Vaginal douching in adolescents attending a family planning clinic

Background: One of the variables most consistently associated with vaginal douching is race, with African-American women douching more regularly. Sparse data exists in the medical literature about the practice of vaginal douching among adolescents. The purpose of this study was to assess the prevalence, knowledge, attitude, and practices of vaginal douching among adolescent females attending a public family planning clinic, and determine whether African-American (AA) females douche to a greater degree than Caucasian females. Methods: In this cross-sectional study, a one-page questionnaire was administered to all adolescent females ( 19 years of age) presenting to a public family planning clinic in a small southern city. Participant charts were abstracted for demographic and clinical information. Chi-square analysis, Pearsonʹs correlation coefficient, and odds ratio were used in data analysis conducted in SPSS for Windows software. Results: Of the 169 participants, the mean age was 17.0 years (±1.5 years), 53% were Caucasian, 47% were AA, and 74% were nulliparous. Sixty-nine percent of participants reported vaginal douching, mostly for hygienic reasons (68%). Those reporting vaginal douching were more likely to have a history of one or more sexually transmitted diseases (O.R. 3.7, 95% C.I. 1.5–9.0, p < 0.01). Age of first douche correlated positively with age of first sexual intercourse (r = 0.34, p < 0.001). African-Americans did not douche to a greater degree than Caucasians. Among those who douched, AA females were more likely than Caucasians to believe that the reason women douche was after a period (p < 0.01) and after sex (p < 0.05), and to agree that douching clears up a discharge (p < 0.05) and odor (p < 0.01) from the vagina. Caucasians were more likely than AA to believe that some discharge from the vagina is normal (p < 0.05), and most women never need to douche (p < 0.01). Conclusions: Vaginal douching was a common practice among adolescent females attending a public family planning clinic in a small southern city, and racial differences were noted in knowledge of and attitude toward vaginal douching. This suggests development of a culturally-based educational program to convince AA and Caucasian adolescent females to cease vaginal douching.