Personal Hygiene Practices related to Genito-urinary Tract and Menstrual Hygiene Management in Female Adolescents

PURPOSE: The study was to survey personal hygiene practice related to genito-urinary tract and menstrual hygiene management in female adolescents in order to obtain basic information for health education. METHODS: With a descriptive survey design, 389 adolescents were recruited via convenience sampling in Korea. Survey instrument was the feminine and menstrual hygiene practice and perception of vaginal douching. Data were collected from a self-administered structured questionnaire. RESULTS: Mean age of adolescents was 16.09 and menarche was at 13.21. While washing hands after urination/defecation was highly performed, wipe front to back and wash with soap and water were reported as being not well done. Twenty-eight percent reported douching habit. More positive beliefs about douching were reported by adolescents who practiced douching. Menstrual hygiene management was very appropriate with changing sanitary pads regularly with hand washing; but less performed for limiting bathing activity during menstrual periods and washing hands after activity of genito-urinary area. CONCLUSION: Some adolescents practiced inadequate hygiene practices especially for body cleansing during menstrual period and vaginal douching. It is important to develop and implement school health education programs on feminine and personal hygiene for adolescents to help them perform adequate health behaviors.

Relação entre ducha vaginal e vaginose bacteriana, doenças sexualmente transmissíveis e infecção por HIV: uma revisão sistemática / Relationship between vaginal douching and bacterial vaginosis, sexually transmitted diseases and HIV infection: a systematic review

Apesar de ducha vaginal estar fortemente condenada pela maioria dos profissionais de saúde; esta prática continua a ser um hábito muito comum entre as mulheres, por diversas razões. Objetivo: Avaliar se há relação entre a prática de duchas vaginais e vaginose bacteriana, DST e HIV.Métodos: Foi realizada uma revisão sistemática e meta-análise para avaliar a relação entre a ducha vaginal e vaginose bacteriana, doenças sexualmente transmissíveis e infecção pelo HIV. Os seguintes bancos de dados foram pesquisados utilizando descritores: PubMed, Embase, Scielo e Google Scholar.Os critérios de seleção: (1) estudos prospectivos de mulheres que usam ducha vaginal; (2) mulheres com 12 anos ou mais e (3) estudos publicados de 2000a outubro de 2011. Estudos envolvendo mulheres grávidas foram excluídos. A qualidade metodológica foi avaliada usando a escala de Newcastle-Ottawa.Coleta de dados e análise: Review Manager 5.1 foi utilizado para análise estatística. Resultados: Sete estudos (2 STD, 3 vaginose bacteriana e 2 HIV)foram incluídos com base nos critérios escolhidos: 9,796 mulheres foram incluídos. A razão de risco global para a vaginose bacteriana, DST e aquisição do HIV foram, (IC95% 1,12-1,43) 1,24 (IC95% 0,94-1,32) 1,12 e (IC95% 0,92-2,01) 1,36, respectivamente. Conclusão: Há poucos estudos para verificar a associação entre a ducha vaginal e STD, VB e infecção pelo HIV. Foi encontrada uma correlação positiva entre a ducha vaginal e vaginose bacteriana, mas não para DST e infecção pelo HIV

Despite of vaginal douching has been strongly condemned by most of health care professionals; this practice remains a very common habit among women for several reasons. Objective: To assess if there is any association between vaginal douching and bacterial vaginoses, STD and HIV Methods: We conducted a systematic review and metanalysis to evaluate the relation ship between vaginal douching and bacterial vaginosis, sexually transmitted diseases and HIV infection. The following databases were searched using Mesh terms: PubMed, Embase, Scielo and Google Scholar. Selection criteria: (1) prospective cohort studies of women using vaginal douching; (2) women 12 years or older and (3) studies published from 2000 to October2011. Studies involving pregnant women were excluded. Methodological quality was assessed using Newcastle-Ottawa scale. Data collection and analysis:Review Manager 5.1 was used for statistical analysis. Results: Seven studies (2 STD, 3 Bacterial Vaginosis and 2 HIV) were included based on the chosen criteria: 9.796 women were enrolled. The global Risk Ratios for Bacterial Vaginosis, STD and HIV acquisition were, 1.24 (95%CI 1.12?1.43), 1.12 (95%CI0.94?1.32), and 1.36 (95%CI 0.92?2.01) respectively. Conclusion: There are few studies checking the association between vaginal douching and STD, BVand HIV infection. A weak positive correlation was found between vaginal douching and bacterial vaginosis, but not to STD and HIV infection.

