Female genital cutting:

Definition and Classification

 Definition
The W.H.O. defines female genital mutilation/
cutting a
“all procedures involving partial or total removal
of the external female genitalia or other injury to
the female genital organs for non medical
reasons”
The word “mutilation,” establishes a clear linguistic distinction
from male circumcision and signals harm of the practice.
WHO, Eliminating Female Genital Mutilation: An Interagency Statement, World Health Organization, Geneva,
Switzerland, 2008
UNICEF, Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of
Change, UNICEF, New York, NY, USA, 2013
.

FGC Classification
World Health Organization Classification

Type I, Clitoridectomy :
Partial or total removal of
the clitoris and/or hood of
the clitoris .

Egypt, Iraq, Ethiopia, Somalia,

Kenia, Tanzania, Cameroon,
Nigeria, Cote de Ivoire, Mali,
Mauritania, Guinea, Sierra Leone
World Health Organization Classification
Type II, Excision : Partial
or total removal of the
clitoris and/or hood of the
clitoris, with partial or total
removal of the inner lips

Egypt, Iraq, Yemen, Ethiopia, Somalia,

Kenia, Tanzania, Cameroon, Niger,
Nigeria, Cote de Ivoire, Mali, Mauritania,
Guinea, Sierra Leone, Gambia, Senegal,
Liberia, Burkina Faso
World Health Organization Classification
Type III, infibulation:
External genitals removed,
with or without removal of
the clitoris, and the vaginal
opening stitched closed

Sudan,Somalia, Ethiopia, Eritrea,Egypt,

Kenia, Tanzania, Chad, Ghana, Guinea,
Sierra Leone, Gambia
World Health Organization Classification
Type IV: All other harmful
procedures, including
1) Pricking, cutting or burning of
the clitori
2) Cutting or scarring of vaginal
openin
3) Stretching the labia .

Sudan, Ethiopia, Eritrea,Tanzania

g

Epidemiology
Prevalence of FGM/C
Prevalence of FGM/C
 Prevalence of FGM/C
Egypt 27 M
24 M
Nigeria 20 M
12 M
Kenya 9M
9M
Mali 8M
8M
Guinia 7M
7M
Côte d'Ivoire 5M Nearly half of African
5M women with FGM/C live
Chad & Iraq 4M
4M in Egypt and Ethiopia.
Senegal, Mauritania 3M
3M
0M 7.5M 15M 22.5M 30M
United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and
exploration of the dynamics of change, UNICEF, New York, 2013
Prevalence is related to the socio-economic level
Poorest quintile Richest quintile
Mauritania

Eritrea

Somalia

ِSudan

Egypt

Senegal

iraq

0 23 45 68 90

Sources: DHS, MICS and SHHS, 2008-2011

Prevalence is related to the education level
No education Primary education Secondary or higher education

Mali

Eritrea

mauritania

Egypt

Sudan

Yemen

iraq

0 20 40 60 80

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
 The chances that a girl will undergo FGM/C
increase significantly if her mother has been cut
Mother was cut Mother was not cut
Gambia
Mauritania
Sudan
Senegal
Nigeria
ِEgypt
Burkina Faso
Sierra Leone
Ghana

0 20 40 60 80
United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
 Age at which girls are genitally cut
Egypt 5-14 Years

In half of the
countries with
available data,
the majority of
girls were cut
before age 5

0-4 Y 10-14 Y
5-9 Y 15+ Y

United Nations Children’s Fund: A statistical overview and exploration of the dynamics of change UNICEF, New York, 2013
While the majority of cut females are Muslim, other
religious groups also practice FGM/C
Muslim Christians
98%
Eritrea
82%
96%
Guinea
80%
95%
Sierra Leone
80%
93%
Egypt
74%
90%
Sudan
47%
88%
Ethiopia
77%

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
Who is performing the procedure?
Health Personnel Traditional practitioners Others

In nearly all
countries surveyed
(except Egypt &
Sudan), traditional
practitioners
perform most
cases of FGM/C

Sudan
Egypt Health Personnel
 In Egypt, the percentage of girls cut by health
personnel has increased dramatically
Health personnel Traditional practitioners
100

80
75% 77%
60
61%
55%
40
42% 38%
20 24% 22%
0
1995 2000 2005 2008

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
The most commonly reported reason of FGM/C

Gaining social acceptance

Cleanliness/hygiene

Better marriage prospect

Preservation of virginit

More sexual pleasure for me

Required by religion

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
.

