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      Douching practices among women in the Bolgatanga municipality of the upper east region of Ghana

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          Abstract

          Background

          Vaginal douching is a common practice among women all over the world. Women douche for various reasons, despite evidence indicating the harmful health effects of the practice. There is lack of data on the practice in Ghana but health behaviors like vaginal douching may be influenced by differences in culture and geography. Therefore, this study sought to assess prevalence and predictors of vaginal douching practices among women of the Bolgatanga Municipality of Ghana.

          Methods

          This cross-sectional study was conducted among 200 women from January to March 2016.

          Results

          Sixty-seven percent of the women practiced vaginal douching, from which a similar proportion did it daily. Over two-thirds (67.7%) of the women used water for douching. The reasons for douching were cleansing the vagina (67.7%), therapeutic effects (12.8%) and tightening of the vaginal muscles (19.5%). The majority (87.2%) of women who douched were unaware of the harmful health effects associated with the practice. The educational level of the women ( p = 0.025) and having knowledge of the dangers associated with douching ( p <  0.001) were then significantly associated with douching practices.

          Conclusion

          Vaginal douching is commonly practiced by women in the Bolgatanga Municipality. Most of these women douche because they did not know that there are health problems associated with the practice. Health education on the issues of women health is very vital for the improvement of women’s health.

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          Most cited references23

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          Fertility, family planning, and reproductive health of U.S. women: data from the 2002 National Survey of Family Growth.

          J Abma, A Chandra, T. J. Jones … (2005)
          This report presents national estimates of fertility, family planning, and reproductive health indicators among females 15-44 years of age in the United States in 2002 from Cycle 6 of the National Survey of Family Growth (NSFG). For selected indicators, data are also compared with earlier cycles of the NSFG. Descriptive tables of numbers and percentages are presented and interpreted. Data were collected through in-person interviews of the household population 15-44 years of age in the United States between March 2002 and March 2003. The sample included 7,643 females and 4,928 males, and this report focuses on data from the female sample. The overall response rate for the Cycle 6 NSFG was 79 percent, and the response rate for women was 80 percent. Given the range of topics covered in the report, only selected findings are listed here. About 14 percent of recent births to women 15-44 years of age in 2002 were unwanted at time of conception, an increase from the 9 percent seen for recent births in 1995. Among recent births, 64 percent occurred within marriage, 14 percent within cohabiting unions, and 21 percent to women who were neither married nor cohabiting. The overall rate of breastfeeding initiation among recent births increased from 55 to 67 percent between 1995 and 2002. About 50 percent of women 15-44 had ever cohabited compared with 41 percent of women in the 1995 survey; the percentage of women currently cohabiting also increased, from 7 to 9 percent between 1995 and 2002.
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            Vaginal douching and racial/ethnic disparities in phthalates exposures among reproductive-aged women: National Health and Nutrition Examination Survey 2001–2004

            Francesca Branch, Tracey J. Woodruff, Susanna D. Mitro … (2015)
            Background Diethyl phthalate (DEP) and di-n-butyl phthalate (DnBP) are industrial chemicals found in consumer products that may increase risk of adverse health effects. Although use of personal care/beauty products is known to contribute to phthalate exposure, no prior study has examined feminine hygiene products as a potential phthalate source. In this study, we evaluate whether vaginal douching and other feminine hygiene products increase exposure to phthalates among US reproductive-aged women. Methods We conducted a cross-sectional study on 739 women (aged 20–49) from the National Health and Nutrition Examination Survey 2001–2004 to examine the association between self-reported use of feminine hygiene products (tampons, sanitary napkins, vaginal douches, feminine spray, feminine powder, and feminine wipes/towelettes) with urinary concentrations of monoethyl phthalate (MEP) and mono-n-butyl phthalate (MnBP), metabolites of DEP and DnBP, respectively. Results A greater proportion of black women than white and Mexican American women reported use of vaginal douches, feminine spray, feminine powder, and wipes/towelettes in the past month whereas white women were more likely than other racial/ethnic groups to report use of tampons (p < 0.05). Douching in the past month was associated with higher concentrations of MEP but not MnBP. No other feminine hygiene product was significantly associated with either MEP or MnBP. We observed a dose–response relationship between douching frequency and MEP concentrations (ptrend < 0.0001); frequent users (≥2 times/month) had 152.2 % (95 % confidence intervals (CI): (68.2 %, 278.3 %)) higher MEP concentrations than non-users. We also examined whether vaginal douching mediates the relationship between race/ethnicity and phthalates exposures. Black women had 48.4 % (95 % CI: 16.8 %, 88.6 %; p = 0.0002) higher MEP levels than white women. Adjustment for douching attenuated this difference to 26.4 % (95 % CI:−0.9 %, 61.2 %; p = 0.06). Mediation effects of douching were statistically significant for black-white differences (z = 3.71, p < 0.001) but not for differences between Mexican Americans and whites (z = 1.80, p = 0.07). Conclusions Vaginal douching may increase exposure to DEP and contribute to racial/ethnic disparities in DEP exposure. The presence of environmental chemicals in vaginal douches warrants further examination.
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              Vaginal douching: personal practices and public policies.

