Skip to main content
Top
Published in: Maternal and Child Health Journal 1/2009

01-01-2009

Vaginal Douching Among Latinas: Practices and Meaning

Authors: M. Diane McKee, María Baquero, Matthew R. Anderson, Adelyn Alvarez, Alison Karasz

Published in: Maternal and Child Health Journal | Issue 1/2009

Login to get access

Abstract

Objectives Vaginal douching is widely practiced by American women, particularly among minority groups, and is associated with increased risk of pelvic and vaginal infections. This research sought to investigate vaginal hygiene practices and meaning associated with them among Latina women and adolescents. Study results would guide development of an intervention to decrease douching among Latinas. Methods In depth qualitative interviews conducted with English- and Spanish-speaking women aged 16–40, seeking care for any reason who reported douching within the last year (n = 34). Interviews were audiotaped, transcribed and analyzed using qualitative methods. One-third of interviews were conducted in Spanish. Results Two explanatory models for douching motives emerged: one stressed cosmetic benefits; the other, infection prevention and control. Most women reported douching to eliminate menstrual residue; a small number reported douching in context of sexual intercourse or vaginal symptoms. Many were unaware of associated health risks. Respondents typically learned about douching from female family members and friends. Male partners were described as having little to no involvement in the decision to douche. Women varied in their willingness to stop douching. Two-thirds reported receiving harm reduction messages about “overdouching”. About half indicated previous discussion about douching with health care providers; some had reduced frequency in response to counseling. A number of previously unreported vaginal hygiene practices and products were described, including use of a range of traditional hygiene practices, and products imported from outside the US. Conclusions Respondents expressed a range of commitment to douching. Counseling messages acknowledging benefits women perceive as well as health risks should be developed and delivered tailored to individual beliefs. Further research is needed to assess prevalence and safety of previously unreported practices.
Literature
1.
go back to reference Aral, S. O., Mosher, W. D., & Cates, W., Jr. (1992). Vaginal douching among women of reproductive age in the United States: 1988. American Journal of Public Health, 82(2), 210–214.PubMedCrossRef Aral, S. O., Mosher, W. D., & Cates, W., Jr. (1992). Vaginal douching among women of reproductive age in the United States: 1988. American Journal of Public Health, 82(2), 210–214.PubMedCrossRef
2.
go back to reference Abma, J. C., Chandra, A., Mosher, W. D, Peterson, L. S., & Piccinino, L. J. (1997). Fertility, family planning, and women’s health: New data from the 1995 National Survey of Family Growth. Vital Health Statistics, 23(19), 1–114. Abma, J. C., Chandra, A., Mosher, W. D, Peterson, L. S., & Piccinino, L. J. (1997). Fertility, family planning, and women’s health: New data from the 1995 National Survey of Family Growth. Vital Health Statistics, 23(19), 1–114.
3.
go back to reference Koblin, B. A., Mayer, K., Mwatha, A., Brown-Peterside, P., Holt, R., & Marmor, M., et al. (2002). Douching practices among women at high risk of HIV infection in the United States: Implications for microbicide testing and use. Sexually Transmitted Diseases, 29(7), 406–410.PubMedCrossRef Koblin, B. A., Mayer, K., Mwatha, A., Brown-Peterside, P., Holt, R., & Marmor, M., et al. (2002). Douching practices among women at high risk of HIV infection in the United States: Implications for microbicide testing and use. Sexually Transmitted Diseases, 29(7), 406–410.PubMedCrossRef
4.
go back to reference Foch, B. J., McDaniel, N. D., & Chacko, M. R. (2001). Racial differences in vaginal douching knowledge, attitude, and practices among sexually active adolescents. Journal of Pediatric and Adolescent Gynecology, 14(1), 29–33.PubMedCrossRef Foch, B. J., McDaniel, N. D., & Chacko, M. R. (2001). Racial differences in vaginal douching knowledge, attitude, and practices among sexually active adolescents. Journal of Pediatric and Adolescent Gynecology, 14(1), 29–33.PubMedCrossRef