 Support for FGC/M in Jeddah, Saudi Arabia

not sure not sure

20% 21%
it depends
it depends 4%
Should stop should continue
10% Cut 52%
Uncut
2%
Should stop
should continue 73%
18%

not sure
21%
it depends
5%
should continue Total
5% Should stop
69%

Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684.
 The most commonly reported reason of FGM/C
Cut Uncut Total

Religious beliefs

Moral reasons

Tradision & culture norms

Social Conventions

Personal hygiene

Sexual pleasure for hubsband

0 12.5 25 37.5 50

Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684.
 Among females, the most commonly reported
benefit is gaining social acceptance
Country No Cleanliness/ Social Better Preservation More Required Other
benefits hygiene acceptance marriage of virginity sexual by religion
prospects pleasure
for men
Benin 55 6 24 3 4 0.4 3 2
Burkina Faso 52 6 24 3 4 ,4 3 2
Cameroon 50 0 1 1 4 0.4 2 2
Chad 37 5 31 8 7 2 23 4
Eritrea 29 13 42 25 4 N/A 18 3
Kenya 81 3 8 3 5 1 2 5
Mauritania 21 19 35 4 31 2 29 9
Nigeria 58 6 19 3 14 1 7 19
Senegal 49 6 19 3 14 1 7 19

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013

 Males reported similar benefits as females

Country No Cleanliness/ Social Better Preservation More Required Other
benefits hygiene acceptance marriage of virginity sexual by religion
prospects pleasure
for men
Benin 72 0.4 3 1 2 1 0.4 2
Burkina Faso 69 4 10 2 5 1 5 1
Cameroon 70 0.3 4 2 6 2 2 4
Chad 42 8 19 5 15 3 12 7
Sierra Leone 36 24 42 18 8 4 3 13
Kenya 81 3 8 3 5 1 2 5
Mauritania 21 13 29 9 25 2 41 10
Nigeria 52 4 6 6 17 7 3 4
Senegal 58 4 10 2 8 2 5 21

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013

 In only 4 countries, the majority of females regard

FGM/C as a religious requirement
Females Males
Mali

Eritria

Mauritania

Guinea

Egypt

Sierra Leon

Chad

Senegal

0% 10% 20% 30% 40% 50% 60% 70% 80%

. United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013
Support for FGM/C
The level of support among girls and women is lower
than the prevalence level
Prevalence of FGM/C Think FGM/C should continue

Mali

Eritrea

mauritania

Djibouti

Egypt

Sudan

Yemen

Iraq

0 25 50 75 100
Percentage of females aged 15 to 49 years who have undergone FGM/C and
percentage of females who think the practice should continue
 In Egypt the support is far less among younger
generation
Women aged 45 to 49 years Girls aged 15 to 19 years

Mali

Eritrea

Djibouti

Egypt

Sudan

Yemen

Iraq

0 20 40 60 80

Percentage of girls aged 15 to 19 years and women aged 45 to 49 years who think the
practice should continue
The majority Men think FGM/C should end
Should Continue

Should stop Not sure

Egypt
 Support for FGM/C is stronger among girls and women in the poorest
households than in the richest households
Poorest quintile Richest quintile

Mali

Eritrea

Mauritania

Côte d'Ivoire

Egypt

Sudan

Senegal

Iraq

0 20 40 60 80

Among girls and women aged 15 to 49 years, percentage who support the
continuation of the practice, by poorest and richest wealth quintiles

 Females with no education are substantially more likely to

support the practice of FGM/C
No education Primary education Secondary or higher education

Mali

Eritrea

Mauritania

Djibouti

Egypt

Sudan

Yemen

iraq

0 20 40 60 80
Percentage of females who support the continuation of the practice, by level of education

 Survey on female genital mutilation/

cutting in Jeddah, Saudi Arabia
In a convenience sample of 963 women aged 18 to 75 years, 175 (18.2%) had undergone FGM/C.

