{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:15:46Z","timestamp":1774430146449,"version":"3.50.1"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"\n Introduction<\/jats:title>\n Type III female genital mutilation\/cutting (FGM\/C), or infibulation, negatively impacts girls' and women's health and well-being. Some evidence suggests women who have experienced infibulation may have distinct menstrual health challenges. However, the intersection of infibulation and menstrual health is under-explored. The present study documented women's and providers' perspectives on menstrual health and infibulation among Somali communities in Wajir County, Kenya.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a qualitative study including in-depth interviews (\n n<\/jats:italic>\n \u2009=\u200923) with Somali women ages 18\u201345, and key informant interviews (\n n<\/jats:italic>\n \u2009=\u200910) with healthcare providers. Interviews with women explored their reflections on and experiences of FGM\/C, including infibulation, menstrual health, and perceived connections between the two. Interviews with healthcare providers explored their perspectives on women's healthcare needs in relation to menstrual health and infibulation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thematic analysis identified three themes: (1) informal discussion among women shapes their menstruation and infibulation knowledge; (2) multiple factors that shape women's care-seeking for menstrual health concerns; and (3) healthcare providers lack the necessary preparation to address menstrual health concerns among women who have undergone infibulation.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n This study's findings provide insights into the intersections of menstrual health and infibulation within the broader educational, social and healthcare context of Somali communities in rural Kenya. While women learn, interpret, and describe infibulation as a source of acute menstrual health problems, including menstrual pain and irregular bleeding, clinical evidence on this relationship is needed. Findings illuminated multiple factors inhibiting Somali women's receipt of adequate care for menstrual health needs. Additional challenges included women's perceptions of healthcare quality, distrust of formal healthcare providers, and gendered family decision-making processes around healthcare. Healthcare providers' inadequate training and support hindered diagnosis and care for menstrual disorders for women who have and have not experienced infibulation, while confusion about Kenya's FGM\/C ban further complicates provider engagement.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1753459","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:48:04Z","timestamp":1774421284000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cI had a feeling the period did not have an opening to come out:\u201d A qualitative assessment of Type III Female Genital Mutilation\/Cutting and menstrual health among Somali communities in Kenya"],"prefix":"10.3389","volume":"7","author":[{"given":"Anne","family":"Achieng","sequence":"first","affiliation":[{"name":"African Population and Health Research Center","place":["Nairobi, Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah C.","family":"Blake","sequence":"additional","affiliation":[{"name":"Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University","place":["New York, NY, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramatou","family":"Ouedraogo","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center","place":["Nairobi, Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Kabiru","sequence":"additional","affiliation":[{"name":"African Population and Health Research Center","place":["Nairobi, Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marni","family":"Sommer","sequence":"additional","affiliation":[{"name":"Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University","place":["New York, NY, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","year":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"557","DOI":"10.2147\/IJWH.S112226","article-title":"Attitude toward female genital mutilation among Somali and Harari people, Eastern Ethiopia","volume":"8","author":"Abathun","year":"2016","journal-title":"Int J Womens Health"},{"key":"B3","volume-title":"Gynecological Consequences of Female Genital Mutilation\/Cutting (FGM\/C)","author":"Berg","year":"2014"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1186\/s12889-025-21584-z","article-title":"Exploring the health complications of female genital mutilation through a systematic review and meta-analysis","volume":"25","author":"Pallitto","year":"2025","journal-title":"BMC Public