What is female genital schistosomiasis (FGS)?

Female genital schistosomiasis (FGS) is a chronic and preventable condition caused by the Schistosoma haematobium—a waterborne parasite found in freshwater sources across many parts of sub-Saharan Africa.

When girls and women are repeatedly exposed to contaminated water and do not receive treatment, the infection can slowly progress over months or years, damaging both the urinary and reproductive systems. 

FGS is one of the most overlooked sexual and reproductive health conditions in the region. Today, an estimated 56 million women and girls are living with FGS, many without a diagnosis, and even fewer with access to care. 

What are the symptoms of FGS?

FGS occurs when parasite eggs become trapped in the reproductive tissues, causing longterm inflammation and scarring. Girls and women may experience symptoms such as:

• Vaginal discharge

• Blood in urine

• Abdominal or pelvic pain

Without treatment, the damage can lead to profound and longlasting complications, including:

• Infertility

• Miscarriage or ectopic pregnancy

• Genital ulcers

• Increased vulnerability to HIV and human papillomavirus (HPV)

FGS and HIV

FGS creates open sores and increases inflammation in the genital tract. This makes it far easier for viruses—including HIV—to enter the body.
Girls and women living with FGS are up to three times more likely to acquire HIV compared to their peers. Addressing FGS is therefore not only essential for women’s health—it is also a critical HIV prevention strategy.

Is FGS a sexually transmitted infection?

No. FGS is not a sexually transmitted infection.

It develops only after someone acquires schistosomiasis through skin contact with contaminated freshwater. Because symptoms can resemble those of STIs, women may face stigma or be misdiagnosed, often leading to unnecessary treatments and emotional distress.

How is FGS diagnosed?

Diagnosis currently depends on:

• Visual examination of the genitals

• Colposcopy, which allows a close inspection of the cervix and vagina

However, many health facilities in affected communities lack the equipment and training required for accurate diagnosis. FGS is not routinely taught in medical programmes, meaning many healthcare workers have never learned to recognise it. As a result, the disease remains under detected, misdiagnosed, and largely untreated.

To support clinicians, the World Health Organization has developed an FGS Pocket Atlas, providing clear visual guidance on identifying the disease.

Can FGS be treated or cured?

FGS can be treated with praziquantel, a safe, inexpensive medicine that kills the parasite and prevents new damage. Treatment can ease symptoms and stop progression. However, once advanced lesions or scarring develop, they cannot be fully reversed. This makes early detection and regular treatment essential.

Why awareness of FGS matters

Ending FGS requires more than clinical tools—it requires knowledge, training, and systems that put women and girls first.

Raising awareness helps to:

• Equip health workers with the skills to diagnose and treat FGS

• Reduce stigma and misconceptions

• Encourage early treatment of schistosomiasis

• Protect future generations from preventable disease

Communities, healthcare systems, and global partners all have a role to play.

How Unlimit Health is tackling FGS

Unlimit Health works to ensure that women affected by FGS are no longer invisible. Through our leadership in the FGS Integration Group (FIG)—a coalition of organisations fighting to end this disease—we are advancing coordinated action across:

• Sexual and reproductive health and rights (SRHR)

• HIV and HPV/cervical cancer programmes

• Neglected tropical disease (NTD) initiatives

• Water, sanitation and hygiene (WASH) sectors

Together, we are raising awareness, advocating for policy change, and promoting sustainable approaches that bring FGS services to scale. Read our FGS position paper.

Driving integration for stronger health systems

We champion the integration of FGS services into primary health care, because integration means:

Efficiency

Using existing systems, staff, and platforms—maximising value for money and reducing costs for patients.

Equity

Reaching those who have historically been left behind, including women in rural or underserved communities.

Dignity

Ending years of misdiagnosis, unnecessary procedures, and silent suffering.