Cut
13%
Cut
33%
Saudi Non-Saudi
Uncut
67%
Uncut
87%

Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684.
 Type of Cutting
Saudi women undergoing the procedure earlier (3.86±2 Y) than Egyptian(10.57±2 Y), Somali,
Yemeni and Sudanese women

Type I&II
21%

Do not know Type III

46% 6%

Type IV
26%

Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684.
Medicalization
In Egypt, doctors, as opposed to other health personnel,
undertake most FGM/C procedures
Doctor Nurse/midwife/other health worker

Egypt

Kenya

Nigeria

Yemen

Sudan

Iraq

0 20 40 60 80 100

United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the
dynamics of change UNICEF, New York, 2013

Person performing FGM in Egypt

Change in trends between mothers and daughters
80 74% Girls and women aged 0-19
Women aged 15-49
60
52%

40
31%

20 16%
8% 7% 6% 5%
1% 1%
0
Doctor Nurse/other Daya Barber other/don't
health workers know

Source: UNICEF Health Issues Survey 2015 based on estimates from surveys undertaken between 2004-2015
 Who is performing the procedure?

Do not know
21%
Traditional birth attendant
37%

Relative
20%

physician or a nurse
22%

Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684.
 Where is the cutting performed
Do not know Government hospital
15% 5%
midwife’s house
5% Private clinic
private clinic 29%
8% Jeddah area home Egypt
57% At home
hospital 66%
15%

1- Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684
2- United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamic
of change UNICEF, New York, 2013
.

 Use of Anesthesia

Do not know
2%
General Without
Without
13% 25%
31%

Do not know
50% Jeddah area Egypt

Local
General 14% Local
4% 60%

1- Rouzi AA, Berg RC, Alamoudi R, Alzaban F, Sehlo M. Survey on female genital mutilation/cutting in Jeddah, Saudi Arabia.
BMJ Open 2019; 9 (5): e024684
2- United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamic
of change UNICEF, New York, 2013
.

 The Medicalization of FGM/C

Medicalization is a social process through which a human
experience or condition is culturally defined as pathological
and treatable as a medical condition
The trend towards increased medicalization may be
attributed to decades of advocacy about the health risks of
the practice
While these campaigns have raised awareness of health
risks, they may have created the perception that these risks
could be largely avoided if cutting is performed by medical
personnels
.

 The Medicalization of FGM/C

There is no evidence that medicalization reduces the long-
term complications associated with FGM/C.1
United Nations condemned medicalization of FGM/C in
1979.2
Numerous medical associations , including the ISSM, have
condemned FGM/C under any circumstances, in health
establishments or by health professionals.3

1- WHO, Eliminating Female Genital Mutilation: An interagency statement, p. 12

2- WHO, Global Strategy to Stop Health-care Providers from Performing Female Genital Mutilatio
3- International Society for Sexual Medicine, “Public Policy Statement – Female Genital Cutting” (April 18, 2012)
.

Physical health
outcomes
 Health benefits of FGM/C
Unlike male genital cutting, which provides protection
from certain infections, such as urinary tract infections,
HIV, human papilloma virus, syphilis, and chancroid1,2,3,
there are no known health benefits of FGM/C4.

1. Weiss et al. Male circumcision and risk of syphilis, chancroid, and genital herpes: A systematic review and
meta-analysis. Sex Transm Infect 2006;82:101–9
2. Backes et al. Male circumcision is associated with a lower prevalence of human papillomavirus-associated
penile lesions among Kenyan men. Int J Cancer 2012;130:1888–97
3. Vardi et al. Male circumcision and HIV prevention. J Sex Med 2007;4(4, Pt 1):838–43
4. WHO. Eliminating female genital mutilation: An inter-agency statement. Geneva, Switzerland: World Health
Organization; 2008.
.

