Female Genital Mutilation, Sexual Quality of Life and Marital Relationship: A Case-Control Study From Iran
,
Abstract
Objective: Studies on the sexual consequences of female genital mutilation is mostly related to sexual function, while sexual quality of life is a more objective criterion for studying the effects of genital mutilation on the women's sexual life. The purpose of this study was to compare the sexual quality of life and marital relationship in the mutilated women with other women living in the Kurd region of Mahabad (Iran).
Materials and methods: In a case-control study, 600 married women (300 mutilated and 300
non- mutilated women) who referred to the health centers completed the sexual quality of life questionnaire (SQOL-F) as well as demographic questionnaires. Data analyzed using chi-square, independent t-test, and linear regression model with stepwise method at 95% confidence level.
Results: The mean total score of sexual quality of life in the mutilated group (40.28±16.76) was significantly lower than the control group (45.29±19.16). The chance of having a higher score of sexual quality of life in the mutilated group was 0.13 times lower than the control group. This value was
0.16 times for self-worthlessness area, 0.10 for sexual repression, 0.12 for psycho-sexual feeling, and 0.32 for sexual and marital satisfaction areas (p <0.05). In the mutilated group, the total score of sexual quality of life was significantly correlated with age, income, spouse's violence, spouse's infidelity, intercourse frequency, and residence status (P <0.05).
Conclusion: Female genital mutilation can decrease the sexual quality of life and increase the chance of negative consequences such as spouse violence, infidelity, and intercourse reduction.
1. Johansen REB, Ziyada MM, Shell-Duncan B, Kaplan AM, Leye E. Health sector involvement in the management of female genital mutilation/cutting in 30 countries. BMC Health Serv Res 2018; 18: 240.
2. González-Timoneda A, Ruiz Ros V, González-Timoneda M, Cano Sánchez A. Knowledge, attitudes and practices of primary healthcare professionals to female genital mutilation in Valencia, Spain: are we ready for this challenge? BMC Health Serv Res 2018; 18: 579.
3. Pashaei T, Rahimi A, Ardalan A, Felah A, Majlessi F. Related factors of female genital mutilation (FGM) in Ravansar (Iran). J Women’s Health Care 2012;1: 1000108.
4. Shafaati Laleh S, Maleki A, Samiei V, Roshanaei G, Soltani F. The comparison of sexual function in women with or without experience of female genital circumcision: A case-control study in a Kurdish region of Iran. Health Care Women Int 2022; 43: 194-206.
5. World Health Organization. Female genital mutilation. Fact sheet No241, 2022. https://apps.who.int/iris/bitstream/handle/10665/112328/WHO_RHR_14.12_eng.pdf
6. Esho T, Kimani S, Nyamongo I, Kimani V, Muniu S, Kigondu C, et al. The 'heat' goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya. Reprod Health 2017; 14:164.
7. Ismail SA, Abbas AM, Habib D, Morsy H, Saleh MA, Bahloul M. Effect of female genital mutilation/cutting; types I and II on sexual function: case-controlled study. Reprod Health 2017; 14: 108.
8. Horowicz M, Cottler-Casanova S, Abdulcadir J. Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study. Reprod Health 2022; 19: 104.
9. Klein E, Helzner E, Shayowitz M, Kohlhoff S, Smith-
Norowitz TA. Female Genital Mutilation: Health Consequences and Complications-A Short Literature Review. Obstet Gynecol Int 2018: 7365715.
10. Alradie-Mohamed A, Kabir R, Arafat SMY. Decision-Making Process in Female Genital Mutilation: A Systematic Review. Int J Environ Res Public Health 2020; 17: 3362.
11. Smolak A. The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis. J Acquir Immune Defic Syndr 2014; 65(5): 597-602.
12. Buggio L, Facchin F, Chiappa L, Barbara G, Brambilla M, Vercellini P. Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review. Health Equity 2019; 3: 36-46.
13. Alsibiani SA, Rouzi AA. Sexual function in women with female genital mutilation. Fertil Steril 2010; 93: 722-4.
14. Anderson SH, Rymer J, Joyce DW, Momoh C, Gayle CM. Sexual quality of life in women who have undergone female genital mutilation: A case-control study. BJOG 2012; 119: 1606–11.
15. Anis TH, Aboul Gheit S, Awad HH, Saied HS. Effects of female genital cutting on the sexual function of Egyptian women. A cross‐sectional study. J Sex Med 2012; 9: 2682-92.
16. Catania L, Abdulcadir O, Puppo V, Verde JB, Abdulcadi, J, Abdulcadir D. Pleasure and orgasm in women with female genital mutilation/cutting (FGM/C). J Sex Med 2007; 4: 1666-78.
17. Sylla F, Moreau C, Andro A. A systematic review and meta-analysis of the consequences of female genital mutilation on maternal and perinatal health outcomes in European and African countries. BMJ Glob Health 2020; 5: e003307.
