Associations between Vaginal Douching Practice and Lower Genital Tract Symptoms and Menstrual Disorders among Young Women: A Search for Risk Modulating Factors

Aim: This study assessed the associations between vaginal douching practice and the adverse
reproductive tract outcomes, and the risk modulating factors among young women.
Methodology: The data source was a cross-sectional population based sample of 1488 women aged
18 - 35 years in a university community. Self-administered socio-demographic and female genital
hygiene practices questionnaire were used to survey the participants.
Results: The overall prevalence of vaginal douching was 79.8%. Pelvic pain, vaginal itching, and
vaginal discharge were significantly associated with higher odds for douching. Moreover, participants
with menstrual disorders such as menorrhagia, oligomenorrhea, and inter-menstrual bleeding douche
more often than those without these disorders. Early-onset, higher-frequency, and prolonged
douching, as well as douching with commercial vaginal deodorant and inserting the nozzle of the
douching tube inside the vagina were associated with higher rate of pelvic and menstrual disorders.
Conclusion: The present study revealed a paradoxical relation between vaginal douching and
adverse reproductive tract disorders, which supports the hypothesis of confounding by indication. The
direction of the association is dependent on several modifiable and un-modifiable risk factors.