 Immediate complications
Data from a recent systematic review1 including 185
studies involving 3.17 million female participants

Excessive bleeding 32%

Urine retention 31%
Genital tissue swelling 15%
Wound healing problems 13%

A study in Yemen, in which 600 women were questioned

about their daughters, reported a death rate of 2.3%2
1. Berg, et al. Effects of female genital cutting on physical health outcomes: a systematic review and metaanalysis. BMJ Open 2014;4:
e006316
2. Yemen Women’s Union. Quantitative study in Aeden, Hadhramout and Al-Hudaidah, including 600 women with at least one
daughter cut. WHO/UNICF/UNFPA conference on the medicalization of FGM 2009
.

 28 comparative studies, involving 3 million participants

Berg RC, Odgaard-Jensen J, Fretheim A, Underland V, and Vist G. An Updated Systematic Review and
Meta-Analysis of the Obstetric Consequences of Female Genital Mutilation/Cutting. Obstetrics and
Gynecology International 2014, Vol 2014
 Difficult Labor

Berg RC, et al. An Updated Systematic Review and Meta-Analysis of the Obstetric Consequences of Female
Genital Mutilation/Cutting. Obstetrics and Gynecology International 2014, Vol 2014
 Obstetric Tears/Lacerations

Berg RC, et al. An Updated Systematic Review and Meta-Analysis of the Obstetric Consequences of Female
Genital Mutilation/Cutting. Obstetrics and Gynecology International 2014, Vol 2014
Obstetric/Postpartum Hemorrhage

Berg RC, et al. An Updated Systematic Review and Meta-Analysis of the Obstetric Consequences of Female
Genital Mutilation/Cutting. Obstetrics and Gynecology International 2014, Vol 2014
 Female Sexual
Function Outcomes
 Difficulties to study the effects of FGM/C on
sexual functions in the Middle East

Social customs like FGM/C do not lend itself to randomized

controlled trials, the gold standard for drawing causal inferences

Cross-sectional studies are inherently problematic with respect to

sampling, because recruiting sufficiently equivalent exposed and
unexposed groups of females may be difficult

Until recently, the FSFI which is the “gold standard” of the

assessment of female sexual function was not validated for the
Arabic language and in cut women.

Rosen et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of
female sexual function. J Sex Marital There 2000;26:191–208.
.

 Effects of FGM/C in Somalis women

Catania and colleagues compared the FSFI scores of 57
infibulated Somali women in Florence and a control
group of 57 uncut women (3 Somali and 54 Italian).
Surprisingly,Infibulated women obtained higher scores
in the desire, arousal, orgasm, and satisfaction domains.

These results need to be interpreted with caution, since the control group
was not selected from Somali population, and study did not control for
ethnicity. The study also used an Italian preliminary adaptation of the
FSFI questionnaire, which was not tested for validity and reliability.
Catania et al., Pleasure and orgasm in women with female genital mutilation/cutting (FGMC). J Sex Med 2007;4:1666–78

Effects of FGM/C in Saudi Arabia

Alsibiani and Rouzi reported that women who had been
subjected to FGM/C scored significantly lower on an Arabic-
translated version of the FSFI
Cut women also reported significantly lower arousal,
lubrication, orgasm, and satisfaction domain scores
The study however had 2 major drawbacks; the Arabic
translated version used was not tested for validity and
reliability, and exposure was based on self-reporting and
participants were not examined clinically to confirm the cutting
status

Alsibiani SA, Rouzi AA. Sexual function in women with female genital mutilation. Fertil Steril 2010;93:722–4.
.

Arabic Translation of Female Sexual Function Index

and Validation in an Egyptian Population
The included 855 married women, 62.2% were genitally cut.
Face, content, discriminant, Construct and concurrent
validity were assessed as well as test–retest and internal
consistency reliabilit
The study concluded that ArFSFI is valid and reliable, and it
is as good as the original FSFI in assessing female sexual
function
ArFSFI was used so far in 51 studies assessing female sexual
function in different medical conditions.
Anis et al, Arabic Translation of Female Sexual Function Index and Validation in
an Egyptian Population, J Sex Med. 2011 Dec;8(12):3370-8
.

