Managing chronic pelvic pain and experiences with healthcare encounters by Somali women in Norway

Female chronic pelvic pain (CPP) is a prevalent condition associated with substantial cognitive, behavioral, sexual, and emotional consequences, representing an important public health concern due to its impact on quality of life and healthcare utilization. Somali women constitute one of the largest immigrant groups in Norway and may be at increased risk of CPP due to the high prevalence of female genital mutilation (FGM) and its long-term health effects. Cultural norms, stigma, and socioeconomic challenges, including low health literacy, may further influence health-seeking behaviors and limit access to healthcare services, contributing to health inequities. This qualitative study aimed to explore how Somali women in Norway experience healthcare encounters when seeking help for CPP and to examine their perspectives on improving its management. Nineteen Somali-born women aged over 18 years and experiencing CPP were recruited through social media. Individual interviews were conducted by a female native Somali speaker and analyzed using inductive reflexive thematic analysis. Three themes were identified: (1) normalization and resignation in healthcare interactions, where symptoms were often dismissed as normal and primarily managed with painkillers without referral to specialist care; (2) barriers and cultural influences on healthcare-seeking, including shame, limited knowledge of treatment options, and underestimation of symptom severity; and (3) pathways to improvement and empowerment, highlighting the need for increased knowledge of CPP, preference for female healthcare providers, and the importance of social support. From a public health perspective, improving health literacy, strengthening culturally competent care, and promoting equitable access to healthcare services are essential to enhance care utilization and reduce gynecological health disparities among Somali women in Norway.

Key messages

• Somali women in Norway with CPP face stigma, low awareness, and dismissal in care; improving health literacy and culturally competent services can enhance access and outcomes.

• Public health action is needed as CPP in Somali women is under-recognized; improving access, knowledge, and culturally sensitive care can reduce disparities and improve outcomes.