18. Van Rossem R, Gage AJ. The effects of female genital mutilation on the onset of sexual activity and marriage in Guinea. Arch Sex Behav 2009; 38: 178–85.
19. Sena HFAA, El Shahed ARM, Moahmmad SHAR. Effect of Female Genital Mutilation on Female Quality of Life. SM Journal of Gynecology and Obstetrics 2017; 3: 1018.
20. Riazi H, Madankan F, Azin SA, Nasiri M, Montazeri A. Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study. Womens Midlife Health 2021; 7: 8.
21. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26: 191-208.
22. Flynn KE, Lin L, Bruner DW, Cyranowski JM, Hahn EA, Jeffery DD, et al. Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults. J Sex Med 2016; 13: 1642-50.
23. Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T. Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran. Iran J Public Health 2017; 46: 1265-74.
24. Raheem TAA, Eltahalawi SMR, Raia NMA, Elsary AY, Ibrahem KM. The effect of female genital mutilation on couple sexual function. International Journal of Community Medicine and Public Health 2018; 5: 905-11.
25. Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther 2005; 31: 385-97.
26. Pakpour AH, Zeidi IM, Saffari M, Burri A. Psychometric Properties of the Iranian Version of the Sexual Quality of Life Scale Among Women.J Sex Med 2013; 10: 981–9.
27. World Health Organization (WHO). Sexual and Reproductive Health and Research (SRH) Health risks of female genital mutilation (FGM) 2022.
28. O'Neill S, Pallitto C. The Consequences of Female Genital Mutilation on Psycho-Social Well-Being: A Systematic Review of Qualitative Research. Qual Health Res 2021; 31: 1738-50.
29. Owiredu WK, Owusu AO, Amidu N, Quaye L, Gyasi-Sarpong CK, Dapare PP, et al. Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana. Health Qual Life Outcomes 2015; 13: 3.
30. Park JW, Kim DJ, Shin MH. The Effect of Stress on Compulsive Sexual Behavior Disorder: Active Coping Strategy and Self-Control as Mediators. Psychiatry Investig 2021; 18: 997-1005.
31. Laumann EO, Waite LJ. Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative U.S. probability sample of men and women 57-85 years of age. J Sex Med 2008; 5: 2300-11.
32. Jeong JY, Lee SK, Kang YW, Jang SN, Choi YJ, Kim DH. Relationship between ED and depression among middle-aged and elderly men in Korea Hallym aging study. Int J Impot Res 2011; 23: 227-34.
33. Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia. BMJ Open 2019; 9: e024684.
34. Peltzer K, Pengpid S. Female genital mutilation and intimate partner violence in the Ivory Coast. BMC Womens Health 2014; 14: 13.
35. Aboagye RG, Seidu AA, Asare BY, Peprah P, Addo IY, Ahinkorah BO. Exposure to interparental violence and justification of intimate partner violence among women in sexual unions in sub-Saharan Africa. Arch Public Health 2021; 79: 162.
2. González-Timoneda A, Ruiz Ros V, González-Timoneda M, Cano Sánchez A. Knowledge, attitudes and practices of primary healthcare professionals to female genital mutilation in Valencia, Spain: are we ready for this challenge? BMC Health Serv Res 2018; 18: 579.
3. Pashaei T, Rahimi A, Ardalan A, Felah A, Majlessi F. Related factors of female genital mutilation (FGM) in Ravansar (Iran). J Women’s Health Care 2012;1: 1000108.
4. Shafaati Laleh S, Maleki A, Samiei V, Roshanaei G, Soltani F. The comparison of sexual function in women with or without experience of female genital circumcision: A case-control study in a Kurdish region of Iran. Health Care Women Int 2022; 43: 194-206.
5. World Health Organization. Female genital mutilation. Fact sheet No241, 2022. https://apps.who.int/iris/bitstream/handle/10665/112328/WHO_RHR_14.12_eng.pdf
6. Esho T, Kimani S, Nyamongo I, Kimani V, Muniu S, Kigondu C, et al. The 'heat' goes away: sexual disorders of married women with female genital mutilation/cutting in Kenya. Reprod Health 2017; 14:164.
7. Ismail SA, Abbas AM, Habib D, Morsy H, Saleh MA, Bahloul M. Effect of female genital mutilation/cutting; types I and II on sexual function: case-controlled study. Reprod Health 2017; 14: 108.
8. Horowicz M, Cottler-Casanova S, Abdulcadir J. Diagnoses and procedures of inpatients with female genital mutilation/cutting in Swiss University Hospitals: a cross-sectional study. Reprod Health 2022; 19: 104.
9. Klein E, Helzner E, Shayowitz M, Kohlhoff S, Smith-
Norowitz TA. Female Genital Mutilation: Health Consequences and Complications-A Short Literature Review. Obstet Gynecol Int 2018: 7365715.
10. Alradie-Mohamed A, Kabir R, Arafat SMY. Decision-Making Process in Female Genital Mutilation: A Systematic Review. Int J Environ Res Public Health 2020; 17: 3362.
