Tag Archives: Sexual Dysfunctions/Psychological

Disturbances in sexual desire and the psychophysiologic changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty. (APA, DSM-IV, 1994)

The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Reprod Health. 2017 Dec 2;14(1):164. doi: 10.1186/s12978-017-0433-z.FREE

The ‘heat’ goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya.

Esho T, Kimani S, Nyamongo I, Kimani V, Muniu S, Kigondu C, Ndavi P, Guyo J

ABSTRACT

BACKGROUND: Female genital mutilation/cutting (FGM/C) has been implicated in sexual complications among women, although there is paucity of research evidence on sexual experiences among married women who have undergone this cultural practice. The aim of this study was to investigate the sexual experiences among married women in Mauche Ward, Nakuru County. METHODS: Quantitative and qualitative data collection methods were used. Quantitative data were obtained from 318 married women selected through multistage sampling. The women were categorized into: cut before marriage, cut after marriage and the uncut. A questionnaire was used to collect demographic information while psychometric data were obtained using a female sexual functioning index (FSFI) tool. The resulting quantitative data were analyzed using SPSS® Version 22. Qualitative data were obtained from five FGDs and two case narratives. The data were organized into themes, analyzed and interpreted. Ethical approval for the study was granted by Kenyatta National Hospital-University of Nairobi Ethics and Research Committee. RESULTS: The mean age of the respondents was 30.59 ± 7.36 years. The majority (74.2%) had primary education and 76.1% were farmers. Age (p = 0.008), number of  children (p = 0.035) and education (p = 0.038) were found to be associated with sexual functioning. The cut women reported lower sexual functioning compared to the uncut. ANOVA results show the reported overall sexual functioning to be significantly (p = 0.019) different across the three groups. Women cut after marriage (mean = 22.81 ± 4.87) scored significantly lower (p = 0.056) than the uncut (mean = 25.35 ± 3.56). However, in comparison to the cut before marriage there was no significant difference (mean = 23.99 ± 6.63). Among the sexual functioning domains, lubrication (p = 0.008), orgasm (p = 0.019) and satisfaction (p = 0.042) were significantly different across the three groups. However, desire, arousal and pain were not statistically different. CONCLUSION: Generally, cut women had negative sexual experiences and specifically adverse changes in desire, arousal and satisfaction were experienced among cut after marriage. FGM/C mitigating strategies need to routinely provide sexual complications management to safeguard women’s sexual right to pleasure subsequently improving their general well-being.

This article can be accessed in this LINK

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

FREEIran J Public Health. 2017 Sep;46(9):1265-1274.

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T

ABSTRACT

BACKGROUND: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. METHODS: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15-49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. RESULTS: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. CONCLUSION: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level.

This article can be accessed in this LINK

Sexual counselling for treating or preventing sexual dysfunction in women living with female genital mutilation: A systematic review.

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.

ABSTRACT

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.

This article is available in this LINK

Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

Am J Obstet Gynecol. 2017 Jul;217(1):62.e1-62.e6. doi: 10.1016/j.ajog.2017.02.044. Epub 2017 Mar 3. Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

Rouzi AA, Berg RC, Sahly N, Alkafy S, Alzaban F, Abduljabbar H.

ABSTRACT

BACKGROUND: Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. OBJECTIVE: To assess the impact of FGM/C on the sexual functioning of Sudanese women. STUDY DESIGN: This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women’s type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. RESULTS: A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication,
orgasm, satisfaction, and pain) and overall. CONCLUSION: The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction.

This article is available in this LINK

Effect of female genital mutilation/cutting on sexual functions.

Sex Reprod Healthc. 2016 Dec;10:3-8. doi: 10.1016/j.srhc.2016.07.002. Epub 2016 Jul 28.

Effect of female genital mutilation/cutting on sexual functions.

Biglu MH, Farnam A, Abotalebi P, Biglu S, Ghavami M

ABSTRACT

BACKGROUND: Female Genital Mutilation/Cutting (FGM/C) or female circumcision is the procedure of eliminating some or all parts of the external female genitalia. FGM/C is carried out by traditional circumcisers. They usually use cutting tools like a blade or straight-razor. Although FGM/C is well described in the African continent and some Arabic countries, data from Iran are scarce.

OBJECTIVES: The major objective of this current study was to investigate the effects of FGM/C on the female sexual function of married women compared to the non-circumcised women in the Kurdistan province of Iran.

METHODS: A case-control study was conducted in a sample of 280 married women (140 circumcised-women and 140 non-circumcised-women) who referred to the healthcare centers for vaccination, midwifery, or family planning services. Participants were requested to complete the Persian-translated version of the Female Sexual Function Index.

MAIN OUTCOME MEASURES: The total score of the FSFI and its individual domains.

RESULTS: Of the circumcised women, 51.4% reported circumcision procedures before the age of 3 years. Religion motivation (53.6%) was mentioned as the most important factor for the family leading to FGM/C. Almost all operations were performed by traditional circumcisers. Non-circumcised women had significantly higher Persian-FSFI total score (25.3 ± 4.34) compared to the circumcised women (17.9 ± 5.39).

CONCLUSION: Sexual function in women with FGM/C is adversely altered. In Kurdistan province women, FGM/C is associated with reduction of scores of Persian-FSFI on all domain scores. Education in general and informing the people that FGM/C is not a religious Hadith certainly would have a great impact on the suffering of the women from FGM/C as well as the level of “desire, arousal, lubrication, orgasm, satisfaction, and pain in the sexual function of women”.