Intravaginal cleansing among women attending a sexually transmitted infection clinic in Kingston, Jamaica / Limpieza intravaginal entre mujeres que asisten a una clínica de infecciones de transmisión sexual en Kingston, Jamaica

OBJECTIVES: Although common worldwide, intravaginal cleansing is associated with poor health outcomes. We sought to describe intravaginal cleansing among women attending a sexually transmitted infection (STI) clinic in Jamaica. METHODS: We examined intravaginal cleansing ("washing up inside the vagina", douching, and products or materials used) among 293 participants in a randomized trial of counselling messages at an STI clinic in Kingston. We focussed on information on intravaginal cleansing performed in the 30 days and three days preceding their baseline study visit. We describe reported cleansing behaviours and used logistic regression to identify correlates of intravaginal cleansing RESULTS: Fifty-eight per cent of participants reported intravaginal cleansing in the previous 30 days, and 46% did so in the three days before baseline. Among those who cleansed in the previous 30 days, 88% reported doing so for hygiene unrelated to sex, and three-fourths reported generally doing so more than once per day. Soap (usually with water) and water alone were the most common products used for washing; commercial douches or detergents were reported infrequently. Intravaginal cleansing in the three days before the baseline visit was positively associated with having more than one sex partner in the previous three months (adjusted odds ratio [AOR], 1.9; 95% CI, 1.1, 3.2), and negatively associated with experiencing itching in the genital area at baseline (AOR, 0.6; 95% CI, 0.4, 1.0). CONCLUSIONS: A large proportion of women attending STI clinics in Jamaica engage in frequent intravaginal cleansing, indicating a need for clinicians to discuss this topic with them accordingly.

OBJETIVOS: Aunque común mundialmente, la limpieza intravaginal se halla asociada con pobres resultados de salud. Buscamos describir la limpieza intravaginal entre mujeres que asisten a una clínica de infecciones de transmisión sexual (ITS) en Jamaica. MÉTODOS: Examinamos la limpieza intravaginal ("lavado del interior de la vagina", ducha, y productos o materiales usados) entre 293 participantes en una prueba aleatoria de mensajes de counseling en una clínica de ITS en Kingston. Las participantes proporcionaron la información sobre la limpieza intravaginal realizada en los 30 y tres días que precedieron a su visita para el estudio inicial. Describimos las conductas de limpieza reportadas y la regresión logística usada para identificar los correlatos de la limpieza intravaginal. RESULTADOS: Cincuenta y ocho por ciento de las participantes reportaron la limpieza intravaginal en los 30 días anteriores, y el 46% lo hicieron en los tres días antes del inicio del estudio. Entre aquéllas que realizaron la limpieza en los 30 días anteriores, el 88% reportó haberlo hecho por razones de higiene independientes de la vida sexual, y tres cuartos reportaron hacerlo de manera general más de una vez al día. Jabón (normalmente con agua) y agua solamente fueron los productos más comunes usados para el lavado. Las duchas comerciales o detergentes no fueron reportadas muy frecuentemente. La limpieza intravaginal en los tres días antes de la visita del estudio inicial estuvo positivamente asociada con tener más de una pareja sexual en los tres meses anteriores (odds ratio ajustado [AOR], 1.9; 95% CI, 1.1, 3.2), y negativamente asociado con experimentar comezón en el área genital al inicio del estudio (AOR, 0.6; 95% CI, 0.4, 1.0). CONCLUSIONES: Un gran número de mujeres que asisten a las clínicas de ITS en Jamaica practican frecuentemente la limpieza intravaginal, lo cual indica la necesidad de que los médicos clínicos discutan este asunto con ellas.

Feminine Hygiene and Vaginal Douche Practices in Middle-aged Women

PURPOSE: The study was done to survey feminine hygiene and vaginal douche practices in middle-aged women to obtain basic information for public health education. METHODS: With a descriptive survey design, 134 middle-aged women who have menstrual period were recruited via convenience sampling. Survey contents were from the study by Czerwinski (2000) regarding feminine hygiene and vaginal douching practices. After obtaining IRB approval, a self-administered structured questionnaire was distributed to study participants. RESULTS: Mean age of middle-aged women was 46.88 years old. Fifty-six percent of the women practiced vaginal douching. Women performed douching with water (68%), commercial products (13%), soap (12%), and vinegar-mixed water (6%) for clean and fresh feeling, removal of unpleasant odor, and removal of vaginal discharge. Vaginal douche practice was significantly related to a history of vaginitis. CONCLUSION: The study results indicate that most of the women practiced inadequate feminine hygiene especially in douching, suggesting that is important to develop education programs on feminine hygiene practices for women of all ages, especially regarding douching and hand washing before and after changing pads or tampons.