11. Smolak A. The Association of Female Circumcision with HIV Status and Sexual Behavior in Mali: A Multilevel Analysis. J Acquir Immune Defic Syndr 2014; 65(5): 597-602.
12. Buggio L, Facchin F, Chiappa L, Barbara G, Brambilla M, Vercellini P. Psychosexual Consequences of Female Genital Mutilation and the Impact of Reconstructive Surgery: A Narrative Review. Health Equity 2019; 3: 36-46.
13. Alsibiani SA, Rouzi AA. Sexual function in women with female genital mutilation. Fertil Steril 2010; 93: 722-4.
14. Anderson SH, Rymer J, Joyce DW, Momoh C, Gayle CM. Sexual quality of life in women who have undergone female genital mutilation: A case-control study. BJOG 2012; 119: 1606–11.
15. Anis TH, Aboul Gheit S, Awad HH, Saied HS. Effects of female genital cutting on the sexual function of Egyptian women. A cross‐sectional study. J Sex Med 2012; 9: 2682-92.
16. Catania L, Abdulcadir O, Puppo V, Verde JB, Abdulcadi, J, Abdulcadir D. Pleasure and orgasm in women with female genital mutilation/cutting (FGM/C). J Sex Med 2007; 4: 1666-78.
17. Sylla F, Moreau C, Andro A. A systematic review and meta-analysis of the consequences of female genital mutilation on maternal and perinatal health outcomes in European and African countries. BMJ Glob Health 2020; 5: e003307.
18. Van Rossem R, Gage AJ. The effects of female genital mutilation on the onset of sexual activity and marriage in Guinea. Arch Sex Behav 2009; 38: 178–85.
19. Sena HFAA, El Shahed ARM, Moahmmad SHAR. Effect of Female Genital Mutilation on Female Quality of Life. SM Journal of Gynecology and Obstetrics 2017; 3: 1018.
20. Riazi H, Madankan F, Azin SA, Nasiri M, Montazeri A. Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study. Womens Midlife Health 2021; 7: 8.
21. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26: 191-208.
22. Flynn KE, Lin L, Bruner DW, Cyranowski JM, Hahn EA, Jeffery DD, et al. Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults. J Sex Med 2016; 13: 1642-50.
23. Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T. Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran. Iran J Public Health 2017; 46: 1265-74.
24. Raheem TAA, Eltahalawi SMR, Raia NMA, Elsary AY, Ibrahem KM. The effect of female genital mutilation on couple sexual function. International Journal of Community Medicine and Public Health 2018; 5: 905-11.
25. Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther 2005; 31: 385-97.
26. Pakpour AH, Zeidi IM, Saffari M, Burri A. Psychometric Properties of the Iranian Version of the Sexual Quality of Life Scale Among Women.J Sex Med 2013; 10: 981–9.
27. World Health Organization (WHO). Sexual and Reproductive Health and Research (SRH) Health risks of female genital mutilation (FGM) 2022.
28. O'Neill S, Pallitto C. The Consequences of Female Genital Mutilation on Psycho-Social Well-Being: A Systematic Review of Qualitative Research. Qual Health Res 2021; 31: 1738-50.
29. Owiredu WK, Owusu AO, Amidu N, Quaye L, Gyasi-Sarpong CK, Dapare PP, et al. Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana. Health Qual Life Outcomes 2015; 13: 3.
30. Park JW, Kim DJ, Shin MH. The Effect of Stress on Compulsive Sexual Behavior Disorder: Active Coping Strategy and Self-Control as Mediators. Psychiatry Investig 2021; 18: 997-1005.
31. Laumann EO, Waite LJ. Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative U.S. probability sample of men and women 57-85 years of age. J Sex Med 2008; 5: 2300-11.
32. Jeong JY, Lee SK, Kang YW, Jang SN, Choi YJ, Kim DH. Relationship between ED and depression among middle-aged and elderly men in Korea Hallym aging study. Int J Impot Res 2011; 23: 227-34.
33. Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia. BMJ Open 2019; 9: e024684.
34. Peltzer K, Pengpid S. Female genital mutilation and intimate partner violence in the Ivory Coast. BMC Womens Health 2014; 14: 13.
35. Aboagye RG, Seidu AA, Asare BY, Peprah P, Addo IY, Ahinkorah BO. Exposure to interparental violence and justification of intimate partner violence among women in sexual unions in sub-Saharan Africa. Arch Public Health 2021; 79: 162.
| Files | ||
| Issue | Vol 16, No 4 (December 2022) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v16i4.11357 | |
| Keywords | ||
| Female Genital Mutilation Quality of Life Sexuality Women's Health | ||
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How to Cite
1.
Shafaati Laleh S, Soltani F, Roshanaei G. Female Genital Mutilation, Sexual Quality of Life and Marital Relationship: A Case-Control Study From Iran. J Family Reprod Health. 2022;16(4):264-271.
