The Impact of Female Genital Mutilation on Sexual Function: A Study Conducted in Rural Sudan.

Abstract

There are few studies comparing sexual functionin women with female genital mutilation (FGM) in the literature, and most of these were evaluated with the Female Sexual Function Index (FSFI) questionnaire. Only one used the Female Genital Self-Image Scale (FGSIS) questionnaire. This study aims to evaluate the effects of FGMon sexual function in Sudanese women who did or did not undergo FGM, using the FSFI and FGSIS questionnaires. This descriptive study was conducted on Sudanese women from July 2020 to March 2021. Patients who attended to our hospital's gynecology outpatient clinic for health screening were included in this study. A total of 211 patients113 with FGMand 98 without FGMwere included in the study. The group with FGMwas categorized according to the classification of the World Health Organization. The validated Arabic FSFI and FGSIS questionnaires were administered to groups with and without female genital mutilation and cutting (FGM/C). When the FGMtypes of the cases participating in the study were examined, patients with FGMwere classified according to the FGM/C classification defined by the World Health Organization. They were classified as 20.4% (n=23) Type 1, 49.6% (n=56) Type 2, and 30.1% (n=34) Type 3. FSFI and FGSIS scores were significantly lower in the FGM/C group, especially in Type 3 with the highest tissue loss. The survey results statistically support the possibility of sexual dysfunction inFGMgroup. Female genital circumcision negatively affects sexual function. Therefore, clinicians should considerand sexual dysfunction in women with FGM attending primary care. Strengths and limitations: The strengths of this study are its originality, as it is the first study in the literature to use validated FGSIS and FSFI questionnaires together to assess sexual function in groups with and without FGMand to evaluate correlation of questionnaire results. We undertook the study it using validated and reliable scales, trained clinical staff, local staff gynecologist, and multivariate analysis. Limitation of the study is the chosen age range. The reason for limiting the age to under 35 is that we wanted to evaluate the more sexually active age group in our study. We cannot comment on the correlation of FSFI and FGSIS in circumcised patients over 35 years of age. Sexual functionand sexual self-imageof women with FGM/C were found to be significantly lower compared to women without FGMwhen compared with the validated FSFI and FGSIS questionnaires.