The Survey of Circumcision’s Effect on Sexual Function, Sexual Satisfaction and Quality of Sexual Life in Pregnant Women

Document Type : Original Article(s)

Authors

1 Professor, Department of Midwifery, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran

2 MSc of Consultation on Midwifery, Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran

3 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: Female circumcision can be associated with unfavorable health outcomes, including physical, psychological, social, and sexual consequences. The present study was conducted to investigate the effect of circumcision and its predictor factors on sexual performance, life, and satisfaction of women.
Methods: The present study was a cross-sectional (descriptive-analytical) study of 320 women referred to the childbirth ward in 2019-2020. It was done using the available sampling method. Information was collected through questionnaires and interviews. The data collection tool was a 4-part questionnaire that included a researcher-made questionnaire, sexual questionnaires, and sexual quality of life. After collecting the data, they were analyzed using ANCOVA, a simple and multiple linear regression.
Findings: The mean score of sexual satisfaction, sexual function, and quality of sexual life in two groups (circumcised and uncircumcised women) showed a statistically significant difference (P < 0.001). Also, the mean score in all dimensions of sexual function was significant in two groups (desire (P < 0.001), stimulation (P < 0.001), humidity (P < 0.001), orgasm (P = 0.002), satisfaction (P < 0.001), pain (P = 0.049), respectively). The rate of sexual dysfunction in circumcised women was 83.9%, and in uncircumcised women was 71.6%. According to the coefficient effect in covariance analysis, 5, 7, and 13% changes in sexual satisfaction, sexual quality of life, and sexual function in women were related to circumcision, respectively. Also, the age of circumcision has the most outstanding effect and is a significant predictor of sexual satisfaction (β: 1.51; P: 0.018; CI95%: 2.77 to 0.26) and quality of sexual life (P: 0.027; CI95%: 0.12 to 2.06). The degree of circumcision 2 compared to 1 has the most distinguished effect and predictor on the overall sexual function score (β: 2.87; P: 0.018; CI95%: -0.22 to -5.52) and its dimensions.
Conclusion: The findings of the present study showed a decrease in the sexual satisfaction action and quality of life scores in circumcised women, and by emphasizing the negative consequences of circumcised women's sexual health, it tried to inform healthcare providers about counseling to change the views of families to improve women's sexual health.

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  1. Female genital mutilation/cutting: a global concern. [February 3, 2016] Available from: https://data.unicef.org/resources/female-genital-mutilationcutting-global-concern/.
  2. Fund UNCs, Gupta GR. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. UNICEF, United Nations Children's Fund; 2013. p. 184-90.
  3. Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T. Sexual function, mental well-being and quality of life among Kurdish circumcised women in

    Iran J Public Health 2017; 46(9): 1265-74.
  4. Abdoli S, Masoumi SZ, Jenabi E. Investigation of prevalence and complications of female genital circumcision: a systematic and meta-analytic review study. Curr Pediatr Rev 2021; 17(2): 145-60.
  5. Mulongo P, Hollins Martin C, McAndrew S. The psychological impact of female genital mutilation/cutting (FGM/C) on girls/women’s mental health: a narrative literature review. J Reprod Infant Psychol 2014; 32(5): 469-85.
  6. Kaplan A, Forbes M, Bonhoure I, Utzet M, Martín M,