This article can be accessed in this LINK

Female genital mutilation and mental health: how can research help the victims?

BJPsych Bull. 2016 Aug;40(4):230-1. doi: 10.1192/pb.40.4.230.

Female genital mutilation and mental health: how can research help the victims?

Alachkar M

EXTRACT

In their paper on mental health problems associated with female genital mutilation (FGM) Knipscheer et al1 concluded that ‘a considerable minority group, characterised by infibulated women who have a vivid memory of the circumcision and cope with their symptoms in an avoidant way, reports to experience severe consequences of genital circumcision’.

I welcome the authors’ brave contribution to this crucial but under-researched topic, and appreciate their attempt at exploring the relationship between FGM and psychopathology in circumcised migrant women. However, despite their genuine acknowledgement of the limitations of their findings, it is my opinion that their paper suffers from various shortcomings which I will try to address here…

This article can be accessed for free in this LINK

Female genital mutilation: Cultural and psychological implications

Sexual and Marital Therapy. 2002, 17(2):161-170.

Female genital mutilation: cultural and psychological implications.

Whitehorn J, Ayonrinde O & Maingay S

ABSTRACT

Female genital mutilation (FGM) is widely practised in several regions of the world. It is often associated with physical, psychological, sexual and social sequelae. Migration of persons from cultures that actively practice FGM to the UK and other Western countries increases the chances that clinicians will be faced with patients who have undergone this procedure. Clinical presentations often occur against a background of differences in culture and social identity, which may pose a challenge to any form of intervention. Perceptions of normalcy, human rights violation and gender roles may also differ. This paper discusses historical, cultural, gender and identity issues associated with FGM and its psychological and sexual implications.

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

ABSTRACT

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

Female Genital Mutilation/Cutting: Will It Continue?

J Sex Med. 2014 Aug 14. doi: 10.1111/jsm.12655. [Epub ahead of print]

Female Genital Mutilation/Cutting: Will It Continue?

Mohammed GF, Hassan MM, Eyada MM.

ABSTRACT

INTRODUCTION: Female genital mutilation/cutting (FGM/C) is a prevalent, deeply rooted traditional practice in Egypt. AIMS: Specification of the motives behind the continuation of FGM/C in Egyptian community and evaluation of the sexual function in women with FGM/C.

METHODS: This cross-sectional study, involved 2,106 sexually active female participants with FGM/C. Full history-taking and general examination to evaluate the type of FGM/C were conducted. Sexual function was assessed by using the Female Sexual Function Index (FSFI) questionnaire.

MAIN OUTCOME MEASURES: Enumerate and specify the motivational factors and its percent among the participants. The correlation between FGM/C and FSFI domain scores was done with Pearson’s correlation.

RESULTS: Tradition, cleanliness, and virginity were the most common motives empowering the continuation of FGM/C (100%), followed by men’s wish, esthetic factors, marriage, and religion factors (45.2-100%). Type I FGM/C was the most common, followed by type II. There was only negative correlation between the type II FGM/C and sexual satisfaction. No statistically significant difference between type I and non-FGM/C was found.

CONCLUSIONS: FGM/C remains high. A variety of socio-cultural myths, religious misbelievers, and hygienic and esthetic concerns were behind the FGM/C. Overall, a large proportion of the participants supported the continuation of FGM/C in spite of adverse effect and sexual dysfunction associated with FGM/C.

This article can be accessed in this LINK

Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands.

Ethn Health. 2012 Dec;17(6):677-95. doi: 10.1080/13557858.2013.771148.

Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands.

Vloeberghs E, van der Kwaak A, Knipscheer J, van den Muijsenbergh M.

Research & Development Department , PHAROS – Knowledge and Advisory Centre on Refugees’ and Migrants’ Health , Utrecht , The Netherlands.

Objective. The study presented in this article explored psychosocial and relational problems of African immigrant women in the Netherlands who underwent female genital mutilation/cutting (FGM/C), the causes they attribute to these problems – in particular, their opinions about the relationship between these problems and their circumcision – and the way they cope with these health complaints. Design. This mixed-methods study used standardised questionnaires as well as in-depth interviews among a purposive sample of 66 women who had migrated from Somalia, Sudan, Eritrea, Ethiopia or Sierra Leone to the Netherlands. Data were collected by ethnically similar female interviewers; interviews were coded and analysed by two independent researchers. Results. One in six respondents suffered from post-traumatic stress disorder (PTSD), and one-third reported symptoms related to depression or anxiety. The negative feelings caused by FGM/C became more prominent during childbirth or when suffering from physical problems. Migration to the Netherlands led to a shift in how women perceive FGM, making them more aware of the negative consequences of FGM. Many women felt ashamed to be examined by a physician and avoided visiting doctors who did not conceal their astonishment about the FGM. Conclusion. FGM/C had a lifelong impact on the majority of the women participating in the study, causing chronic mental and psychosocial problems. Migration made women who underwent FGM/C more aware of their condition. Three types of women could be distinguished according to their coping style: the adaptives, the disempowered and the traumatised. Health care providers should become more aware of their problems and more sensitive in addressing them.

This article can be accessed in this LINK