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Yalvaç S, Akyıldız D, Dönmez A. A qualitative study of women's experiences of vaginal douching in Türkiye. CULTURE, HEALTH & SEXUALITY 2024:1-15. [PMID: 39078387 DOI: 10.1080/13691058.2024.2384701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024]
Abstract
Vaginal douching, a practice that has existed for many years, is defined as the process of intravaginal cleansing using a liquid solution. Despite its negative consequences with respect to health, vaginal douching is widely practised in many countries. This study sought to examine the vaginal douching experiences of women in the southeastern region of Türkiye. We used a phenomenological approach with semi-structured, in-depth interviews conducted between January and June 2022. Participants were 20 women who either currently practised vaginal douching or had stopped practising it at some point in their lives. The women were admitted to the obstetrics and gynaecology outpatient clinic of a district state hospital in Eastern Turkey for care and treatment. The data collected from the respondents were categorised into five thematic areas: sources of information about douching; reasons for doing so; as well as frequency, methods, and feelings about douching. The findings provide a rich source of information about each of these areas. These findings may help inform future studies on the prevention of vaginal douching in women.
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Affiliation(s)
- Sibel Yalvaç
- Gölbaşı District State Hospital, Adıyaman, Türkiye
| | - Deniz Akyıldız
- Division of Midwifery, Faculty of Health Sciences, Kahramanmaras Sutcu Imam University, Kahramanmaras, Türkiye
| | - Ayşegül Dönmez
- Division of Midwifery, Faculty of Health Sciences, Izmir Tinaztepe University, Izmir, Türkiye
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Manjate A, Sergon G, Kenga D, Golparian D, Tyulenev Y, Loquilha O, Mausse F, Guschin A, Langa JC, Passanduca A, Sacarlal J, Unemo M. Prevalence of sexually transmitted infections (STIs), associations with sociodemographic and behavioural factors, and assessment of the syndromic management of vaginal discharge in women with urogenital complaints in Mozambique. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1323926. [PMID: 38706519 PMCID: PMC11067503 DOI: 10.3389/frph.2024.1323926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
In Mozambique, sexually transmitted infections (STIs) are estimated to be prevalent, but diagnosis and treatment of curable STIs rely only on syndromic management. We examined the prevalence of four non-viral STIs and HIV-1/2, based on etiological diagnosis, associations with sociodemographic and behavioural factors, and the STI diagnostic accuracy of the vaginal discharge syndromic management in women with urogenital complaints in Maputo, Mozambique. A cross-sectional study was performed in Maputo, Mozambique, February 2018-January 2019, enrolling 924 women of reproductive age with urogenital complaints. Endocervical/vaginal swabs were sampled and chlamydia, gonorrhoea, trichomoniasis and Mycoplasma genitalium infections were diagnosed using a multiplex real-time PCR (AmpliSens; InterLabServices). Serological testing was performed for HIV-1/2. A structured questionnaire collected metadata. All data were analyzed in STATA/IC 12.1 using descriptive statistics, chi-square tests and logistic regression model. About 40% of the women were less than 24 years old, 50.8% were single, 62.1% had their sexual debut between 12 and 17 years of age, and the main complaint was vaginal discharge syndrome (85%). The prevalence of chlamydia was 15.5%, trichomoniasis 12.1%, gonorrhoea 4.0%, M. genitalium 2.1%, and HIV-1/2 22.3%. The vaginal discharge syndrome flowchart had a sensitivity of 73.0%-82.5% and a specificity of 14%-15% for the detection of any individual non-viral STI in women with urogenital complaints. In total, 19.2% of the symptomatic women with chlamydia, trichomoniasis or gonorrhoea would not be detected and accordingly treated using the vaginal discharge syndromic management (missed treatment) and 70.0% of the women would be treated despite not being infected with any of these three STIs (overtreatment). In conclusion, a high prevalence of especially chlamydia, trichomoniasis, and HIV-1/2 was found in women of childbearing age with urogenital complaints in Maputo, Mozambique. Syndromic management of vaginal discharge revealed low accuracy in the detection of STIs in symptomatic women, especially low specificity, which resulted in under-treatment of STI-positive cases and incorrect or over-treatment of women with urogenital complaints, many of whom were negative for all the non-viral STIs. Etiological diagnosis is imperative for effective management of STIs in symptomatic and asymptomatic women.