5.
go back to reference Oh, M. K., Funkhouser, E., Simpson, T., Brown, P., & Merchant, J. (2003). Early onset of vaginal douching is associated with false beliefs and high-risk behavior. Sexually Transmitted Diseases, 30(9), 689–693.PubMedCrossRef Oh, M. K., Funkhouser, E., Simpson, T., Brown, P., & Merchant, J. (2003). Early onset of vaginal douching is associated with false beliefs and high-risk behavior. Sexually Transmitted Diseases, 30(9), 689–693.PubMedCrossRef
6.
go back to reference Chacko, M. R., McGill, L., Johnson, T. C., Smith, P. B., & Nenney, S. W. (1989). Vaginal douching in teenagers attending a family planning clinic. Journal of Adolescent Health Care, 10(3), 217–219.PubMedCrossRef Chacko, M. R., McGill, L., Johnson, T. C., Smith, P. B., & Nenney, S. W. (1989). Vaginal douching in teenagers attending a family planning clinic. Journal of Adolescent Health Care, 10(3), 217–219.PubMedCrossRef
7.
go back to reference Scholes, D., Daling, J. R., Stergachis, A., Weiss, N. S., Wang, S. P., & Grayston, J. T. (1993). Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstetrics and Gynecology, 81(4), 601–606.PubMed Scholes, D., Daling, J. R., Stergachis, A., Weiss, N. S., Wang, S. P., & Grayston, J. T. (1993). Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstetrics and Gynecology, 81(4), 601–606.PubMed
8.
go back to reference Wolner-Hanssen, P., Eschenbach, D. A., Paavonen, J., Stevens, C. E., Kiviat, N. B., & Critchlow, C. et al. (1990). Association between vaginal douching and acute pelvic inflammatory disease. JAMA, 263(14), 1936–1941.PubMedCrossRef Wolner-Hanssen, P., Eschenbach, D. A., Paavonen, J., Stevens, C. E., Kiviat, N. B., & Critchlow, C. et al. (1990). Association between vaginal douching and acute pelvic inflammatory disease. JAMA, 263(14), 1936–1941.PubMedCrossRef
9.
go back to reference Zhang, J., Thomas, A. G., & Leybovich, E. (1997). Vaginal douching and adverse health effects: A meta-analysis. American Journal of Public Health, 87(7), 1207–1211.PubMedCrossRef Zhang, J., Thomas, A. G., & Leybovich, E. (1997). Vaginal douching and adverse health effects: A meta-analysis. American Journal of Public Health, 87(7), 1207–1211.PubMedCrossRef
10.
go back to reference Kendrick, J. S., Atrash, H. K., Strauss, L.T., Gargiullo, P. M., & Ahn, Y. W. (1997). Vaginal douching and the risk of ectopic pregnancy among black women. American Jouranl of Obstetrics and Gynecology, 176(5), 991–997.CrossRef Kendrick, J. S., Atrash, H. K., Strauss, L.T., Gargiullo, P. M., & Ahn, Y. W. (1997). Vaginal douching and the risk of ectopic pregnancy among black women. American Jouranl of Obstetrics and Gynecology, 176(5), 991–997.CrossRef
11.
go back to reference Peters, S. E., Beck-Sague, C. M., Farshy, C. E., Gibson, I., Kubota, K. A., & Solomon, F., et al. (2000). Behaviors associated with Neisseria gonorrhoeae and Chlamydia trachomatis: Cervical infection among young women attending adolescent clinics. Clinical Pediatrics, 39(3), 173–177.PubMedCrossRef Peters, S. E., Beck-Sague, C. M., Farshy, C. E., Gibson, I., Kubota, K. A., & Solomon, F., et al. (2000). Behaviors associated with Neisseria gonorrhoeae and Chlamydia trachomatis: Cervical infection among young women attending adolescent clinics. Clinical Pediatrics, 39(3), 173–177.PubMedCrossRef
12.
go back to reference Baird, D. D., Weinberg, C. R., Voigt, L. F., & Daling, J. R. (1996). Vaginal douching and reduced fertility. American Journal of Public Health, 86(6), 844–850.PubMedCrossRef Baird, D. D., Weinberg, C. R., Voigt, L. F., & Daling, J. R. (1996). Vaginal douching and reduced fertility. American Journal of Public Health, 86(6), 844–850.PubMedCrossRef
13.
