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Maternal and Child Health Journal

, Volume 13, Issue 1, pp 98–106 | Cite as

Vaginal Douching Among Latinas: Practices and Meaning

  • M. Diane McKee
  • María Baquero
  • Matthew R. Anderson
  • Adelyn Alvarez
  • Alison Karasz
Article

Abstract

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices.

Keywords

Vaginal douching Feminine hygiene Latinas Qualitative research 

References

  1. 1.
    Aral, S. O., Mosher, W. D., & Cates, W., Jr. (1992). Vaginal douching among women of reproductive age in the United States: 1988. American Journal of Public Health, 82(2), 210–214.PubMedCrossRefGoogle Scholar
  2. 2.
    Abma, J. C., Chandra, A., Mosher, W. D, Peterson, L. S., & Piccinino, L. J. (1997). Fertility, family planning, and women’s health: New data from the 1995 National Survey of Family Growth. Vital Health Statistics, 23(19), 1–114.Google Scholar
  3. 3.
    Koblin, B. A., Mayer, K., Mwatha, A., Brown-Peterside, P., Holt, R., & Marmor, M., et al. (2002). Douching practices among women at high risk of HIV infection in the United States: Implications for microbicide testing and use. Sexually Transmitted Diseases, 29(7), 406–410.PubMedCrossRefGoogle Scholar
  4. 4.
    Foch, B. J., McDaniel, N. D., & Chacko, M. R. (2001). Racial differences in vaginal douching knowledge, attitude, and practices among sexually active adolescents. Journal of Pediatric and Adolescent Gynecology, 14(1), 29–33.PubMedCrossRefGoogle Scholar
  5. 5.
    Oh, M. K., Funkhouser, E., Simpson, T., Brown, P., & Merchant, J. (2003). Early onset of vaginal douching is associated with false beliefs and high-risk behavior. Sexually Transmitted Diseases, 30(9), 689–693.PubMedCrossRefGoogle Scholar
  6. 6.
    Chacko, M. R., McGill, L., Johnson, T. C., Smith, P. B., & Nenney, S. W. (1989). Vaginal douching in teenagers attending a family planning clinic. Journal of Adolescent Health Care, 10(3), 217–219.PubMedCrossRefGoogle Scholar
  7. 7.
    Scholes, D., Daling, J. R., Stergachis, A., Weiss, N. S., Wang, S. P., & Grayston, J. T. (1993). Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstetrics and Gynecology, 81(4), 601–606.PubMedGoogle Scholar
  8. 8.
    Wolner-Hanssen, P., Eschenbach, D. A., Paavonen, J., Stevens, C. E., Kiviat, N. B., & Critchlow, C. et al. (1990). Association between vaginal douching and acute pelvic inflammatory disease. JAMA, 263(14), 1936–1941.PubMedCrossRefGoogle Scholar
  9. 9.
    Zhang, J., Thomas, A. G., & Leybovich, E. (1997). Vaginal douching and adverse health effects: A meta-analysis. American Journal of Public Health, 87(7), 1207–1211.PubMedCrossRefGoogle Scholar
  10. 10.
    Kendrick, J. S., Atrash, H. K., Strauss, L.T., Gargiullo, P. M., & Ahn, Y. W. (1997). Vaginal douching and the risk of ectopic pregnancy among black women. American Jouranl of Obstetrics and Gynecology, 176(5), 991–997.CrossRefGoogle Scholar
  11. 11.
    Peters, S. E., Beck-Sague, C. M., Farshy, C. E., Gibson, I., Kubota, K. A., & Solomon, F., et al. (2000). Behaviors associated with Neisseria gonorrhoeae and Chlamydia trachomatis: Cervical infection among young women attending adolescent clinics. Clinical Pediatrics, 39(3), 173–177.PubMedCrossRefGoogle Scholar
  12. 12.
    Baird, D. D., Weinberg, C. R., Voigt, L. F., & Daling, J. R. (1996). Vaginal douching and reduced fertility. American Journal of Public Health, 86(6), 844–850.PubMedCrossRefGoogle Scholar
  13. 13.
    Bruce, F. C., Kendrick, J. S., Kieke, B. A. Jr., Jagielski, S., Joshi, R., & Tolsma, D. D. (2002). Is vaginal douching associated with preterm delivery? Epidemiology, 13(3), 328–333.PubMedCrossRefGoogle Scholar
  14. 14.
    Cherpes, T. L., Meyn, L. A., Krohn, M. A., & Hillier, S. L. (2003). Risk factors for infection with herpes simplex virus type 2: Role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Diseases, 30(5), 405–410.PubMedCrossRefGoogle Scholar
  15. 15.
