Objective: Use of vaginal douche products has been linked with a variety of reproductive health problems; nonetheless, the practice of douching persists. The goals of this study were to 1) determine the use of vaginal douches and other feminine hygiene products, 2) ascertain how safe women think vaginal douche products are, and 3) evaluate women's readiness to stop douching. Methods: A random-digit-dial computer-assisted telephone survey was conducted among US women between the ages of 18 and 44. Results: Of the 2,602 women interviewed, 11.8% (n = 307) engaged in regular douching (White: 9.1%; African American: 27.7%; Hispanic: 15.0%). Women who douched, compared to women who did not douche, used other feminine hygiene products significantly more often (vaginal sprays [ p < .0001], wipes/towelettes [ p < 0.01], vaginal powder [ p < 0.0001] and bubble bath for feminine cleansing [ p < 0.001]). Women who douched also were more likely than nondouchers to agree with the statement, “Douche products are safe to use; otherwise they wouldn't be on the market” (70.3% vs. 33.4%, respectively; p < 0.0001). Nearly all women (90.0%) who douched had no intention to discontinue the practice. Conclusion: Compared with women who do not douche, women who douche use other feminine hygiene products at a much higher rate and also believe that douche products are safe. Women who douche will remain resistant to stopping the practice without innovative interventions. Given that most women start douching in adolescence, teens should be targeted for prevention efforts.
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REFERENCES
Scholes D, Daling JR, Stergachis A, Weiss NS, Wang SP, Grayston JT. Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstet Gynecol 1993;81:601–6.
Wolner-Hanssen P, Eshenbach DA, Paavonen J, Stevens CE, Kiviat NB, Critchlow C, DeRouen T, Koutsky L, Holmes KK. Association between vaginal douching and acute pelvic inflammatory disease. JAMA 1990;263:1936–41.
Baird DD, Weinberg CR, Voigt LF, Daling JR. Vaginal douching and reduced fertility. Am J Public Health 1996;86:844–50.
Beaton JH, Gibson R, Roland M. Short-term use of a medicated douche preparation in the symptomatic treatment of minor vaginal irritation, in some cases associated with infertility. Int J Fertil 1984;996(292):109–12.
Kendrick JS, Atrash HK, Strauss LT, Gargiullo PM, Ahn YW. Vaginal douching and the risk of ectopic pregnancy among African-American women. Am J Obstet Gynecol 1997;176:991–7.
Zhang J, Thomas AG, Leybovich E. Vaginal douching and adverse health effects: A metaanalysis. Am J Public Health 1997;87:1207–11.
Fiscella K, Franks P, Kendrick JS, Bruce FC. The risk of low birth weight associated with vaginal douching. Obstet Gynecol 1998;92:913–7.
Bruce FC, Kendrick JS, Kieka BA Jr, Jagielski S, Joshi R, Tolsma DD. Is vaginal douching associated with preterm delivery? Epidemiol 2002;3:328–33.
Fiscella K, Franks P, Kendrick JS, Meldrum S, Kieke BA Jr. Risk of preterm birth that is associated with vaginal douching. Am J Obstet Gynecol 2002;186:1345–50.
Holzman C, Leventhal JM, Qui H, Jones NM, Wang J, the BV Study Group. Factors linked to bacterial vaginosis in nonpregnant women. Am J Pub Health 2001;91:1664–70.
Rajamanoharan S, Low N, Jones SB, Pozniak AA. Bacterial vaginosis, ethnicity, and the use of genital cleaning agents: A case control study. Sex Trans Dis 1999;26:404–9.
Peters SE, Beck-Sague CM, Farshy CE, Gibson I, Kubota KA, Solomon F, Morse SA, Sievert AJ, Black CM. Behaviors associated with Neiseria gonorrhoeae and Chlamydia trachomatis: Cervical infection among young women attending adolescent clinics. Clin Pediatr 2000;39:173–7.
Foch BJ, McDaniel ND, Chacko MR. Racial differences in vaginal douching knowledge, attitude, and practices among sexually active adolescents. J Ped Adol Gynecol 2001;14:29–33.
Gresenguet G, Kreiss JK, Chapko MK, Hillier SL, Weiss NS. HIV infection and vaginal douching in central Africa. AIDS 1997;11:101–6.