Evaluation of habitual behavior related to genital hygiene in women living in a health care center area

To evaluate that habitual behaviors related to genital hygiene in women living in a Health Care Center Area. In this cross-sectional study, 400 women were sampled to represent women in reproductive ages [15-49 ages] living in the Park Health Care Center Area, Ankara, Turkey between June and September 2008. Three hundred and eighty-six [96.55] women were interviewed for evaluation of habitual behaviors related to genital hygiene. The chi-square test was used for statistical analysis. The man age of the study group was 32.19 +/- 9.54 [15-49] years. Of the study group, 21.5% had daily baths, 77.2% used cotton underwear, and 71.8% wiped front to back after using the toilet. Of those who menstruated, 83.4% used hygienic pads during menstrual periods, and 42.1% of the 321 married women confirmed practicing vaginal douching. The education level [p=0.001, p=0.000], income level [p=0.034, p=0.005], employment [p=0.022, p=0.000], and house type [p=0.005, p=0.006] were found as factors affecting general frequency of bathing and type of pad used during the menstrual period. Frequency of vaginal douching was higher in housewives than employed women [p=0.000]. The rate of women who had appropriate behaviors related to genital hygiene among the study group was found to be low, particularly within groups with a low socioeconomic level. Thus, it will be useful for health care employers to emphasize this issue at every opportunity

Duchas vaginales y otros riesgos de vaginosis bacteriana / Vaginal douching and other risks for bacterial vaginosis

La vaginosis bacteriana (VB) es una infección caracterizada por el cambio en la microflora de la vagina, se asocia conresultados adversos del embarazo y a la adquisición de infecciones de transmisión sexual (ITS), que incluyen el VIH. Objetivos. Identificar la asociación entre el uso de duchas vaginales y otros factores de riesgo con VB. Materiales y métodos. Se realizó un estudio transversal en 1252 mujeres que asistieron al servicio de planificación familiar de treshospitales nacionales y un instituto especializado de Lima, durante el año 1997. Se utilizó un cuestionario estructurado donde se registró las variables sociodemográficas y las características del estilo de vida de las participantes. La VB fue diagnosticada mediante el puntaje de Nugent. Se empleó análisis de regresión logística para calcular odds ratio (OR) e intervalos de confianza al 95 por ciento. Resultados. La edad promedio fue 25,1 mas o menos 4,7 años, el 23,4 por ciento tenían más de 11 años de educación. La prevalencia de VB fue 20,1 por ciento. Las mujeres que practicaban duchas vaginales (OR: 2,28; IC95 por ciento: 1,0- 5,0), que tenían dos o más parejas sexuales (OR: 2,0; IC95 por ciento: 1,2-3,5) y que iniciaron una relación sexual a una edadtemprana (OR: 1,4; IC95 por ciento: 1,0 -1,9) tuvieron mayor probabilidad de adquirir VB. Conclusiones. El uso de duchas vaginales es un factor de riesgo de VB en mujeres peruanas. Los programas destinados a la salud de la mujer deben abordar las repercusiones perjudiciales para la salud asociados con las duchas vaginales.

Bacterial vaginosis (BV) is an infection characterized by a change in the micro flora of the vagina. BV has been associated with adverse pregnancy outcomes and increased risk of acquiring sexually transmitted infections (STI). Objective. To identifiythe association of douching and other behavioral risk factors in relation to BV. Material and methods. This cross-sectional study was carried out among 1252 women attending in 3 public hospitals and one specialized institute in Lima, Peru in 1997. A structured questionnaire was used to collect information on socio-demographic and lifestyle characteristics of women. BV was diagnosed by the NugentÆs score. Logistic regression procedures were employed to estimate adjusted odds ratios (OR) and 95 per cent confidence intervals (95 per cent CI). Results. Mean age of participants was 25.1 more or less 4.7 and 23.4 per cent hadmore than 11 years of formal education. The prevalence of BV was 20.1 per cent and significantly associated with a number of behavioral risk factors. Women who practice douching (OR: 2.28; 95 per cent CI: 1.0-5.0), having two or more sexual partners (OR: 2.0; 95 per cent CI: 1.2-3.5) and who started sexual intercourse at a younger age (OR:1.4; 95 per cent CI: 1.0-1.9) have more risk to get BV. Conclusion. Vaginal douching is a risk factor associated with BV among Peruvian women. Programs aimed at womenÆs health must address the adverse health outcomes associated with douching.

Study on the association between vaginal douching and sexually transmitted diseases among female sex workers in a county of Yunnan province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the epidemic characteristics of vaginal douching, human immunodeficiency virus (HIV) and other sexually transmitted diseases(STD) among female sex workers (FSWs) in Yunnan province.</p><p><b>METHODS</b>FSWs were recruited to be investigated on their demographic data, drug abuse and sexual behavior, HIV/AIDS knowledge and procreation health status. Venous blood were collected to test for HIV, herpes simplex virus 2 (HSV-2) and syphilis while urine specimen was for morphine, cervical secretion for Gonorrhoea and Chlamydia trachomatis, and vaginal secretion for Trichomonas.</p><p><b>RESULTS</b>A total number of 833 blood specimen were collected, in which 84 specimen were confirmed to be HIV positive with a prevalence rate of 10.1%. The prevalence rates of syphilis and HSV-2 were 8.2% and 68.4% respectively. 832 vaginal and cervical secretion specimen were collected with the prevalence rates of Gonorrhoea, Chlamydia trachomatis and Trichomonas were 11.5%, 28.2% and 11.9% respectively. In multivariate logistic analysis, the factors associated with vaginal douching were: being Han nationality, locations of sex work at middle/high level, ever heard of HIV/AIDS, emerged hypogastric pain last year, the number of sex work location > or =4.</p><p><b>CONCLUSION</b>Vaginal douching was shown a risk factor for HIV and some STD.</p>

