A recent study has shown that many young female cancer survivors are not fully aware of information about how they are at high risk of early menopause and how to preserve their fertility after completing treatment.
About 43-62 percent women had unmet information needs and two-thirds of them were worried about their capability to give birth to a child in future. Researchers have stated that females thinking to have children are not yet ready to start a family and may have to undergo fertility preservation with egg or embryo freezing after treatment. Due to cancer, they are also at high risk of early menopause.
“Failure to provide information and address concerns with respect to fertility-related decisions may have lasting consequences for young women who hope to achieve important life goals such as having children,” said lead author Catherine Benedict from Northwell Health, New York State’s largest health care provider and private employer.
The paper published by Benedict in journal cancer also stated “For women are at risk of early menopause, delaying fertility-related decisions may cause them to miss their narrowed window of opportunity to preserve their fertility, if desired.”
The team wanted to understand about how young female cancer survivors view the decision of undergoing fertility preservation after treatment and to learn about their informational needs.
Members of team examined around 346 participants whose age was about 30 years and they also researched on a subgroup of 179 women about women with certain fertility status who had not undergone the fertility preservation before.
The results showed that greater reproductive concerns and unmet information made it more difficult to think about the fertility preservation.
The findings in the study also established the need for creating support centres to help young female cancer survivors make decisions about fertility preservation and family-building as part of survivorship care.
This study also helped in understanding the importance and need of women making fertility decisions before treatment.
-by Bhaskar Raghavendran
Bhaskar is a graduate in Journalism and mass communication from Amity school of communication, Noida. Contact the author at Twitter: bhaskar_ragha
When a U.S. district judge last month ruled a federal ban on female genital mutilation unconstitutional, he undercut the federal government and alarmed anti-FGM activists, who hope to eradicate the practice.
The World Health Organization calls FGM, also known as female circumcision, a human rights violation of women and girls, with no health benefits.
Some 200 million women and girls around the world, mainly in Africa, have experienced FGM, the WHO says.
In his opinion, Judge Bernard Friedman called FGM “despicable,” but also “a local criminal activity” that must be addressed at the state level. In enacting a federal law, he said, Congress overstepped.
Now, local lawmakers, advocates and newspapers are calling for state bans that equal or surpass the scope of the federal law that was struck down.
The case Friedman ruled on centers around Dr. Jumana Nagarwala, an emergency room physician accused of performing FGM on at least 100 girls in Michigan for more than a decade.
Prosecutors have focused their case on nine girls, aged 7 to 12, from three states. The girls allegedly were subjected to FGM with the aid of Nagarwala and seven others, including the girls’ mothers.
Defense attorneys say the procedure amounted to only a “nick” on the girls performed as part of a religious ritual — not FGM. But they also argued in July that the federal law banning FGM is unconstitutional.
State Senator Rick Jones, who represents Michigan’s 24th district, told VOA by phone that he was shocked to learn about Nagarwala’s case and strongly disagrees with Friedman’s ruling.
Last year, Jones became the spokesperson for a package of bills outlawing FGM statewide. The legislation passed with overwhelming bipartisan support.
Now, Michigan has some of the toughest FGM laws in the country.
Health-care providers convicted of performing FGM face up to 15 years in prison, along with the permanent loss of their medical licenses. Parents who take their daughters to doctors to be cut can lose custody.
The 1996 federal law, meanwhile, stipulated up to five years in prison and fines for medical providers who perform FGM.
“We wanted to send a strong message around the world: Never again bring your girls to Michigan for this horrible procedure,” Jones said.
Across the U.S., 27 states have passed laws banning FGM, many of which have been written in recent years and include penalties that go beyond the federal law, which also criminalizes so-called “vacation cutting,” the practice of taking girls out of the United States to have FGM performed overseas.
News organizations are among those pushing for an expansion of state laws. Last month, the Seattle Times editorial board called for a ban in Washington, one of 23 states yet to outlaw FGM.
Earlier this month, the Los Angeles Times editorial board said all 50 states should ban the “barbaric” practice, in light of Friedman’s ruling.
The health-care providers and families involved in the Michigan case belong to Dawoodi Bohra, a Shi’ite Muslim sect based in India with about 2 million followers worldwide.
According to a study published earlier this year, FGM, called khafd in Dawoodi Bohra communities, is widespread in the sect and involves cutting the clitoral hood or part of the clitoris, without an anesthetic, when girls turn seven.
The study, commissioned by WeSpeakOut, an advocacy group focused on eradicating khafd, also found that three-quarters of Dawoodi Bohra women have experienced FGM.
The severity and nature of FGM can vary.
Health-care providers have identified four types of FGM. Khafd involves Type 1 FGM. Other types involve removing all of the external genitalia and narrowing the vaginal opening.
Jones rejects the idea that there’s a religious basis for the procedure, however it’s performed.
“Across the world, this has been practiced by Christians, pagans, Muslims, even a small Jewish sect in Ethiopia,” he said.
“This is not about a religion,” he added. “This is about men attempting to control women’s behavior by this horrible procedure.”
The WHO identifies both short-term and permanent harms associated with the practice. Immediate concerns include severe pain, infections and, in some cases, death. Long term, women and girls subjected to FGM face a range of physiological and psychological complications that can affect menstruation, childbirth and sexual health.
The United States has been unequivocal in condemning the practice, saying “the U.S. government considers FGM/C to be a serious human rights abuse, and a form of gender-based violence and child abuse” on a fact sheet posted to the Citizenship & Immigration Services website.
Education and legislation
Friedman’s November decision is the latest in a series of setbacks for prosecutors.
Nagarwala spent seven months in 2017 in jail before 16 friends posted a $4.5 million unsecured bond, against the pleas of prosecutors, who argued Nagarwala could silence potential witnesses or even flee the country if released.
And in January, the judge dismissed charges that Nagarwala and a second doctor, Fakhruddin Attar, transported minors with the intent to engage in criminal sexual activity, an offense that carries a lifetime sentence.
Nagarwala still faces conspiracy and obstruction charges that could result in decades in prison.
The trial is now set to begin next April, the Detroit Free Press reported last month. However, the prosecution could appeal last month’s decision, drawing the case out further.