conclusion, Pharaonic or Intermediate circumcision may be associated with higher primary infertility while there was no evidence suggesting that either secondary infertility or fertility was associated with a woman’s circumcision status.

This article can be purchased in this LINK

Circumvention tourism.

Cornell Law Rev. 2012 Sep;97(6):1309-98.FREE

Circumvention tourism.

Cohen G.

Harvard Law School Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics.


Under what circumstances should a citizen be able to avoid the penalties set by the citizen’s home country’s criminal law by going abroad to engage in the same activity where it is not criminally prohibited? Should we view the ability to engage in prohibited activities by traveling outside of the nation state as a way of accommodating cultural or political differences within our polity? These are general questions regarding the power and theory of extraterritorial application of domestic criminal law. In this Article, I examine the issues through a close exploration of one setting that urgently presents them: medical tourism. Medical tourism is a term used to describe the travel of patients who are citizens and residents of one country, the “home country,” to another country, the “destination country,” for medical treatment. This Article is the first to comprehensively examine a subcategory of medical tourism that I call “circumvention tourism,” which involves patients who travel abroad for services that are legal in the patient’s destination country but illegal in the patient’s home country–that is, travel to circumvent domestic prohibitions on accessing certain medical services. The four examples of this phenomenon that I dwell on are circumvention medical tourism for female genital cutting (FGC), abortion, reproductive technology usage, and assisted suicide. I will briefly discuss the “can” question: assuming that a domestic prohibition on access to one of these services is lawful, as a matter of international law, is the home country forbidden, permitted, or mandated to extend its existing criminal prohibition extraterritorially to home country citizens who travel abroad to circumvent the home country’s prohibition? Most of the Article, though, is devoted to the “ought” question: assuming that the domestic prohibition is viewed as normatively well-grounded, under what circumstances should the home country extend its existing criminal prohibition extraterritorially to its citizens who travel abroad to circumvent the prohibition? I show that, contrary to much of current practice, in most instances, home countries should seek to extend extraterritorially their criminal prohibitions on FGC, abortion, assisted suicide, and, to a lesser extent, reproductive technology use to their citizens who travel abroad to circumvent the prohibition. I also discuss the ways in which my analysis of these prohibitions can serve as scaffolding for a more general theory of circumvention tourism.

This article can be accessed in this LINK

Health complications of female genital mutilation in Sierra Leone.

Int J Womens Health. 2012;4:321-331.

Health complications of female genital mutilation in Sierra Leone.

Bjälkander O, Bangura L, Leigh B, Berggren V, Bergström S, Almroth L.

Division of Global Health, Department of Public Health, Karolinska Institutet, Stockholm, Sweden.

Sierra Leone has one of the highest rates of female genital mutilation (FGM) in the world, and yet little is known about the health consequences of the practice. PURPOSE: To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors. PATIENTS AND METHODS: A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258) attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected.  Participants answered interview-administrated pretested structured questionnaires with open- ended-questions, administrated by trained female personnel. RESULTS: All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%), the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8%) sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser), and 16 a health professional. CONCLUSION: The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who undergo FGM before 10 years of age seem to be  more vulnerable to serious complications than those who are older at the time of FGM. It is important that health care personnel are aware of, and look for possible complications from FGM, and encourage girls and women to seek medical care for their problems.

This article can be accessed in this LINK