go back to reference Bruce, F. C., Kendrick, J. S., Kieke, B. A. Jr., Jagielski, S., Joshi, R., & Tolsma, D. D. (2002). Is vaginal douching associated with preterm delivery? Epidemiology, 13(3), 328–333.PubMedCrossRef Bruce, F. C., Kendrick, J. S., Kieke, B. A. Jr., Jagielski, S., Joshi, R., & Tolsma, D. D. (2002). Is vaginal douching associated with preterm delivery? Epidemiology, 13(3), 328–333.PubMedCrossRef
14.
go back to reference Cherpes, T. L., Meyn, L. A., Krohn, M. A., & Hillier, S. L. (2003). Risk factors for infection with herpes simplex virus type 2: Role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Diseases, 30(5), 405–410.PubMedCrossRef Cherpes, T. L., Meyn, L. A., Krohn, M. A., & Hillier, S. L. (2003). Risk factors for infection with herpes simplex virus type 2: Role of smoking, douching, uncircumcised males, and vaginal flora. Sexually Transmitted Diseases, 30(5), 405–410.PubMedCrossRef
15.
go back to reference Schwebke, J. R., Desmond, R. A., & Oh, M. K. (2004). Predictors of bacterial vaginosis in adolescent women who douche. Sexually Transmitted Diseases, 31(7), 433–436.PubMedCrossRef Schwebke, J. R., Desmond, R. A., & Oh, M. K. (2004). Predictors of bacterial vaginosis in adolescent women who douche. Sexually Transmitted Diseases, 31(7), 433–436.PubMedCrossRef
16.
go back to reference Holzman, C., Leventhal, J. M., Qiu, H., Jones, N. M., & Wang, J. (2001). Factors linked to bacterial vaginosis in nonpregnant women. American Journal of Public Health, 91(10), 1664–1670.PubMedCrossRef Holzman, C., Leventhal, J. M., Qiu, H., Jones, N. M., & Wang, J. (2001). Factors linked to bacterial vaginosis in nonpregnant women. American Journal of Public Health, 91(10), 1664–1670.PubMedCrossRef
17.
go back to reference Martino, J. L., & Vermund, S. H. (2002). Vaginal douching: Evidence for risks or benefits to women’s health. Epidemiologic Reviews, 24(2), 109–124.PubMedCrossRef Martino, J. L., & Vermund, S. H. (2002). Vaginal douching: Evidence for risks or benefits to women’s health. Epidemiologic Reviews, 24(2), 109–124.PubMedCrossRef
18.
go back to reference Buckley, T., & Gottlieb, A. (1988). Blood magic: The anthropology of menstruation. Berkeley: The University of California Press. Buckley, T., & Gottlieb, A. (1988). Blood magic: The anthropology of menstruation. Berkeley: The University of California Press.
19.
go back to reference Oh, M. K., Merchant, J. S., & Brown, P. (2002). Douching behavior in high-risk adolescents. What do they use, when and why do they douche? Journal of Pediatric and Adolescent Gynecology, 15(2), 83–88.PubMedCrossRef Oh, M. K., Merchant, J. S., & Brown, P. (2002). Douching behavior in high-risk adolescents. What do they use, when and why do they douche? Journal of Pediatric and Adolescent Gynecology, 15(2), 83–88.PubMedCrossRef
20.
go back to reference Crosby, R. A., Newman, D., Kamb, M. L., Zenilman, J., Douglas, J. M. J., & Iatesta, M. (2000). Misconceptions about STD-protective behavior. Project RESPECT Study Group. American Journal of Preventive Medicine, 19(3), 167–173.PubMedCrossRef Crosby, R. A., Newman, D., Kamb, M. L., Zenilman, J., Douglas, J. M. J., & Iatesta, M. (2000). Misconceptions about STD-protective behavior. Project RESPECT Study Group. American Journal of Preventive Medicine, 19(3), 167–173.PubMedCrossRef
21.
go back to reference Lichtenstein, B., & Nansel, T. R. (2000). Women’s douching practices and related attitudes: Findings from four focus groups. Women Health, 31(2–3), 117–131.PubMed Lichtenstein, B., & Nansel, T. R. (2000). Women’s douching practices and related attitudes: Findings from four focus groups. Women Health, 31(2–3), 117–131.PubMed
22.
go back to reference Gazmararian, J. A., Bruce, F. C., Kendrick, J. S., Grace, C. C., & Wynn, S. (2001). Why do women douche? Results from a qualitative study. Maternal and Child Health Journal, 5(3), 153–160.PubMedCrossRef Gazmararian, J. A., Bruce, F. C., Kendrick, J. S., Grace, C. C., & Wynn, S. (2001). Why do women douche? Results from a qualitative study. Maternal and Child Health Journal, 5(3), 153–160.PubMedCrossRef
23.
