Health Article: Danger and Risks of Female Genital Mutilation (Cutting/Circumcision) - FGM

05/May/2019
According to WHO, Female Genital Mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons — And the procedure has no health benefits for girls and women.

Many girls and women in different part of the world living with FGM have experienced harmful and barbaric practices that lead to serious health consequences (short and long term risks).

More than three million girls are estimated to be at risk for FGM annually.. — Over two-hundred million girls and women alive today have been cut in thirty countries in Africa, the Middle East and Asia where FGM is concentrated.

The practice is most common in the western, eastern, and north-eastern regions of Africa, in some countries the Middle East and Asia, as well as among migrants from these areas.


Short-term Health Risks of FGM

    ● Severe pain: cutting the nerve ends and sensitive genital tissue causes extreme pain. Proper anaesthesia is rarely used and, when used, is not always effective.
    The healing period is also painful and Type III FGM is a more extensive procedure of longer duration, hence the intensity and duration of pain may be more severe. The healing period is also prolonged and intensified accordingly.

    ● Excessive bleeding: (haemorrhage) can result if the clitoral artery or other blood vessel is cut during the procedure.

    ● Shock: can be caused by pain, infection and/or haemorrhage.

    ● Genital tissue swelling : due to inflammatory response or local infection.

    ● Infections : may spread after the use of contaminated instruments (e.g. use of same instruments in multiple genital mutilation operations), and during the healing period.

    ● HIV Transmission: Risk of transmission of HIV between girls who undergo female genital mutilation together.

    ● Urination problems: these may include urinary retention and pain passing urine. This may be due to tissue swelling, pain or injury to the urethra.

    ● Impaired wound healing: can lead to pain, infections and abnormal scarring.

    ● Death: can be caused by infections, including tetanus and haemorrhage that can lead to shock.

    ● Psychological consequences: the pain, shock and the use of physical force by those performing the procedure are mentioned as reasons why many women describe FGM as a traumatic event..



Long-term Health Risks from Type I, II and III (occurring at any time during life)


    ● Pain: due to tissue damage and scarring that may result in trapped or unprotected nerve endings.

    ● Chronic genital infections: with consequent chronic pain, and private-part discharge and itching. Cysts, abscesses and genital ulcers may also appear.

    ● Chronic reproductive tract infections: May cause chronic back and pelvic pain.

    ● Urinary tract infections: If not treated, such infections can ascend to the kidneys, potentially resulting in renal failure, septicaemia and death. An increased risk for repeated urinary tract infections is well documented in both girls and adult women.

    ● Painful urination: due to obstruction of the urethra and recurrent urinary tract infections.

    ● Menstrual problems: result from the obstruction of the private-part opening. This may lead to painful menstruation (dysmenorrhea), irregular menses and difficulty in passing menstrual blood, particularly among women with Type III FGM.

    ● Keloids: there have been reports of excessive scar tissue formation at the site of the cutting.

    ● Human immunodeficiency virus (HIV): given that the transmission of HIV is facilitated through trauma of the private-part epithelium which allows the direct introduction of the virus, it is reasonable to presume that the risk of HIV transmission may be increased due to increased risk for bleeding during intercourse, as a result of FGM.

    ● Female s*xual health : removal of, or damage to highly sensitive genital tissue, especially the clitoris, may affect s*xual sensitivity and lead to s*xual problems, such as decreased libido and pleasure, pain during intercourse, difficulty during penetration, decreased lubrication during copulation, reduced frequency or absence of orgasm (anorgasmia). Scar formation, pain and traumatic memories associated with the procedure can also lead to such problems.

    ● Obstetric complications: FGM is associated with an increased risk of Caesarean section, post-partum haemorrhage, recourse to episiotomy, difficult labour, obstetric tears/lacerations, instrumental delivery, prolonged labour, and extended maternal hospital stay. The risks increase with the severity of FGM.

    ● Obstetric fistula: a direct association between FGM and obstetric fistula has not been established. However, given the causal relationship between prolonged and obstructed labour and fistula, and the fact that FGM is also associated with prolonged and obstructed labour it is reasonable to presume that both conditions could be linked in women living with FGM.

    ● Perinatal risks: obstetric complications can result in a higher incidence of infant resuscitation at delivery and intrapartum stillbirth and neonatal death.

    ● Psychological consequences: some studies have shown an increased likelihood of post-traumatic stress disorder (PTSD), anxiety disorders and depression. The cultural significance of FGM might not protect against psychological complications..