FGM is against the law in the UK and is recognised as a form of child abuse. Undergoing the practice can affect girls and women in many ways and there are often long term effects on your physical and emotional health.
This page provides details about potential health problems and gives advice about how to live as halthily as possible with FGM.
Mental and Emotional Health
Any situation that leaves you feeling overwhelmed and alone can be traumatic and undergoing FGM can be one of those experiences. You may not really remember what happened to you but that experience can be held within your mind at a deeper level. This may lead to many painful feelings. These can include low self esteem, depression, anxiety and anger. You can feel like this even if you wanted to go through FGM because that is what happens to all girls in your community. It is likely to have been a very painful and frightening experience for you. Flashbacks, panic attacks and sometimes nightmares are usual following very distressing experiences.
What is a flashback?
A flashback is a temporary state of remembering something painful or traumatic which has been hidden for quite some time in the subconscious mind. Flashbacks can be triggered at any time by anything such as a smell or a sound and you may feel you are right back there in the traumatic situation. If this happens to you try to remember that this is a memory and remind yourself of the time and date now. Flashbacks can be very frightening but they are the body’s way of healing.
You may wish to seek counselling and there are a number of organisations that can help you.
Counselling is a way of talking through your feelings and experiences and looking at how you have managed them. The counsellor does not give advice but can help you to find more positive ways of managing those feelings.Sexuality, Sex and Intercourse
It can often be difficult for women who have been through FGM to think about having sex. You may be really worried that it will be painful because of the scar or that you may not have an orgasm if your clitoris has been removed. Women often choose to have a de-infibulation before they get married. However, as many women have sex before getting married they may also choose to have the procedure at any time. Your health professional will not judge you and will respect your need for confidentiality.
You may find that you have frequent vaginal discharge and though some discharge is normal for women it may mean you have an infection. You can talk this through at your GP’s or at a sexual health clinic.
Many women who have had FGM do enjoy a happy and satisfying sex life and it is possible to have an orgasm even though your clitoris was removed. It could help you to talk to your partner about your feelings and anxieties.
The World Health Organisation recognised that the practice of FGM can deny girls and women the right to the highest attainable level of sexual health.
There are several recognised types of FGM and the more severe the cutting the more impact that has on your physical health. However, undergoing any type of FGM can cause emotional and psychological difficulties.
Pregnancy and Labour
Pregnancy can be an anxious time for women who have had FGM because of the worry about the delivery especially if you have a long and closed scar.
When you first meet your midwife they will ask you certain questions which are designed to establish if a woman has any problems that could affect her pregnancy. As part of this the midwife should ask you whether you have undergone FGM. This is to ensure that you receive the best care and to enable you to talk through your anxieties. You can have a de-infibulation during your pregnancy and that is best done at around 20. However in some cases it can be carried out up to 32 weeks of pregnancy.
You may also have the scar cut during the labour to help with the delivery; the decision when to have the procedure should be yours in consultation with your midwife. It is important to talk through any worries with your midwife.
The midwife may also refer you to children’s services. This is because FGM causes harm to children and it is covered by safeguarding policies. You do not need to feel anxious about this. Many people fear social services but they will support you and help you with your decision not to have any daughters cut.
Cervical Smear Test
Cervical screening is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb).
This test is offered at regular intervals to all women between the ages of 25 and 64. This test is usually carried out in your GP practice or at a women’s health clinic. It is sometimes a little uncomfortable but it should not be painful.
If you have had FGM you may be anxious about having this test and it is important to talk to the nurse about your anxieties. Undergoing any vaginal examination may trigger a flashback for you or a panic attack because it makes you remember the time you were cut. If this happens to you do ask the nurse to stop and let them know how you feel. They may refer you to a specialist clinic to have your smear taken.
Your monthly period can also be very painful (dysmenorrhoea) and prolonged because of the long scar restricting the blood flow. It is usual for any woman to have pain with her periods but for girls and women who had had FGM this can be worse and last longer. Sometimes the scar of the cutting is very long with a tiny opening and this will make it worse for you.
If you are experiencing any of these difficulties you are not alone and it is important to talk with someone. You can talk to your GP, practice nurse and health visitor or you can ring one of the specialist centres. Daughters of Eve can help you by providing support and information.
If you have had the most severe type of cutting often called infibulation or being closed this can affect your physical health in several ways. The long closed scar will cover the urethra (where you pass urine) and often most of the vaginal opening. This makes going to pass urine very difficult and it may take a long time as the flow is restricted by the scar. You may need to go more frequently or spend many minutes trying to empty your bladder. Some of the urine may collect in the area of the scar and when you lie down it can leak out. This can be embarrassing but it does not mean you have incontinence.