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Affiliation(s)
- Alice Manjate
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Gladys Sergon
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Darlenne Kenga
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Daniel Golparian
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yuriy Tyulenev
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Osvaldo Loquilha
- Departamento de Matemática e Informática, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Fabião Mausse
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alexander Guschin
- Department of Healthcare, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia
| | - José Carlos Langa
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Alfeu Passanduca
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Jahit Sacarlal
- Departament de Microbiologia, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Magnus Unemo
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- WHO Collaborating Centre for Gonorrhoea and Other Sexually Transmitted Infections, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, United Kingdom
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Maldonado S. The Folkloric Practices of Dominican Women in Managing Bacterial Vaginosis. Nurs Womens Health 2024; 28:143-147. [PMID: 38369296 DOI: 10.1016/j.nwh.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 10/01/2023] [Accepted: 01/17/2024] [Indexed: 02/20/2024]
Abstract
Bacterial vaginosis (BV) is characterized by changes in the vaginal flora caused by an elevated pH, resulting in symptoms of vaginal discharge, odor, and irritation. BV affects all women, including Dominican women who have specific cultural beliefs regarding vaginal health hygiene. Due to the prevalence of this condition and cultural norms that may influence how women respond to the diagnosis of BV, it is important to understand the factors that may promote the development of BV and that may influence women's choices of treatment options. Amsel's criteria are the most commonly used clinical approach for the diagnosis of BV. Recurrent BV is common and affects women's lives to varying degrees. Discussion about cultural norms and hygienic practices may provide information that may decrease the recurrence of BV. Nurses can provide support and evidence-based information in a culturally sensitive manner to help Dominican women manage BV.
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Thong C, Doyle A. Conceptual anatomy of the female genitalia using text mining and implications for patient care. MEDICAL HUMANITIES 2024; 50:86-94. [PMID: 38164575 DOI: 10.1136/medhum-2023-012747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
This article analyses the conceptual histories of words associated with female genital parts to explore how they may affect the lived experience of people with these parts and the quality of gynaecological care they receive. Specifically, we examine the implications of using the word 'vagina' to replace the word 'vulva', or indeed to indicate the entire female genitalia. This article does so through an analysis of existing scholarly work and through text mining methods such as word frequencies, most distinctive word collocates and word-embeddings drawn from literary and women's magazine corpora. We find that words indicating specific female genital parts are very infrequently mentioned in our corpora, which shows that there is a troubling lack of exposure and education in our socio-cultural context when it comes to the female genital anatomy. When they are mentioned, their usage reflects historical and patriarchal associations that have been primarily attached to the word 'vagina'. When it comes to the 'vagina' and 'vulva', the penis is the most prevalent association by far; whereas the most commonly occurring female genital parts are parts to do with reproduction-reinforcing a long-standing and disproportionate emphasis on the female genitalia's reproductive function. Our research also reveals a concerning emphasis on non-evidence-based female hygiene products, thus perpetuating the damaging stereotype of the dirty vagina. These findings may explain many negative patient outcomes such as stigma attached to seeking out timely gynaecological care, lack of informed medical consent and non-evidence-based practices exacerbated by problematic cultural depictions of the female genitalia. They can also explain the neglect of female sexual agency, pleasure and well-being. Understanding historical and contemporary usages of words for the female genitalia has important implications for the quality of patient care today and is a critical component of gender and reproductive justice.
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Affiliation(s)
- Carmen Thong
- English, Stanford University, Stanford, California, USA
| | - Alexis Doyle
- Department of Obstetrics and Gynecology, The University of Utah, Salt Lake City, Utah, USA
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Youssef AA, Shaaban OM, Kamal M, Shaltout A, Abbas AM, Mohamed AA. Internal vaginal douching increases the incidence of vaginal infection among IUD users: a cross-sectional study. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2023; 28:19. [DOI: 10.1186/s43043-023-00143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/08/2023] [Indexed: 09/18/2023] Open
Abstract
Abstract
Background
We compared the rate, type and severity of vulvovaginitis in women who are practicing internal vaginal douching (IVD) or not while using an intrauterine contraceptive device (IUCD).
