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

Abstract

BackgroundFemale 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.MethodsQuantitative 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.ResultsThe 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.ConclusionGenerally, 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.

Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study

“…Women with FGM/C also suffer obstetric complications such as difficult in birthing process, obstructed and prolonged labour, tears and episiotomies [4,10,11]. Of note are sexual consequences related to the severed organs notably painful sexual intercourse, lack of orgasm, satisfaction and lubrication [12][13][14][15]. Additionally, women living with FGM/C present with anxiety, depression, post-traumatic stress disorder, and low self-esteem -the so called psychological impacts [16][17][18].…”

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

“…Furthermore, sexual experience and function of married women are negatively affected. This causes a poor sexual quality of life and nephrolithiasis [ 17 ]. Post-traumatic stress disorder commonly occurs in those women.…”

Developing Physician Educational Competencies for the Management of Female Genital Cutting: A Call to Action

“…[20][21][22][23] Sexual functioning can be affected as well, with studies showing FGC is linked to clinically significant and distressing problems with all three phases of the sexual response cycle-desire, arousal/excitement, and orgasm. 24 Studies have shown, for example, that FGC-affected women have reported higher rates of lack of sexual desire, 25 dyspareunia, 26,27 decreased orgasmic functioning, 28,29 and less sexual satisfaction 29,30 than women who have not been cut. However, it is important to note that women with FGC have sexual erectile tissues for sexual arousal and orgasm, 27 and some can and do experience pleasure and orgasm and report satisfying sexual lives.…”