Health"},{"key":"B5","volume-title":"WHO Guideline on the Prevention of Female Genital Mutilation and Clinical Management of Complications","year":"2025"},{"key":"B6","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1080\/14767058.2018.1503246","article-title":"Correlations between the proportion of type III female genital mutilations in the series and adverse obstetric outcomes: a short meta-analysis","volume":"33","author":"Indraccolo","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B7","first-page":"9","volume-title":"Managing and Preventing Female Genital Cutting (FGM\/C) among the Somali Community in Kenya","author":"Abdi","year":"2008"},{"key":"B8","article-title":"Female genital cutting among the Somali of Kenya and management of its complications","author":"Guyo","year":"2005"},{"key":"B9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.srhc.2013.04.004","article-title":"Perceptions and experiences of female genital mutilation after immigration to Sweden: an explorative study","volume":"4","author":"Isman","year":"2013","journal-title":"Sex Reprod Healthc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1177\/1049732320979183","article-title":"Negotiating female genital cutting in a transnational context","volume":"31","author":"Johansen","year":"2021","journal-title":"Qual Health Res"},{"key":"B11","first-page":"462","volume-title":"The Somali Health and Demographic Survey 2020","year":"2020"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1177\/17455057231199032","article-title":"Knowledge, attitudes, and practices of female health care service providers on female genital mutilation in Somalia: a cross-sectional study","volume":"19","author":"Mehriban","year":"2023","journal-title":"Womens Health"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e0228410","DOI":"10.1371\/journal.pone.0228410","article-title":"Female genital mutilation\/cutting: emerging factors sustaining medicalization related changes in selected Kenyan communities","volume":"15","author":"Kimani","year":"2020","journal-title":"PLoS One"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.1186\/s12889-025-22371-6","article-title":"Attitudes towards the practice of female genital mutilation\/cutting in Somaliland: evidence from the Somali demographic health survey 2020","volume":"25","author":"Nuh","year":"2025","journal-title":"BMC Public Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e0268322","DOI":"10.1371\/journal.pone.0268322","article-title":"Discourses of change: the shift from infibulation to sunna circumcision among Somali and Sudanese migrants in Norway","volume":"17","author":"Johansen","year":"2022","journal-title":"PLoS One"},{"key":"B16","doi-asserted-by":"publisher","first-page":"116664","DOI":"10.1016\/j.socscimed.2024.116664","article-title":"People will talk about her if she is not circumcised\u201d: exploring the patterning, drivers and gender norms around female genital mutilation in Ethiopia\u2019s Somali region","volume":"345","author":"Presler-Marshall","year":"2024","journal-title":"Soc Sci Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e0284900","DOI":"10.1371\/journal.pone.0284900","article-title":"Advancing the measurement of knowledge, attitudes and practices of health workers who care for women and girls who have undergone female genital mutilation\/ cutting (FGM\/C): a qualitative exploration of expert opinion","volume":"18","author":"Marea","year":"2023","journal-title":"PLoS One"},{"key":"B18","year":""},{"key":"B19","doi-asserted-by":"publisher","first-page":"3493","DOI":"10.1080\/17441692.2022.2049345","article-title":"Persistence of female genital mutilation\/cutting in two Kenyan communities: what can we learn from change that falls short of abandonment?","volume":"17","author":"Matanda","year":"2022","journal-title":"Glob Public Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1111\/lasr.12579","article-title":"Coercion versus facilitation: context and the implementation of anti-FGM\/C law","volume":"55","author":"Meroka-Mutua","year":"2021","journal-title":"Law Soc Rev"},{"key":"B21","year":""},{"key":"B22","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1186\/s12913-022-07979-3","article-title":"Quality of services offered to women with female genital mutilation across health facilities in a Kenyan county","volume":"22","author":"Kimani","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1080\/26410397.2021.1911618","article-title":"Menstrual health: a definition for policy, practice, and research","volume":"29","author":"Hennegan","year":"2021","journal-title":"Sex Reprod Health Matters"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.2147\/IJWH.S469902","article-title":"Comparison of menstrual symptoms in university students