It is a cross-sectional study on 604 consecutive attendees of the outpatient clinics using IUCD for at least 6 months prior to recruitment. Eligible participants were divided into two groups: group 1 (302 women) performing IVD and group 2 (302 women) not practicing this habit (NIVD). The frequency of vaginal infections in IUCD users who perform IVD compared to women who were abstaining from this habit was our primary outcome.
Results
They are IUCD users who were practicing IVD more frequent history of vaginal infection (VI) compared with NIVD-IUCD users [260 (88.1%) versus 151(43.4%); respectively] (P < 0.001). Current diagnosis of VI was significantly higher in IVD group (275; 91.05%) compared to NIVD group (115; 38.1%) (P < 0.001). Bacterial vaginosis was the most common infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infections were significantly more common in IVD.
Conclusion
The use of IUCD may not increase occurrence of vulvovaginitis, but IVD does increase vaginal infection rate either with or without IUCD use. When vaginal infection happens with IUCD, BV is the most common type of infection followed by Candida albicans.
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The Vaginal Microbiome in Health and Disease-What Role Do Common Intimate Hygiene Practices Play? Microorganisms 2023; 11:microorganisms11020298. [PMID: 36838262 PMCID: PMC9959050 DOI: 10.3390/microorganisms11020298] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 01/25/2023] Open
Abstract
The vaginal microbiome is a dynamic, sensitive microenvironment. The hallmark of a 'healthy' vaginal microbiome is currently believed to be one dominated by Lactobacillus spp., which acidifies the vaginal environment and help to protect against invading pathogens. However, a 'normal' microbiome is often difficult, if not impossible, to characterise given that it varies in response to numerous variables, including pregnancy, the menstrual cycle, contraceptive use, diet, ethnicity, and stress. A Lactobacillus-depleted microbiome has been linked to a variety of adverse vaginal health outcomes, including preterm birth (PTB), bacterial vaginosis (BV), and increased risk of sexually transmitted infections. The latter two of these have also been associated with feminine intimate hygiene practices, many of which are practised without any evidence of health benefits. The most extensively studied practice is vaginal douching, which is known to cause vaginal dysbiosis, predisposing women to BV, pelvic inflammatory disease, and PTB. However, little is known of the impact that intimate hygiene practices and associated products have on the vaginal microbiome. This review aims to outline the major factors influencing the vaginal microbiome and common vaginal infections, as well as to summarise current research surrounding the impact of hygiene products and practices on the vaginal microbiome.
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Murina F, Lubrano C, Cappelli E, Campo M, Taraborrelli S. The role of female intimate hygiene practices in the management of vulvovaginal candidiasis: A randomized, controlled open-label trial. Health Care Women Int 2022; 44:689-700. [PMID: 35759680 DOI: 10.1080/07399332.2022.2061972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this multicenter, observational, controlled open-label trial, researchers randomized 200 women with vulvovaginal candidiasis (VVC) to: Group 1, 6-days clotrimazole 2% vaginal cream once-daily plus 15-days concomitant acid pH thymol and zinc-containing cleansing wash (SaugellaActi3) twice-daily; Group 2, 6-days clotrimazole treatment alone. In both groups, pruritus and burning VAS scores improved from baseline at Days 6, 10 and 15. On Day 10 and Day 15, the pruritus score was significantly lower in Group 1 versus Group 2 (P <0.005 at both timepoints), suggesting acid pH thymol and zinc-containing cleansing wash ameliorates VVC-associated pruritus as part of a female hygiene regimen.