              Sten Vermund, Surasak Youngpairoj, L. Martino (2004)
              Vaginal douching is associated with adverse reproductive health outcomes, yet both health providers and women are often poorly informed about details of this practice. We searched the English language articles in the MEDLINE database (1965-March 2004) to describe vaginal douching products, policies of professional organizations, predictors of douching practice, douching methods used, timing of use, and motivation. A key report was obtained from the Food and Drug Administration (FDA) via the Freedom of Information Act. Additional product information was obtained from manufacturers. Primary key terms for the literature search included (vagina OR vaginal) and (douche OR douching). Health effects of douching are reviewed briefly; personal practices and public policies are highlighted. From the literature search, we identified 432 papers, of which 150 were reviewed in detail. Contrary to the assumptions of many health professionals, douching products are only loosely regulated by the FDA. Few professional organizations have clearly stated policy statements regarding douching. In the United States, the prevalence of douching varies considerably by race (more common among African Americans) and age cohort (more common in women born earlier). Internationally, vaginal douching is common in some cultures and is rare in others. Opinions of mothers, peers, and health professionals, in addition to marketing of commercial products, affect douching behavior. Regulation of vaginal douching products and public education efforts on douching behavior need to be reassessed. Because of the preponderance of evidence that suggests an association between vaginal douching and adverse reproductive health outcomes, professional and public health associations should consider educational and policy activities to discourage women from douching.
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                Author and article information

                Contributors
                Florence Assibi Ziba:
                ORCID: http://orcid.org/0000-0003-4900-4435
                aziba@uds.edu.gh
                Vida Nyagre Yakong: vidayakong@yahoo.ca
                Rockson Asaan Asore: asorerockson@gmail.com
                Keville Frederickson: Kfrederickson@pace.edu
                Michele Flynch: mflynch@pace.edu
                Journal
                Journal ID (nlm-ta): BMC Womens Health
                Journal ID (iso-abbrev): BMC Womens Health
                Title: BMC Women's Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6874
                Publication date (Electronic): 8 February 2019
                Publication date PMC-release: 8 February 2019
                Publication date Collection: 2019
                Volume: 19
                Electronic Location Identifier: 32
                Affiliations
                [1 ]GRID grid.442305.4, Department of Nursing, , University for Development Studies, ; Tamale, Ghana
                [2 ]GRID grid.442305.4, Department of Midwifery, , University for Development Studies, ; Tamale, Ghana
                [3 ]ISNI 0000 0001 0582 2706, GRID grid.434994.7, Bongo District Hospital, Ghana Health Service, ; Bongo, Ghana
                [4 ]ISNI 0000 0000 8592 1116, GRID grid.261572.5, Lienhard School of Nursing, , Pace University, ; Pleasantville, New York City, USA
                Author information
                http://orcid.org/0000-0003-4900-4435
                Article
                Publisher ID: 720
                DOI: 10.1186/s12905-019-0720-7
                PMC ID: 6368746
                PubMed ID: 30736772
                SO-VID: fde5b068-3107-414c-bd53-321b2431beca
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 2 August 2017
                Date accepted : 18 January 2019
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: douching practices,knowledge,women,vaginal hygiene,bolgatanga municipality
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: douching practices, knowledge, women, vaginal hygiene, bolgatanga municipality

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