Genital HPV linked to vaginal douching
Women who reported vaginal douching within the previous 6 months showed a greater risk for genital HPV, according to a study of national survey data.
Although douching raised women’s risk for all HPV types by approximately 25%, the chance of infection with high-risk HPV types was further increased by 40%, according to Thanh Cong Bui, DrPH, MD, instructor in the University of Texas MD Anderson Cancer Center’s behavioral science department, and colleagues.
“Douching has been suggested to be associated with adverse health outcomes, including sexually transmitted bacterial infections and cervical cancer,” the researchers wrote. “Very few studies have examined the association between douching and cervicovaginal HPV infection, and those that have investigated this association have found contrary results.”
It is unclear whether douching’s disruption of the vaginal microenvironment may facilitate HPV acquisition or clear transmitted infection, Bui and colleagues wrote. To investigate, the researchers reviewed data from 1,271 women aged 20 to 49 years who participated in the 2003-2004 U.S. National Health and Nutrition Examination Survey. Specifically, they examined sociodemographic factors, feminine hygiene product use and sexual behaviors reported by the women, and conducted statistical analyses to compare these variables with HPV test results recorded for each participant.
Twenty-three percent of participating women reported vaginal douching within the previous 6 months, Bui and colleagues wrote, and the weighted prevalence of genital HPV was 48.6%. When excluding women with HPV types 6 and 11, 40.5% harbored one high-risk type, 16.2% harbored two and 9.1% harbored three to six high-risk types.
In bivariate analysis, douching within the previous 6 months was associated with an increased number of HPV types infected (relative RR = 1.26; 95% CI, 1.03-1.54), as well as a greater number of high-risk HPV types (relative RR = 1.4; 95% CI, 1.09-1.8). Other characteristics — such as cigarette smoking, greater frequency of sexual partners, use of additional hygiene products, age, race, education and other recent vaginal problems — also were related to infection prevalence, but did not significantly confound the association between douching and HPV.
“Despite the inconsistent association between douching and HPV infection in the literature, this analysis in the U.S. general population revealed that douching was associated with an increased number of HPV types infected,” the researchers wrote. “Further studies, particularly longitudinal ones, are needed to determine whether specific types of douching or specific solutions actually increase the risk of HPV infection and persistence.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.