Which type of circumcision is more harmful to female sexual functions?

Abstract

Background: Female genital mutilation (FGM) is common in Sub-Saharan Africa. It has been shown that it can cause sexual dysfunction. Materials and Methods: A total of 239 volunteer women were included in the study, which was conducted between April 2014 and January 2015; 210 of these women were circumcised and 29 were uncircumcised. Sexual functions of the women were evaluated by using Female Sexual Functioning Index (FSFI). Statistical analyses were performed by using the Mann-Whitney U-test, Kruskal-Wallis test, and chi-square test. Results: The ages of women examined ranged between 17 and 65 years (mean: 33.54 ± 10.25). The ratio of women circumcised was determined as 87.9%. The most commonly performed circumcision type was Type 2 (51%), followed by Type 3 (25.7%); the remaining cases were determined to be Type 1 circumcision (23.3%). Both the total FSFI scores and each individual score of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain differed between the uncircumcised and circumcised women; these differences were statistically significant. When the circumcision types were compared to each other, the difference between Type 1 and 2 was not statistically significant, whereas the differences between Type 1 and 3, and between Type 2 and 3 were statistically significant. Discussion: Type 3 FGM is the most severe form of FGM, in which almost all of the female external genitalia is excised, and the remaining parts are sewn together; this procedure narrows the opening of the genital organ. In the current study, the lowest FSFI scores were determined in women with Type 3 FGM. Circumcision, and especially the Type 3, is still an important health problem causing female sexual function disorders in the women living in Darfur, Sudan.