Many women who were cut as girls live without problems. Others find, years later, that it affects passing urine, periods, sex, examinations or childbirth. Whichever applies to you, you can be seen by a urogynecologist, at your own pace, without having to explain how or why it happened.
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Female genital mutilation (FGM) — also called female genital cutting or female circumcision — is any procedure that cuts or injures the external genitalia for non-medical reasons. It is usually done in childhood, and the woman had no say in it.
This page is for adult women who want to understand their body, deal with a problem it is causing, or ask about surgery. You do not have to use the word FGM when you contact us. Saying that you were circumcised as a child is enough.
The World Health Organization describes four types. Type I removes part or all of the clitoral glans and/or its hood. Type II also removes part or all of the inner labia. Type III (infibulation) narrows the vaginal opening by cutting and bringing together the labia, leaving a small opening. Type IV covers other harmful procedures such as pricking, piercing or burning.
You do not need to know your type before you come. The examination establishes it, and the type decides what can be offered — defibulation, for example, only applies to type III.
Difficulty passing urine, a slow or spraying stream, or repeated urinary infections. Painful or prolonged periods, or a feeling that menstrual blood cannot get out. Pain during sex, or sex that is not possible at all. A lump or swelling near the scar, which is often a cyst. Pain at the scar. Difficulty having a cervical screening test or a vaginal examination.
Worry about pregnancy and birth is also a reason to be seen, ideally before pregnancy or early in it, so that any planning is done in good time.
Memories, anxiety or low mood can come with any of these. They are part of your health too, and you can raise them at the first appointment if you wish.
The first visit can be a conversation only. Nothing is examined without your agreement, everything is explained before it happens, and you can stop at any point. A chaperone can be present. Female specialists are available — say so when you book.
You decide how much of your history to share. What matters for your care is how your body is now and what is troubling you.
Consultations are conducted in English or Thai, and an interpreter can be arranged if you request one when booking.
Defibulation (also called deinfibulation) is a short operation that opens the scar tissue covering the vaginal opening and the urethra in type III. It is usually done under local or regional anaesthesia.
WHO guidelines on managing the health complications of FGM recommend defibulation for women with type III to prevent and treat problems in childbirth, and for women with urinary difficulties caused by the scar. It can be planned before pregnancy, during pregnancy, or at delivery together with the obstetric team.
It changes how passing urine and periods feel, and it changes appearance. These are discussed with you before you decide. We do not re-close the opening afterwards (reinfibulation), including after childbirth, even if asked.
Part of the clitoris lies beneath the skin and is usually not removed by cutting. Clitoral reconstruction is an operation that releases scar tissue and brings this remaining tissue nearer the surface.
The evidence is limited. WHO guidelines on managing the health complications of FGM made no recommendation for or against this operation, because studies are few and their results vary. Some women report less pain or feeling differently about their body; others notice no change, and some have more pain. Bleeding, infection, wound problems and ongoing pain are possible.
It is not suitable for every woman. Whether it is worth considering is decided after assessment, usually alongside sexual and psychological support rather than instead of it. No result is promised.
Many problems after FGM do not need an operation. Pain during sex often has more than one cause — scar tissue, pelvic floor muscles that tighten in anticipation of pain, dryness, or infection — and each of these is assessed and treated in its own right.
Pelvic floor care, sexual medicine counselling, treatment of infections and assessment of any cyst are all part of the same assessment. If surgery is considered, it is because these have been looked at first.
Operations are performed at our partner hospitals, Praram 9 Hospital and Vimut Hospital, not at the clinic. Which one is used depends on the operation planned, the surgeon's operating schedule and, where relevant, which hospital your insurance works with.
Assessment, planning and follow-up happen at the clinic.
Assoc. Prof. Dr. Orawee Chinthakanan (ว.33071) — urogynecologist; Female Pelvic Medicine and Reconstructive Surgery.
Care is provided by the clinic's urogynecologists. Registration numbers can be checked with the Thai Medical Council.
We do not perform FGM of any type, on anyone, at any age, for any reason — including requests described as cultural, religious or a family wish. We do not re-close a defibulated scar. Requests of this kind are declined.
No operation replaces tissue that was removed. Defibulation opens a closed scar; clitoral reconstruction works with the tissue that remains. What either can do for you is discussed after an examination, and results differ between individuals.
No. What matters for your care is how your body is now and what is troubling you. You share only what you choose to.
Yes. Female specialists are available. Say so when you book.
As early in pregnancy as you can. Defibulation can be done before or during pregnancy or at delivery, and the timing is planned with your obstetric team.
That cannot be promised. Pain during sex often has several causes, and surgery addresses only some of them. The first step is an assessment, and non-surgical care is considered first.
Message us with as much or as little as you want to say. We will tell you whether an appointment is worth making and what it involves.
This page is general information to aid understanding. It is not a diagnosis or individual treatment advice. Which option is appropriate is decided individually after examination, and results differ between individuals. Surgery is performed at a partner hospital, not at the clinic. Consultations are conducted in English or Thai. THE FIT CLINIC, 8th Floor, EM Tower, EMSPHERE, 628 Sukhumvit Road, Bangkok 10110. Open daily 10:00–19:00.