Preoperative vaginal preparations for abdominal hysterectomy for the prevention of febrile morbidity: savlon douching vs povidone-iodine painting.

OBJECTIVE: To compare the effectiveness between savlon solution was douching and povidone-iodine solution painting for reducing febrile morbidity after total abdominal hysterectomy. Study design: Clinical trial. MATERIAL AND METHOD: One hundred and fifty patients at Srinagarind Hospital were scheduled for total abdominal hysterectomy (TAH). All subjects were non-randomly allocated to receive either savlon (1:1000 solutions) douching or povidone-iodine (1% solution) painting as pre-operative vaginal preparations. They also received Cefazolin 1 gm. intravenously before the operation. The principal outcome of the study was febrile morbidity. RESULTS: The overall rate of febrile morbidity was 21 percent. The incidence of febrile morbidity in the savlon vs. povidone-iodine groups was 16 (12/75) and 25 (19/75) percent, respectively. No statistically significant difference was found between the two groups (p-value = 0.16). The odds ratio was 1.78 (95%CI 0.79 to 3.99) and adjusted odds ratio was 2.09(95%CI 0.86 to 5.10) CONCLUSION: The effectiveness between savlon solution douching and povidone-iodine solution painting in conjunction with a prophylactic antibiotic before TAH for reducing febrile morbidity was not significant different.

Comparison of the effect of Garlic extract vaginal douche and clotrimazole vaginal cream in the treatment of women with vaginal candidiasis

Vaginal candidiasis is one of the most common genital infections, which has many different therapeutic methods. Some Para clinical researches suggest garlic for treatment of candidiasis.The purpose of this study was to compare the effect of garlic extract vaginal douche and clotrimazole vaginal cream in the treatment of women with vaginal candidiasis. This is a randomized, controlled, clinical trial on 100 non-pregnant women who came with the symptomatic vaginal candidiasis. Fresh garlic extract was provided by Pharmacologist, and then the patients whose mycologic culture was positive were randomly allocated into 2 groups of vaginal douche containing 1% garlic extract and vaginal cream containing 1% clotrimazole .All patients were treated daily for 7 days and assessed for clinical and mycological results 1-2 .week after the end of treatment. Data were obtained by interview and observation methods and were analyzed by SPSS software using Chi Square, Fisher exact test student, t-test and paired-samples t-test by the confidence of 95%. Successful response [according to clinical and mycologic results] were reported in 34.7% of Garlic users and 56.9% clotrimazole users. [P=0.026] There was not any significant difference between clinical results after treatment in both groups [51% against 66.7%] but there was a significant difference between mycologic results in both groups. [40.8% against 60.8%] [P=0.046] According to the results, percentage of successful response in users of vaginal garlic extract douche was less than users of vaginal clotrimazole cream but there was no significant statistical difference between these groups according to the clinical result. We suggest more studies about different methods and doses of this drug

Effectiveness of vaginal douching on febrile and infectious morbidities after total abdominal hysterectomy: a multicenter randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of vaginal douching with 1 per cent povidone-iodine in reducing febrile and infectious morbidities after total abdominal hysterectomy (TAH). METHOD: The authors conducted a randomized controlled trial in 300 patients undergoing elective TAH in three hospitals in Northeast Thailand: a university, a regional and a general hospital. The patients were randomly allocated to the intervention or control groups. Patients in the intervention group received pre-operative vaginal douching with 1 per cent povidone-iodine while patients in the control group did not. External evaluators not apprised of the intervention assessed febrile and infectious morbidities. RESULTS: 300 patients were enrolled in the study. The incidences of febrile morbidity in patients with and without pre-operative vaginal douching were 25 and 35 per cent, respectively, though not statistically significant (risk difference -9.6%, 95% CI -19.9%, 0.8%, adjusted odds ratio 0.6, 95% CI 0.3%, 1.0%). A statistically significant difference in infectious morbidity was found between the groups (8 vs 19%, risk difference -10.0%, 95% CI -17.8%, -2.2%, adjusted odds ratio 0.4, 95% CI 0.2%, 0.9%). CONCLUSION: Pre-operative vaginal douching with 1 per cent povidone-iodine significantly reduces infectious morbidities after TAH.