    Manneh M, et al. Female genital mutilation/cutting in The Gambia: long-term health consequences and complications during delivery and for the newborn. Int J Womens Health 2013; 5: 323.
  7. Vloeberghs E, Van der Kwaak A, Knipscheer J, van den Muijsenbergh M. Coping and chronic psychosocial consequences of female genital mutilation in the Netherlands. Ethn Health 2012; 17(6): 677-95.
  8. 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. Obstet Gynecology Survey 2018; 73(1): 20-1.
  9. Bjälkander O, Grant DS, Berggren V, Bathija H, Almroth L. Female genital mutilation in Sierra Leone: forms, reliability of reported status, and accuracy of related demographic and health survey questions. Obstet Gynecol Int 2013; 2013: 680926.
  10. Biglu M-H, Farnam A, Abotalebi P, Biglu S, Ghavami M. Effect of female genital mutilation/cutting on sexual functions. Sex Reprod Healthc 2016; 10: 3-8.
  11. Berg RC, Denison E. A tradition in transition: factors perpetuating and hindering the continuance of female genital mutilation/cutting (FGM/C) summarized in a systematic review. Health Care Women Int 2013; 34(10): 837-59.
  12. Ibrahim ZM, Ahmed MR, Mostafa RM. Psychosexual impact of female genital mutilation/cutting among Egyptian women. Human Androl 2012; 2(2): 36-41.
  13. Alsibiani SA, Rouzi AA. Sexual function in women with female genital mutilation. Fertil Steril 2010; 93(3): 722-4.
  14. El-Naser T, Farouk A, El-Nashar A, Mostafa T. Sexual side effects of female genital mutilation/cutting may be type dependent: a hospital-based study KAJOG Kasr Al-Aini. J Obstet Gynecol 2010; 1(2): 65-74.
  15. 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): 1-6.
  16. Gebremicheal K, Alemseged F, Ewunetu H, Tolossa D, Ma’alin A, Yewondwessen M, et al. Sequela of female genital mutilation on birth outcomes in Jijiga town, Ethiopian Somali region: a prospective cohort study. BMC Pregnancy Childbirth 2018; 18(1): 305.
  17. Hudson WW, Harrison DF, Crosscup PC. A short‐form scale to measure sexual discord in dyadic relationships. J Sex Res 1981; 17(2): 157-74.
  18. Talayizadeh F, Bakhtiyarpour S. The relationship between marital satisfaction and sexual satisfaction with couple mental health [in Persian]. Thought & Behavior in Clinical Psychology 2016; 10(40): 37-47.
  19. Asadi L, Ziaei T, Koochak HE, Montazeri A, Rezaei E,

    Moghadam ZB, et al. Effect of counseling based on PLISSIT model on sexual function of HIV-positive married women. HIV & AIDS Review International Journal of HIV-Related Problems 2018; 17(3): 169-75.
  20. Moghadam ZB, Rezaei E, Faezi ST, Zareian A, Ibrahim FM, Ibrahim MM. Prevalence of sexual dysfunction in women with systemic lupus erythematosus and its related factors. Reumatologia/Rheumatology 2019; 57(1): 19-26.
  21. Maasoumi R, Lamyian M, Montazeri A, Azin SA, Aguilar-Vafaie ME, Hajizadeh E. The sexual quality of life-female (SQOL-F) questionnaire: translation and psychometric properties of the Iranian version. Reprod Health 2013; 10: 25.
  22. 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(2): 108.
  23. Riang’a RM, Mutiso MM. Knowledge, Experiences and Perceptions of Abagusii Community of Kisii County, Kenya on the Health Consequences of Female Genital Mutilation (FGM). International Journal of Research in Humanities and Social Studies 2022; 9(2): 19-30.
  24. 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(1-3): 194-206.
  25. Martínez‐Linares JM, López‐Entrambasaguas OM, Fernández‐Medina IM, Berthe‐Kone O, Fernández‐Sola C, Jiménez‐Lasserrotte MdM, et al. Lived experiences and opinions of women of sub‐Saharan origin on female genital mutilation: A phenomenological study. J Clin Nurs 2023; 32(11-12): 2547-58.
  26. Wulfes N, von Fritschen U, Strunz C, Kröhl N, Scherer R, Kröger C. Cognitive–Emotional Aspects of Post-Traumatic Stress Disorder in the Context of Female Genital Mutilation. Int J Environ Res Public Health 2022; 19(9): 4993.
  27. Adelekan B, Kareem YO, Abubakar Z, Bungudu K, Aderemi A, Goldson E, et al. Female genital mutilation and sexual behaviour by marital status among a nationally representative sample of Nigerian women. Reprod Health 2022; 19(1): 1-9.
  28. Kakal T, Hidayana I, Kassegne AB, Gitau T, Kok M, van der Kwaak A. What makes a woman? Understanding the reasons for and circumstances of female genital mutilation/cutting in Indonesia, Ethiopia and Kenya. Cult Health Sex 2023; 25(7): 897-913.
  29. Aglamis SO, Asfuroglu A, Koudonas A. The impact of vaginoplasty on female and male sexual function and satisfaction. Aesthet Surg J 2024: 44(12): NP892-NP897.