with and without female genital mutilation\/cutting","volume":"16","author":"Altunkurek","year":"2024","journal-title":"Int J Womens Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e1003088","DOI":"10.1371\/journal.pmed.1003088","article-title":"Painful gynecologic and obstetric complications of female genital mutilation\/cutting: a systematic review and meta-analysis","volume":"17","author":"Lurie","year":"2020","journal-title":"PLOS Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12119-021-09895-w","article-title":"Adolescent sexual and reproductive health counselling in relation to female genital cutting: Swedish professionals\u2019 approach to menstrual pain as an empirical example","volume":"26","author":"Palm","year":"2022","journal-title":"Sex Cult"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1097\/j.pain.0000000000002121","article-title":"Are you in pain if you say you are not? Accounts of pain in Somali\u2013Canadian women with female genital cutting","volume":"162","author":"Perovi\u0107","year":"2021","journal-title":"Pain"},{"key":"B28","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1136\/jfprhc-2013-100853","article-title":"Women\u2019s experiences of endometriosis: a systematic review and synthesis of qualitative research","volume":"41","author":"Young","year":"2015","journal-title":"J Fam Plann Reprod Health Care"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e0220103","DOI":"10.1371\/journal.pone.0220103","article-title":"Self-care strategies and sources of knowledge on menstruation in 12,526 young women with dysmenorrhea: a systematic review and meta-analysis","volume":"14","author":"Armour","year":"2019","journal-title":"PLoS One"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e000405","DOI":"10.1136\/bmjgh-2017-000405","article-title":"Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries","volume":"2","author":"Sommer","year":"2017","journal-title":"BMJ Glob Health"},{"key":"B31","doi-asserted-by":"publisher","first-page":"4125","DOI":"10.3390\/ijerph20054125","article-title":"Living with endometriosis: a narrative analysis of the experiences of Kenyan women","volume":"20","author":"Bergen","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"B32","year":""},{"key":"B33","doi-asserted-by":"publisher","first-page":"e1004061","DOI":"10.1371\/journal.pmed.1004061","article-title":"The global prevalence of female genital mutilation\/cutting: a systematic review and meta-analysis of national, regional, facility, and school-based studies","volume":"19","author":"Farouki","year":"2022","journal-title":"PLoS Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"e0001855","DOI":"10.1371\/journal.pgph.0001855","article-title":"What interventions are effective to prevent or respond to female genital mutilation? A review of existing evidence from 2008 to 2020","volume":"3","author":"Matanda","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"B35","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s12914-020-0222-6","article-title":"Exploring barriers to seeking health care among Kenyan Somali women with female genital mutilation: a qualitative study","volume":"20","author":"Kimani","year":"2020","journal-title":"BMC Int Health Hum Rights"},{"key":"B36","doi-asserted-by":"publisher","first-page":"114523","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: a systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Soc Sci Med"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e074256","DOI":"10.1136\/bmj-2022-074256","article-title":"Practical thematic analysis: a guide for multidisciplinary health services research teams engaging in qualitative analysis","volume":"381","author":"Saunders","year":"2023","journal-title":"Br Med J"},{"key":"B38","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e006316","DOI":"10.1136\/bmjopen-2014-006316","article-title":"Effects of female genital cutting on physical health outcomes: a systematic review and meta-analysis","volume":"4","author":"Berg","year":"2014","journal-title":"BMJ Open"},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.31899\/rh8.1006","article-title":"Health impacts of female genital mutilation\/cutting: a synthesis of the evidence","author":"Kimani","year":"2016"},{"key":"B41","doi-asserted-by":"publisher","first-page":"832549","DOI":"10.3389\/fgwh.2022.832549","article-title":"Monitoring menstrual health knowledge: awareness of menstruation at menarche as an indicator","volume":"3","author":"Hennegan","year":"2022","journal-title":"Front Glob Womens Health"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e79132","DOI":"10.1371\/journal.pone.0079132","article-title":"\u2018We keep it secret so no one should know\u2019\u2014a qualitative study to explore young