    Schwebke, J. R., Desmond, R. A., & Oh, M. K. (2004). Predictors of bacterial vaginosis in adolescent women who douche. Sexually Transmitted Diseases, 31(7), 433–436.PubMedCrossRefGoogle Scholar
  16. 16.
    Holzman, C., Leventhal, J. M., Qiu, H., Jones, N. M., & Wang, J. (2001). Factors linked to bacterial vaginosis in nonpregnant women. American Journal of Public Health, 91(10), 1664–1670.PubMedCrossRefGoogle Scholar
  17. 17.
    Martino, J. L., & Vermund, S. H. (2002). Vaginal douching: Evidence for risks or benefits to women’s health. Epidemiologic Reviews, 24(2), 109–124.PubMedCrossRefGoogle Scholar
  18. 18.
    Buckley, T., & Gottlieb, A. (1988). Blood magic: The anthropology of menstruation. Berkeley: The University of California Press.Google Scholar
  19. 19.
    Oh, M. K., Merchant, J. S., & Brown, P. (2002). Douching behavior in high-risk adolescents. What do they use, when and why do they douche? Journal of Pediatric and Adolescent Gynecology, 15(2), 83–88.PubMedCrossRefGoogle Scholar
  20. 20.
    Crosby, R. A., Newman, D., Kamb, M. L., Zenilman, J., Douglas, J. M. J., & Iatesta, M. (2000). Misconceptions about STD-protective behavior. Project RESPECT Study Group. American Journal of Preventive Medicine, 19(3), 167–173.PubMedCrossRefGoogle Scholar
  21. 21.
    Lichtenstein, B., & Nansel, T. R. (2000). Women’s douching practices and related attitudes: Findings from four focus groups. Women Health, 31(2–3), 117–131.PubMedGoogle Scholar
  22. 22.
    Gazmararian, J. A., Bruce, F. C., Kendrick, J. S., Grace, C. C., & Wynn, S. (2001). Why do women douche? Results from a qualitative study. Maternal and Child Health Journal, 5(3), 153–160.PubMedCrossRefGoogle Scholar
  23. 23.
    Grimley, D. M., Oh, M. K., Desmond, R. A., Hook, E. W. III, & Vermund, S. H. (2005). An intervention to reduce vaginal douching among adolescent and young adult women: A randomized, controlled trial. Sexually Transmitted Diseases, 32(12), 752–758.PubMedCrossRefGoogle Scholar
  24. 24.
    Miller, W. L., & Crabtree, B. F. (1994). Qualitative analysis: How to begin making sense. The Family Practice Research Journal, 14(3), 289–297.PubMedGoogle Scholar
  25. 25.
    Strauss, A. L., & Corbin, J. M. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage Publications.Google Scholar
  26. 26.
    Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research (2nd ed.). Thousand Oaks, Calif: Sage Publications.Google Scholar
  27. 27.
    Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Philadelphia: Wolters Kluwer Health/lippincott Williams & Wilkins.Google Scholar
  28. 28.
    Grimley, D. M., Annang, L., Foushee, H. R., Bruce, F. C., & Kendrick, J. S. (2006). Vaginal douches and other feminine hygiene products: Women’s practices and perceptions of product safety. Maternal and Child Health Journal, 10(3), 303–310.PubMedCrossRefGoogle Scholar
  29. 29.
    Anderson, M., McKee, D., Yukes, J., Alvarez, A., & Karasz, A. (2008). An investigation of douching practices in the botánicas of the Bronx. Cultural Health and Sexuality, 10(1), 1–11.CrossRefGoogle Scholar
  30. 30.
    Civic, D., & Wilson, D. (1996). Dry sex in Zimbabwe and implications for condom use. Social Science and Medicine, 42(1), 91–98.PubMedCrossRefGoogle Scholar
  31. 31.
    Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMedGoogle Scholar
  32. 32.
    Annang, L., Grimley, D. M., & Hook, E. W., III. (2006). Vaginal douche practices among black women at risk: Exploring douching prevalence, reasons for douching, and sexually transmitted disease infection. Sexually Transmitted Diseases, 33(4), 215–219.PubMedCrossRefGoogle Scholar
  33. 33.
    Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • M. Diane McKee
    • 1
  • María Baquero
    • 1
  • Matthew R. Anderson
    • 1
  • Adelyn Alvarez
    • 1
  • Alison Karasz
    • 1
  1. 1.Department of Family and Social MedicineAlbert Einstein College of MedicineBronxUSA

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