Female genital mutilation and other harmful practices
Health consequences of female genital mutilation
Long-term reproductive health consequences of FGM in Gambia
This article examines the link between FGM, here referred to as female genital cutting, and adult women's reproductive morbidity in rural Gambia. It reports a 1999 community survey of 1348 women aged 1554 years and estimates the prevalence of reproductive morbidity on the basis of women's reports, a gynaecological examination and laboratory analysis of specimens.
A total of 1157 women consented to gynaecological examination and 58% had signs of FGM. There was a high level of agreement between reported circumcision status and that found on examination. Most of the FGM procedures consisted of clitoridectomy and excision of the labia minora (type II) and were performed between the ages of 4 and 7 years. The practice was highly associated with two of the three main ethnic groups in the area.
Women who had undergone FGM had a significantly higher prevalence of bacterial vaginosis and a substantially higher prevalence of herpes simplex virus 2 (HSV2). The researchers conclude that the higher prevalence of HSV2 suggests that women who have been cut in this way may be at increased risk of HIV infection. On the other hand, the researchers found that damage to the perineum or anus, vulval tumours, painful sex, infertility, prolapse and other reproductive tract infections were not significantly more common in women with FGM.
1. Morison L, Scherf C, Ekpo G, Paine K, West B, Coleman R, Walraven G. The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey. Tropical Medicine and International Health 2001; 6(8):643-653.