schoolgirls attitudes and experiences with menstruation in rural western Kenya","volume":"8","author":"Mason","year":"2013","journal-title":"PLoS One"},{"key":"B43","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1007\/s12529-017-9662-3","article-title":"\u201cIn my culture, we don\u2019t know anything about that\u201d: sexual and reproductive health of migrant and refugee women","volume":"24","author":"Metusela","year":"2017","journal-title":"Int J Behav Med"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e0004571","DOI":"10.1371\/journal.pgph.0004571","article-title":"\u201cI just wanted to be like everyone else\u2026\u201d: qualitative exploration of women\u2019s perspectives on female genital mutilation\/cutting and its potential abandonment in Somalia","volume":"5","author":"Ali","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e0206886","DOI":"10.1371\/journal.pone.0206886","article-title":"The lived experience of female genital cutting (FGC) in Somali-Canadian women\u2019s daily lives","volume":"13","author":"Jacobson","year":"2018","journal-title":"PLoS One"},{"key":"B46","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12978-022-01356-3","article-title":"Woman and girl-centred care for those affected by female genital mutilation: a scoping review of provider tools and guidelines","volume":"19","author":"Dawson","year":"2022","journal-title":"Reprod Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"e027452","DOI":"10.1136\/bmjopen-2018-027452","article-title":"Seeking culturally safe care: a qualitative systematic review of the healthcare experiences of women and girls who have undergone female genital mutilation\/cutting","volume":"9","author":"Evans","year":"2019","journal-title":"BMJ Open"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1080\/13557858.2013.828829","article-title":"Perceptions of obstetrical interventions and female genital cutting: insights of men in a Somali refugee community","volume":"19","author":"Johnson-Agbakwu","year":"2014","journal-title":"Ethn Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1007\/s10508-019-1422-9","article-title":"\u201cBean\u201d E. understanding women\u2019s responses to sexual pain after female genital cutting: an integrative psychological pain response model","volume":"50","author":"Connor","year":"2021","journal-title":"Arch Sex Behav"},{"key":"B50","doi-asserted-by":"publisher","first-page":"e0001544","DOI":"10.1371\/journal.pgph.0001544","article-title":"Adolescent girls\u2019 descriptions of dysmenorrhea and barriers to dysmenorrhea management in Moshi, Tanzania: a qualitative study","volume":"3","author":"Cherenack","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"B51","doi-asserted-by":"publisher","first-page":"33945","DOI":"10.1038\/s41598-025-11167-8","article-title":"A qualitative study of patient choices between herbal and hospital care for infectious diseases in Somalia","volume":"15","author":"Jayte","year":"2025","journal-title":"Sci Rep"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1248562","DOI":"10.3389\/fgwh.2024.1248562","article-title":"Strengthening woman-centred care for pregnant women with female genital mutilation in Australia: a qualitative muti-method study","volume":"5","author":"Turkmani","year":"2024","journal-title":"Front Glob Womens Health"},{"key":"B53","doi-asserted-by":"publisher","first-page":"12","DOI":"10.29063\/ajrh2025\/v29i9.2","article-title":"Endometriosis: emerging barriers to care in sub-Saharan Africa","volume":"29","author":"Menakaya","year":"2025","journal-title":"Afr J Reprod Health Rev Afr Sant\u00e9 Reprod"},{"key":"B54","first-page":"40","article-title":"Knowledge of menstrual disorders and health seeking behaviour among female undergraduate students of university of Ibadan, Nigeria","volume":"19","author":"Igbokwe","year":"2021","journal-title":"Ann Ib Postgrad Med"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.56600\/jwmdc.v2i3.85","article-title":"Stigma as a barrier to seeking treatment for dysmenorrhea\u2014a review","volume":"2","author":"Muqaddas","year":"2024","journal-title":"J Women Med Dent Coll"},{"key":"B56","first-page":"1","volume-title":"Person-Centred Communication for Female Genital Mutilation Prevention: A Facilitator\u2019s Guide for Training Health-Care Providers","year":"2022"}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1753459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:48:09Z","timestamp":1774421289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1753459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":56,"alternative-id":["10.3389\/fgwh.2026.1753459"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2026.1753459","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1753459"}}