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What is female genital schistosomiasis?

Female genital schistosomiasis (FGS) is a disease manifestation of schistosomiasis caused by the Schistosoma haematobium, a waterborne parasite that affects both the urinary and genital tract of infected individuals. It develops over a long period of time (months to years) when girls and women do not have access to treatment. It has been described as one of the most neglected sexual and reproductive health diseases in sub-Saharan Africa, with an estimated 56 million women and girls currently living with FGS.

Almost 56 million girls and women in sub-Saharan Africa are estimated to be affected by FGS.
FGS occurs in up to 70% of women infected by schistosomiasis
FGS is underdiagnosed, with serious implications for women’s reproductive health.
FGS leads to infertility and can increased the risk of HIV infection.

Symptoms and complications of FGS

FGS occurs when the parasite eggs cause damage to the reproductive organs, which can result in gynaecological symptoms in women and adolescent girls, such as:

  • Vaginal discharge
  • Blood in urine
  • Abdominal and pelvic pain

If left untreated, women living with FGS can experience a range of complications, including:

  • Infertility
  • Abortion or ectopic pregnancy
  • Genital ulcers
  • Increased risk of HIV and human papillomavirus infections

Schistosomiasis and HIV

FGS causes open sores, inflammation and exposure to blood, giving easy access for any virus to enter the body. As a result, women and girls with FGS are up to three times more likely to acquire HIV.

Is FGS a sexually transmitted infection?

FGS is not a sexually transmitted infection. FGS develops when someone has schistosomiasis, which is only caught through skin contact with contaminated freshwater sources. It cannot be passed from person to person directly.

How is FGS diagnosed?

FGS can be diagnosed by visual examination of the genitals and colposcopy, which is a procedure to take a closer look at someone’s vagina and cervix. Unfortunately the equipment required for this is expensive and requires lots of medical training, and this is not always available in the health facilities in all affected communities. Another challenge is that health professionals are often not familiar with FGS as it is typically not part of standard medical training. Therefore, it remains underreported, misdiagnosed and largely untreated.

This has serious consequences for women, who not only suffer physical symptoms but also mental health problems due to stigma surrounding infertility and because symptoms are often confused with those of sexually transmitted infections. The World Health Organization’s pocket atlas has been developed to aid healthcare professionals with diagnosis of the disease.

Raising awareness of FGS

It is evident that there are many factors at play, but in order to prevent new cases and reduce the morbidity associated with FGS, appropriate training must be provided to healthcare professionals. Through early diagnosis and regular treatment of schistosomiasis, girls and women will be protected from developing FGS, which in turn can lead to improvements in their quality of life. Increased awareness of the disease and how to prevent it is critical so that communities understand the risks and impact of FGS on individuals, including the stigma that surrounds it.

How is Unlimit Health tackling FGS?

Unlimit Health is working on various initiatives to tackle FGS, which you can find out more about below, and we have published a position paper.

Farmer rinsing heads of salad in a water point located in her field in Grand-Zattry, Soubré District of Côte d’Ivoire. Image by: Unlimit Health/Aka Aboubakhr Thierry Kouamé
Women walk through swamp water, which is potentially contaminated with the Schistosoma parasite, between Soubré and Okrouyo in Côte d'Ivoire.

Scaling up FGS prevention in Côte d'Ivoire

Integrating preventive treatment for FGS into the national health system.

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FIG (Female genital schistosomiasis Integration Group)

An innovative coalition of organisations galvanising joint action to tackle the neglected issue of FGS.

Download paper

Unlimit Health FGS position paper

Unlimit Health’s position on FGS.

Download now

FGS Accelerated Scale Together (FAST) package

Improving adolescent girls’ and women’s health by reducing morbidity associated with FGS.

FAST research project

FGS in the news

The Guardian puts a spotlight on female genital schistosomiasis

9 August 2024

Female genital schistosomiasis (FGS) is seen in national news outlet, the Guardian, highlighting the advocacy work of the FGS Integration Group (FIG), crucial integration efforts in Kenya, and the lived reality for women affected by this painful condition.

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Unlimit Health and visual artist Nuits Balnéaires win Inspiring Communicator Award

1 March 2024

On 28 February at a ceremony organised by Charity Comms in central London, Unlimit Health and Nuits Balnéaires were awarded the Inspiring Communicator Award in the 'Best collaboration (freelancer and charity)' category.

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An unspoken taboo impacting women’s health

7 March 2024

Due to misconceptions and stigmatisation, women living with female genital schistosomiasis are often confronted with additional layers of neglect, putting them at risk of life-changing symptoms. By reading this article, you’re supporting women to be seen.

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