Effect of COVID-19 pandemic on female sexual function in women with female genital mutilation

Abstract

We aimed to evaluate the impact of the COVID-19 pandemic on female sexual function in women with female genital mutilation (FGM) in Somalia. This cross-sectional study was conducted on women with FGM attending the gynaecologic outpatient clinic of our hospital, between March and June 2021, using a validated Female Sexual Function Index (FSFI) questionnaire with a physical examination based on FGM typing. Those women who refused to participate, those with mental illness, uncontrolled systemic disease, drug, alcohol, or khat addiction, pregnant, genital prolapse, gynaecological or urological cancer, previous pelvic surgery, premature ovarian failure, genital skin diseases, drug use that affects sexual function and those with or suspected of having COVID-19 infection were excluded. A total of 201 sexually active women enrolled, with a mean age of 29 (14–55) years. Comparison of FSFI scores and the COVID-19 pandemic, a statistically significant worsening in the mean FSFI scores and all its domains (p<.001, for each). All of the domains of the FSFI were determined higher before and during the pandemic except pain. There is a decline in female sexual functioning during the COVID-19 outbreak in women with FGM. FGM is a major public health concern necessitating urgent response in Somalia.

Impact statement

• What is already known on this subject? As it stands, there is a body of research on sexual behaviour during COVID-19 pandemic, but a lack of conclusive evidence. However, our knowledge of the sexual function of women with FGM during the COVID-19 pandemic is largely based on very limited data.

• What do the results of this study add? There is a decline in female sexual functioning during COVID-19 pandemic in women with female genital mutilation in Somalia.

• What are the implications of these findings for clinical practice and/or further research? FGM is a major public health problem necessitating urgent response worldwide. There is an urgent need to implement FGM prevention programmes and raise public awareness in order to eradicate this harmful practice.

Keywords:

• COVID-19
• female sexual function
• FGM
• FSFI
• pandemic
• Somalia

Acknowledgements

The authors sincerely thank Dr. Dilek Başar for her help in the preparation of the figure. The authors also very grateful Stephani Cain for her assistance in language editing.

Declaration of Helsinki

Ethical approval for this study was provided by the Somalia Mogadishu–Turkey Recep Tayyip Erdogan Training and Research Hospital Ethics Committee (Approval number: MSHT/5532). The database management in accordance with privacy legislation and the presented study in accordance with the ethical principle of the Declaration of Helsinki.

Author contributions

OO: participated in the study design, data collection, and interpretation of findings and drafting of the manuscript. EK: participated in study design, interpretation of findings, and drafting of the manuscript. KNB: participated in the data analysis and the interpretation of findings. HHE: participated in the interpretation of findings and drafting of the manuscript. IAN: participated the data collection and the interpretation of findings. All authors participated in the review of the final manuscript. All authors approved the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The dataset used and/or analysed in the study are available from the corresponding author on reasonable request.

Additional information

Funding

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.