Background:
Vaginal douching has been associated with adverse outcomes, such as increased episodes of bacterial vaginosis, pelvic inflammatory disease, and ectopic pregnancy. Although douching is a common practice among women in the United States, previous data from the National Survey of Fam

Objective:
To describe the prevalence of and factors associated with self-reported vaginal douching using data from the National Health and Nutrition Examination Survey (NHANES), 2001-2002.

Method:
Data were analyzed from a nationally representative sample of 2,131women ages 14-49 who participated in the 2001-2002 NHANES. Weighted national estimates were calculated. Vaginal douching was defined as using any feminine hygiene product during the previous 6 months.

Result:
2131 (89%) of 2383 participating women provided analyzable responses to the douching questions. The prevalence of vaginal douching was 22.4% (95% CI=18.8-26.7); for non-Hispanic whites 18.9% (95% CI=14.6-24.4), for Mexican Americans 16.6% (95% CI=12.0-22.5), for non-Hispanic blacks 50.2% (95% CI=42.8-59.0). Factors significantly associated with vaginal douching included first sex between ages 9 and 15 years, annual family income less than $20,000, and less than high school education. Of those who reported douching, 32.1% reported vaginal problems during the past month (odor, discharge, or itching), compared to 21.0% who denied any vaginal problems (p=0.007).

Conclusion:
The NHANES prevalence of douching of 22.4% is lower than previous NSFG estimates. A racial disparity exists: non-Hispanic Black women report douching 2-3 times more frequently than non-Hispanic white and Mexican-American women. Although women with symptoms reported more douching than women without symptoms, douching still occurs frequently among women who deny vaginal problems within the past month.

Implications:
Educational interventions that are appropriate for groups with a high prevalence of douching should be developed in an effort to decrease adverse outcomes.