Effects of Female Genital Cutting on the Sexual Function

of Egyptian Women. A Cross-Sectional Study

The study was conducted in February and May 2011 at the

outpatient clinic of Cairo University Hospital
The study included 650 Egyptian females between 16 and 55
years of age (333 genitally cut women and 317 uncut
women)
Participants were requested to complete the Arabic Female
Sexual Function Index and were then subjected to clinical
examination where the cutting status was confirmed.

Anis et al, Effects of Female Genital Cutting on the Sexual Function of Egyptian Women. A Cross-Sectional Study, J
Sex Med. 2012 Oct;9(10):2682-92
.

Effects of Female Genital Cutting on the Sexual Function

of Egyptian Women. A Cross-Sectional Study
Signs of genital cutting Type No %
Partial clitoridectomy I 157 47.15
Total clitoridectomy I 126 37.84
Total type I 283 84.98 Type II
Partial clitoridectomy + partial 15%
II 9 2.7
excision of labia minora
Partial clitoridectomy +
complete excision of labia II 11 3.3
minora Type I
85%
Full clitoridectomy + partial
II 23 6.91
excision of labia minora
Full clitoridectomy + complete
II 7 2.1
excision of labia minora
Total type II 50 15.02
Anis et al, Effects of Female Genital Cutting on the Sexual Function of Egyptian Women. A Cross-Sectional Study, J
Sex Med. 2012 Oct;9(10):2682-92
 Effects of Female Genital Cutting on the Sexual Function
of Egyptian Women. A Cross-Sectional Study

After adjusting for age, residential area, and education

level, uncut participants scored significantly higher in the
ArFSFI

Anis et al, Effects of Female Genital Cutting on the Sexual Function of Egyptian Women. A Cross-Sectional Study, J
Sex Med. 2012 Oct;9(10):2682-92
 Domains of Arabic Female Sexual Function Index for
cut and uncut participants
Cut (N = 333) Uncut (N = 317)
6

4.5

1.5

0
Desire Arousal Lubrication Orgasm Satisfaction Pain

Anis et al, Effects of Female Genital Cutting on the Sexual Function of Egyptian Women. A Cross-Sectional Study, J
Sex Med. 2012 Oct;9(10):2682-92
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 (1): 108.
 Effect of female genital mutilation/cutting types I and
II on sexual function
FGM/C I (n=145) FMG/C II (n=52) Control (n=197)

24
ArFSFI total score

18

12 23
20.26 18.64
6

0
FGM/C I (n=145) FMG/C II (n=52) Control (n=197)

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 (1): 108.
 Effect of female genital mutilation/cutting types I and
II on sexual function
Control (n=197) FGM/C I (n=145) FMG/C II (n=52)
4.2

3.15

2.1

1.05

0
Desire Arousal Lubrication Orgasm Satisfaction Pain

- There was no statistically significant difference between the two types of except for the pain domain
- Comparing the two types with the control revealed significant lower scores except for the desire
domain
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 (1): 108.

Rouzi AA, Berg RC, Sahly N, Alkafy S, Alzaban F, Abduljabbar H. Effects of female genital mutilation/cutting on the sexual function of Sudanese
women: a cross-sectional study. Am J Obstet Gynecol 2017; 217 (1): 62.e1-62.e6.
Effects of female genital mutilation/cutting on the sexual
function of Sudanese women: a cross-sectional study
107 women completed the survey and clinical examination
Type I (39%)

History taking Gynecologic examination

Type II (25%)

100% self-described Revealed the presence

themselves as Muslim, having of FGM/C Types I, II,
“Sunna” i.e. type I
Type III (36%)
and III

Rouzi et.al. Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study. Am J
Obstet Gynecol 2017; 217 (1): 62.e1-62.e6.
Effects of female genital mutilation/cutting on the sexual
function of Sudanese women: a cross-sectional study
Type I (n=42) Type II (n=27) Type III (n=38)

28
ArFSFI total score

21

14 26.80
21.60
7 15

0
Type I (n=42) Type II (n=27) Type III (n=38)

Rouzi et.al. Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional
study. Am J Obstet Gynecol 2017; 217 (1): 62.e1-62.e6.
Effects of female genital mutilation/cutting on the sexual
function of Sudanese women: a cross-sectional study

