Effects of feminine hygiene products on the vaginal mucosal biome

Abstract

BackgroundOver-the-counter (OTC) feminine hygiene products come with little warning about possible side effects. This study evaluates in-vitro their effects on Lactobacillus crispatus, which is dominant in the normal vaginal microbiota and helps maintain a healthy mucosal barrier essential for normal reproductive function and prevention of sexually transmitted infections and gynecologic cancer.MethodsA feminine moisturizer (Vagisil), personal lubricant, and douche were purchased OTC. A topical spermicide (nonoxynol-9) known to alter the vaginal immune barrier was used as a control. L. crispatus was incubated with each product for 2 and 24h and then seeded on agar for colony forming units (CFU). Human vaginal epithelial cells were exposed to products in the presence or absence of L. crispatus for 24h, followed by epithelium-associated CFU enumeration. Interleukin-8 was immunoassayed and ANOVA was used for statistical evaluation.ResultsNonoxynol-9 and Vagisil suppressed Lactobacillus growth at 2h and killed all bacteria at 24h. The lubricant decreased bacterial growth insignificantly at 2h but killed all at 24h. The douche did not have a significant effect. At full strength, all products suppressed epithelial viability and all, except the douche, suppressed epithelial-associated CFU. When applied at non-toxic dose in the absence of bacteria, the douche and moisturizer induced an increase of IL-8, suggesting a potential to initiate inflammatory reaction. In the presence of L. crispatus, the proinflammatory effects of the douche and moisturizer were countered, and IL-8 production was inhibited in the presence of the other products.ConclusionSome OTC vaginal products may be harmful to L. crispatus and alter the vaginal immune environment. Illustrated through these results, L. crispatus is essential in the preservation of the function of vaginal epithelial cells in the presence of some feminine hygiene products. More research should be invested toward these products before they are placed on the market.

Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis

“…In this regard, longitudinal studies suggest that women who attend these practices have an increased risk of BV incident [96]. The consequences of other intravaginal procedures are not entirely well understood, being some of them more associated with risks of suffering from BV than others [97,98]. Given the heterogeneity of the type of intravaginal practices, the variety of products for this purpose and their wide dissemination among cultures/races, additional research is desirable to clarify the effects on resident microbial communities of vaginal flora [79,81,83].…”

The Bacterial Vaginosis among Pregnant Women in Jatinangor

“…11 Interestingly, some feminine hygiene products currently available in the market do not provide protection against vaginitis and even have harmful effects on the vaginal immune barrier and thus may increase the susceptibility to infections. 18 Most of the pregnant women have practiced front to back cleaning in the perineal area, only a few have a wrong genital area hygiene cleaning practices, i.e. back to front or random which may cause the transfer of microorganisms from the anus to the vagina, 11 indicating that most of the women in the community have performed perineal cleaning correctly.…”

PRECEDE-PROCEED Theory Regarding Socio-Cultural Aspects that Influence the Treatment of Healthy Reproduction Organs among Senior High School Female Students in Surakarta

“…(Upashe, 2015). The selection of female organ cleansing product has been based on the availability and the community knowledge about each product (Fashemi, 2013).…”