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Affiliation(s)
- Filippo Murina
- Lower Genital Tract Disease Unit, Obstetrics and Gynecology Department, V. Buzzi Hospital-University of the Study of Milan, Milan, Italy
| | - Chiara Lubrano
- Lower Genital Tract Disease Unit, Obstetrics and Gynecology Department, V. Buzzi Hospital-University of the Study of Milan, Milan, Italy
| | | | - Maria Campo
- Gynaecology and Obstetrics Hospital Unit, Giovanni Paolo II Hospital, Ragusa, Italy
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Witteman L, van Wietmarschen HA, van der Werf ET. Complementary Medicine and Self-Care Strategies in Women with (Recurrent) Urinary Tract and Vaginal Infections: A Cross-Sectional Study on Use and Perceived Effectiveness in The Netherlands. Antibiotics (Basel) 2021; 10:antibiotics10030250. [PMID: 33802263 PMCID: PMC8000599 DOI: 10.3390/antibiotics10030250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/01/2023] Open
Abstract
Due to the excessive use of antibiotic and antimycotic treatments, the risk of resistant microbes and fungi is rapidly emerging. Previous studies have demonstrated that many women with (recurrent) urinary tract infection (UTI) and/or vaginal infections (VIs) welcome alternative management approaches to reduce the use of antibiotics and antifungals and avoid short- and long-term adverse effects. This study aims to determine which complementary medicine (CM) and self-care strategies are being used by women suffering from (recurrent) UTI and VI in The Netherlands and how they perceive their effectiveness in order to define directions for future research on safety, cost-effectiveness, and implementation of best practices. A cross-sectional online survey was performed among women, ≥18 years old, with a history of UTIs; 162 respondents were included in the data analysis, with most participants aged between 50 and 64 years (36.4%). The women reported having consulted a CM practitioner for UTI-specific symptoms (23.5%) and VI-specific symptoms (13.6%). Consultations of homeopaths, acupuncturists, and herbal physicians are most often reported. Overall, 81.7% of the women suffering from UTI used complementary or self-care strategies besides regular treatment, and 68.7% reported using CM/self-care strategies to treat vaginal symptoms. UTI- related use of cranberries (51.9%), vitamin C (43.8%), and D-mannose (32.7%) were most reported. Perceived effectiveness was mostly reported for homeopathic remedies and D-mannose. The results showed a substantial burden of UTI and VI on daily and sexual activities. Besides the frequency of use, the indication of perceived effectiveness seems to be an important parameter for further and rigorously designed research to encourage nonantibiotic/antifungal treatment implementation into daily clinical practice.
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Abstract
ABSTRACT Bacterial vaginosis increases the risk of sexually transmitted infections, including HIV, and treatment is crucial to avoid complications. This article reviews the evidence-based options for treating bacterial vaginosis to improve patient outcomes.
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Affiliation(s)
- Kelly Ellington
- At the University of North Carolina in Wilmington, N.C., Kelly Ellington and Scott J. Saccomano are assistant professors
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Yaman Sözbir Ş, Erenoğlu R. Harmful traditional health practices used by Syrian refugee women in Turkey. EUR J CONTRACEP REPR 2020; 26:148-154. [PMID: 33025816 DOI: 10.1080/13625187.2020.1826427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this descriptive study was to determine the traditional health practices used by Syrian refugee women in Turkey. METHODS A survey was carried out among Syrian refugee women in the Turkish province of Hatay, which has experienced heavy immigration. The study sample consisted of 75 married Syrian women over the age of 18. Questionnaires were completed during face-to-face interviews and took approximately 60 min. RESULTS All the women (100%) reported using a traditional health method in pregnancy; almost all had used a traditional health method during childbirth and the postpartum period (both 98.7%), and to treat a vaginal infection (92.0%) and induce an abortion (93.3%); most used a traditional method of contraception (85.3%). CONCLUSION Some of the reported known and used methods are harmless or beneficial to women's health. Some, however, can negatively affect women's health in terms of infection, bleeding and toxicity. In order to eliminate potentially harmful traditional health practices, it is recommended that Syrian refugee women receive health education.
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Affiliation(s)
- Şengül Yaman Sözbir
- Department of Gynaecology and Obstetrics, Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Rabiye Erenoğlu
- Department of Gynaecology and Obstetrics, Department of Nursing, Faculty of Health Sciences, Hatay Mustafa Kemal University, Hatay, Turkey
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Abstract
Bacterial vaginosis recurrence is common but can lead to frequent bothersome symptoms associated with infection. This article reviews evidence-based options for practicing providers to improve patient outcomes. Bacterial vaginosis increases the risk of acquiring sexually transmitted infections, including HIV. Adequate treatment is essential to help avoid adverse patient outcomes.
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