Vaginal douching by women with vulvovaginitis and relation to reproductive health hazards

Abstract

BackgroundVaginal douching (VD) is a common practice among married women all over the world specially those in the Middle East. It is used for personal hygiene or for other aesthetic reasons in many countries. The current study investigates the prevalence of VD among patients with vulvovaginitis in Egypt. It also compares the reproductive health hazards among women performing routine VD with those using external hygiene. It also investigates why, and how women practice this douching.MethodsA cross sectional observational study was conducted in a tertiary university affiliated hospital in Assiut, Egypt. An interview administered questionnaire was administered to 620 women by two trained clinic nurses. Women presented to the outpatient clinic and diagnosed to have any type of vaginal infections were approached for participation. The principle outcome was the history of preterm labor in women who routinely performed VD versus those who did not (upon which sample size was estimated). Other outcome measures were the types of vaginal infections, and reproductive implications comprising, ectopic pregnancy, abortion and pelvic inflammatory disease (PID).ResultsThe participants were predominantly multiparas from semi-urban background and middle socioeconomic level. Considering VD as a religious duty and a kind of personal cleanliness were the most common reasons for performing VD in 88.9% and 80.6% of the studied population, respectively. History of preterm labor was reported in 19.2% versus 11.9% (p=0.048), while history of PID in 13.2% versus 6.0% (p=0.008) in women performing VD compared to those not performing this habit, respectively. There were no significant differences between the two groups as regard the history of ectopic pregnancy or the number of previous abortions.ConclusionVaginal douching is a prevalent practice in Egypt and has traditional and religious roots within the community. There are many misbeliefs around this habit in Egypt. Vaginal douching increases certain reproductive health hazards especially preterm labor and PID. Much effort and awareness campaigns are needed to increase women awareness about health hazards of this incorrect practice and to limit its use.

Feminine hygiene practices among female patients and nurses in Lebanon

“…Vaginal douching by a liquid solution in the vagina in the aim of cleanliness, odor control, or relief of vaginal itching and irritation is a common practice worldwide especially among African American and Muslim women [ 4 ]. The use of douching is similar between our two groups (14 % of nurses and 15.1 % of patients) and is considerably less than the prevalence reported by Shaaban et al in Egypt (73 %), Erbil et al (38.6 %) and Ege et al (61.5 %) in Turkey [ 5 – 7 ]. This difference could be explained by the fact that the majority of the women in our study are Christians and do not douche for religious reasons as in other countries in the Middle-East.…”

Clinical audit of ectopic pregnancy

“…Three quarters of the women presented with EP were performing the practice of internal VD. This agrees with a study on the same setting ( 13 ) which reported that 73.0% of women with vaginal infections were performing this practice. Regarding the management strategy of 200 cases of EP, 84.0% of cases were managed by laparotomy, while 4.5% of cases were managed by laparoscopy, 10.0% with medical treatment and 2.5% had had expectant management of EP.…”

Examining the Determinants of Intimate Hygiene for Young Women With an Emphasis on Behavior Related to Risk of Vulvovaginal Infections

“…Vulvovaginal infections occur as a result of a compromised vaginal ecosystem. It may occur as a result of insufficient IH, but also, conversely, as a result of excessive IH (e.g., frequent vaginal douching) (Klebanoff et al, 2011;Shaaban et al, 2013;Geng et al, 2016). 98.87% of the female students questioned perform suitable IH after defecation, wiping from front to back.…”