The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006
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Prevalence and correlates of vaginal douching among women in the United States, 2001-2002

Madeline Y. Sutton1, Carol Bruce2, Maya R. Sternberg3, Geraldine McQuillan4, Juliette S. Kendrick5, Emilia Koumans1, and Lauri Markowitz6. (1) DSTDP, CDC, 1600 Clifton Road, MS E-02, Stone Mountain, GA, USA, (2) DRH, CDC, Atlanta, GA, USA, (3) Division of STD Prevention, CDC, 1600 Clifton Road, Mailstop E-02, Atlanta, GA, USA, (4) NHANES, NCHS, Washington, DC, DC, USA, (5) Div of Reproductive Health, CDC, MS K-20, Atlanta, GA, USA, (6) Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop E-02, Atlanta, GA


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.