go back to reference Grimley, D. M., Oh, M. K., Desmond, R. A., Hook, E. W. III, & Vermund, S. H. (2005). An intervention to reduce vaginal douching among adolescent and young adult women: A randomized, controlled trial. Sexually Transmitted Diseases, 32(12), 752–758.PubMedCrossRef Grimley, D. M., Oh, M. K., Desmond, R. A., Hook, E. W. III, & Vermund, S. H. (2005). An intervention to reduce vaginal douching among adolescent and young adult women: A randomized, controlled trial. Sexually Transmitted Diseases, 32(12), 752–758.PubMedCrossRef
24.
go back to reference Miller, W. L., & Crabtree, B. F. (1994). Qualitative analysis: How to begin making sense. The Family Practice Research Journal, 14(3), 289–297.PubMed Miller, W. L., & Crabtree, B. F. (1994). Qualitative analysis: How to begin making sense. The Family Practice Research Journal, 14(3), 289–297.PubMed
25.
go back to reference Strauss, A. L., & Corbin, J. M. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage Publications. Strauss, A. L., & Corbin, J. M. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage Publications.
26.
go back to reference Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research (2nd ed.). Thousand Oaks, Calif: Sage Publications. Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research (2nd ed.). Thousand Oaks, Calif: Sage Publications.
27.
go back to reference Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Philadelphia: Wolters Kluwer Health/lippincott Williams & Wilkins. Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Philadelphia: Wolters Kluwer Health/lippincott Williams & Wilkins.
28.
go back to reference Grimley, D. M., Annang, L., Foushee, H. R., Bruce, F. C., & Kendrick, J. S. (2006). Vaginal douches and other feminine hygiene products: Women’s practices and perceptions of product safety. Maternal and Child Health Journal, 10(3), 303–310.PubMedCrossRef Grimley, D. M., Annang, L., Foushee, H. R., Bruce, F. C., & Kendrick, J. S. (2006). Vaginal douches and other feminine hygiene products: Women’s practices and perceptions of product safety. Maternal and Child Health Journal, 10(3), 303–310.PubMedCrossRef
29.
go back to reference Anderson, M., McKee, D., Yukes, J., Alvarez, A., & Karasz, A. (2008). An investigation of douching practices in the botánicas of the Bronx. Cultural Health and Sexuality, 10(1), 1–11.CrossRef Anderson, M., McKee, D., Yukes, J., Alvarez, A., & Karasz, A. (2008). An investigation of douching practices in the botánicas of the Bronx. Cultural Health and Sexuality, 10(1), 1–11.CrossRef
30.
go back to reference Civic, D., & Wilson, D. (1996). Dry sex in Zimbabwe and implications for condom use. Social Science and Medicine, 42(1), 91–98.PubMedCrossRef Civic, D., & Wilson, D. (1996). Dry sex in Zimbabwe and implications for condom use. Social Science and Medicine, 42(1), 91–98.PubMedCrossRef
31.
go back to reference Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMed Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMed
32.
go back to reference Annang, L., Grimley, D. M., & Hook, E. W., III. (2006). Vaginal douche practices among black women at risk: Exploring douching prevalence, reasons for douching, and sexually transmitted disease infection. Sexually Transmitted Diseases, 33(4), 215–219.PubMedCrossRef Annang, L., Grimley, D. M., & Hook, E. W., III. (2006). Vaginal douche practices among black women at risk: Exploring douching prevalence, reasons for douching, and sexually transmitted disease infection. Sexually Transmitted Diseases, 33(4), 215–219.PubMedCrossRef
33.
go back to reference Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMed Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., & Sweet, R. L., et al. (2001). Douching and endometritis: Results from the PID evaluation and clinical health (PEACH) study. Sexually Transmitted Diseases, 28(4), 240–245.PubMed
Metadata
Title
Vaginal Douching Among Latinas: Practices and Meaning
Authors
M. Diane McKee
María Baquero
Matthew R. Anderson
Adelyn Alvarez
Alison Karasz
Publication date
01-01-2009
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 1/2009
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-008-0327-3

Other articles of this Issue 1/2009

Maternal and Child Health Journal 1/2009 Go to the issue