Type I (n=42) Type II (n=27) Type III (n=38)

5

3.75

2.5

1.25

0
Desire Arousal Lubrication Orgasm Satisfaction Pain

Rouzi et.al. Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional
study. Am J Obstet Gynecol 2017; 217 (1): 62.e1-62.e6.
Berg RC, et al. BMJ Open 2014;4:e006316. doi:10.1136/bmjopen-2014-006316
Dyspareunia associated with FGM/C

Dyspareunia was reported in 6 studies (n=6204)

The meta-analysis showed an increased risk of dyspareunia
with FGM/C (RR=1.53)
Berg RC, Underland V, Odgaard-Jensen J, Fretheim A, Vist GE. Effects of female genital cutting on
physical health outcomes: a systematic review and meta-analysis. BMJ Open 2014; 4 (11): e006316.
.

Psychological and Marital problems

A cluster random sample of 600 couples representative for 6 districts of Fayoum governorate

Cut Uncut Complicated Uncomplicated

38%
40 38
35%
35%
31%
30 28.5 27%

21%
20 19

12%
10 9% 9.5

0 0
Psychological problems Marital problems Psychological problems Marital problems

Raheem TAA et al. Int J Community Med Public Health. 2018 Mar;5(3):905-911
Effect of FGC/M on Partner’s Sexual Function
A cluster random sample of 600 couples representative for 6 districts of Fayoum governorate

Partners of Cut women Partners of Uncut women

50

42%

37.5
33%

25%
25 22%
20% 20%

12.5

0
Erectile Dysfunction Premature ejaculation Loss of satisfaction

Raheem TAA et al. Int J Community Med Public Health. 2018 Mar;5(3):905-911
Effect of FGC/M on Partner’s Sexual Function
A cluster random sample of 600 couples representative for 6 districts of Fayoum governorate

Partners of women with FGC complications

Partners of women without FGC complications
50 47%

37.5
37%
33%
29%
25%
25

17%
12.5

0
Erectile Dysfunction Premature ejaculation Loss of satisfaction

Raheem TAA et al. Int J Community Med Public Health. 2018 Mar;5(3):905-911
Tramadol abuse
A painkiller becomes Egypt’s favourite recreational drug

The United Nations Office of Drugs and Crime (UNODC)

estimated there were at least 5 billion tramadol pills circulating
Egypt in 2012
According to a study of the National Centre for Criminological
and Social Studies, which was conducted across 10 of Egypt's
governorates, 50 % of all psychotropic substance abusers in
Egypt use Tramado
70 percent of admissions to the toxicology centre of Cairo’s
massive Kasr Al-Aini hospital were linked to tramadol alone in
2014.
The Economist, Apr 18th 2015
.

Risk factors to start tramadol abuse

330 Egyptian substance abusers
Improve mood
prolong intercourse
delay fatigability
relief pain
depression
anxiety
Peer pressure
others
0 5 10 15 20

A causal link still needs to be established between high

FGM/C prevalence and tramadol abuse
Mohamed et al. An epidemiological study of tramadol HCl dependence in an outpatient addiction clinic at
Heliopolis Psychiatric Hospital. Menoufia Med J 2015;28:591-6
Conclusions
Public Policy Statement On
Female Genital Cutting
Female genital cutting is a widespread practice in some parts of the world.
It is usually performed on female infants, children or pubescent girls under
non-sterile conditions without anesthesia. The extent of cutting varies from
a small superficial skin cut to removal of the entire external female
genitalia
Female genital cutting exposes a female to risk of serious infection and may
cause sexual dysfunction, reproductive dysfunction or death from
hemorrhage or sepsis. Unlike male circumcision, there are no known health
benefits to female genital cutting
Female genital cutting should be condemned in the strongest possible
terms and should not be tolerated by any healthcare practitioner, any
agency responsible for public health or any government.

International Society for Sexual Medicine, “Public Policy Statement – Female Genital Cutting” (April 18, 2012)
.

 6 FEBRUARY
International Day of
ZERO
TOLERANCE
for
FEMALE
GENITAL
MUTILATION

# EndFGM

Female genital cutting:

The effect on female sexual
function?