Associations Between Emotional Distress and Lower Urinary Tract Symptoms Among Somali Women Who Have Experienced Female Genital Cutting

Background: Associations between different forms of emotional distress (depression, anxiety, posttraumatic stress) and lower urinary tract symptoms (LUTS) among general populations of women are well established. Objective: To contribute to culturally informed clinical practice, this study examines the association between emotional distress and LUTS among Somali migrant women who have experienced female genital cutting (FGC). Methods: Data was analyzed from the Our body, Our health study of Somali women (n = 300; mean age, 36 years). Data were collected via audio computer-assisted self-survey between September 2021 and April 2023. The Refugee Health Screener was used to assess emotional distress (symptoms of depression, anxiety, and posttraumatic stress). LUTS items were adapted from the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms. Results: In logistic regression analyses adjusting for covariates (age, education, vaginal childbirth, episiotomy, FGC type), total emotional distress was associated with greater odds of experiencing all assessed LUTS (urgency, frequency, nocturia, urgency and stress urinary incontinence, straining, bladder pain). For example, for each 1-unit increment in total emotional distress, participants’ odds of urgency increased by 10% (OR = 1.10, 95% CI = 1.05, 1.16), urgency urinary incontinence by 9% (OR = 1.09, 95% CI = 1.04, 1.14), and stress urinary incontinence by 12% (OR = 1.12, 95% CI = 1.07, 1.18). Conclusions: In this cross-sectional study of Somali migrant women who had experienced FGC, consistent associations were observed between emotional distress in the past month and an array of LUTS. Women who present with LUTS should be screened for emotional distress and referred for mental health services as indicated.