Ness RB, Hillier SL, Richter HE, Soper DE, Stamm C, Bass DC, Sweet RL, Rice P, Downs J, Aral SO. Why women douche and why they may or may not stop. Sex Trans Dis 2003;30:71–4.
Rosenberg MJ, Phillips RS, Holmes MD. Vaginal douching. Who and why? J Reprod Med 1991;36:753.
Funkhouser EM, Pulley L, Lueschen G, Costello C, Hook E III, Vermund S. Douching beliefs and practices among African-American and white women. Wom Health Gender-Based Med 2002;11:29–37.
Vermund SH, Sarr M, Murphy DA, Levin L, Abdalian SE, Crowley-Nowick PA, Wilson CM. Douching practices among HIV infected and uninfected adolescent in the United States. J Adolesc Health 2001;29:80–6.
Oh MK, Funkhouser E, Simpson T, Brown P, Merchant J. Early onset of vaginal douching is associated with false beliefs and high-risk behavior. Sex Transm Dis 2003;30(9):689–93.
Oh MK, Merchant JS, Brown P. Douching behavior in high-risk adolescents: What they use, when and why they douche? J Pediatr Adolesc Gynecol 2002;15:83–8.
Simpson T, Merchant J, Grimley DM, Oh MK. Vaginal douching among adolescent and young adult women: More challenges than progress. J Pediatr Adolesc Gynecol 2004;17:249–55.
Gazmararian JA, Bruce FC, Kendrick JS, Grace CC, Wynn S. Why do women douche? Results from a qualitative study. Matern Child Health J 2001;5:153–60.
Sudman S, Bradburn NM, Schwarz N. Thinking about answers: The application of cognitive processes to survey methodology. San Francisco: Jossey-Bass, 1996.
Aral SO, Mosher WD, Cates W. Vaginal douching among women of reproductive age in the United States: 1988. Am J Pub Health 1992;82:210–14.
Abma JC, Chandra A, Mosher WD, Peterson LS, Piccinino LJ. Fertility, family planning, and women's health: New data from the 1995 National Survey of Family Growth. Vital Health Stat 1997;23(19):1–114
Prochaska JO, DiClemente CC. Stages and processes of self-change in smoking: Toward an integrative model of change. J Consult Clin Psych 1983;5:390–5.
Prochaska JO, DiClemente CC. The transtheoretical approach: Crossing the traditional boundaries of therapy. Homewood, IL: Dow Jones/Irwin, 1984.
Czerwinski BS. Adult feminine hygiene practices. Appl Nurs Res 1996;9(3):123–9.
Czerwinski BS. Variation in feminine hygiene practices as a function of age. J Obstet Gynecol Neonatal Nurse 2000;29(6):625–33.
Martino JL, Youngpairoj S, Vermund SH. Vaginal douching: personal practices and public policies. J Women's Health 2004;13:1048–65.
Prochaska JO, Redding CA, Evers KE. The transtheoretical model and the stages of change. In: Glanz K, Lewis FM, Rimer BK, (Eds.) Health behavior and health education: Theory research, and practice, 2nd ed. San Franciso: Jossey-Bass, 1997.
Koblin BA, Mayer K, Mwatha A, Brown-Peterside P, Holt R, Marmor M, Smith C, Chiasson MA. Douching practices among women at high risk of HIV infection in the United States: Implications for microbicide testing and use. Sex Transm Dis 2002;29:406–10.
Funkhouser E, Haynes TD, Vermund SH. Vaginal douching practices among women attending a university in the southern United States. J Am Coll Health 2002;50:177–82.
ACKNOWLEDGMENTS
This study was funded by grant # S1451 provided by the Association of Schools of Public Health (ASPH) and the Centers for Disease Control and Prevention (CDC). The authors thank Christopher H. Johnson, M.S., from the CDC, Division of Reproductive Health for his thoughtful review and comments on this manuscript.
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Grimley, D.M., Annang, L., Foushee, H.R. et al. Vaginal Douches and Other Feminine Hygiene Products: Women's Practices and Perceptions of Product Safety. Matern Child Health J 10, 303–310 (2006). https://doi.org/10.1007/s10995-005-0054-y
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DOI: https://doi.org/10.1007/s10995-005-0054-y