HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Holzman, C. Articles by Wang, J. Search for Related Content PubMed PubMed Citation Articles by Holzman, C. Articles by Wang, J.

Claudia Holzman, DVM, MPH, PhD, Judith M. Leventhal, PhD, Hong Qiu, MD, Nicole M. Jones, BS, Jenny Wang, MS and the BV Study Group

The authors are with the Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing. Members of the BV Study Group are listed in the Acknowledgments section.

Correspondence: Requests for reprints should be sent to Claudia Holzman, DVM, MPH, PhD, Department of Epidemiology, College of Human Medicine, Michigan State University, 4660 S Hagadorn, Suite 600, East Lansing, MI 48823 (e-mail: holzman{at}pilot.msu.edu).

Objectives. The purposes of this study were to test the hypothesis that vaginal douching is linked to bacterial vaginosis in both symptomatic and asymptomatic women and to identify other demographic, reproductive, and lifestyle factors associated with bacterial vaginosis.

Methods. In this cross-sectional study involving 3 clinic sites, 496 nonpregnant women completed a self-administered questionnaire. Their vaginal smears were assessed and cross-validated for bacterial vaginosis.

Results. The prevalence of bacterial vaginosis across clinics ranged from 15% to 30%. In analyses restricted to site 1, adjusted odds ratios (ORs) for bacterial vaginosis remained significant for African American women with 13 or fewer years of education (OR = 5.5, 95% confidence interval [CI] = 2.1, 14.5), hormone use within the past 6 months (OR = 0.5, 95% CI = 0.2, 0.8), and vaginal douching within the past 2 months (OR = 2.9, 95% CI = 1.5, 5.6).

Conclusions. Two lifestyle factors emerge as strongly associated with bacterial vaginosis: systemic contraceptives appear protective, whereas douching is linked to an increase in prevalence. The temporal relationship between douching and bacterial vaginosis needs further clarification.

This article has been cited by other articles:

				R. M. Brotman, M. A. Klebanoff, T. R. Nansel, W. W. Andrews, J. R. Schwebke, J. Zhang, K. F. Yu, J. M. Zenilman, and D. O. Scharfstein A Longitudinal Study of Vaginal Douching and Bacterial Vaginosis--A Marginal Structural Modeling Analysis Am. J. Epidemiol., July 15, 2008; 168(2): 188 - 196. [Abstract] [Full Text] [PDF]

				W E Josey and J R Schwebke The polymicrobial hypothesis of bacterial vaginosis causation: a reassessment Int J STD AIDS, March 1, 2008; 19(3): 152 - 154. [Abstract] [Full Text] [PDF]

				C. Holzman, X. Lin, P. Senagore, and H. Chung Histologic Chorioamnionitis and Preterm Delivery Am. J. Epidemiol., October 1, 2007; 166(7): 786 - 794. [Abstract] [Full Text] [PDF]

				Y. H. Neggers, T. R. Nansel, W. W. Andrews, J. R. Schwebke, K.-f. Yu, R. L. Goldenberg, and M. A. Klebanoff Dietary Intake of Selected Nutrients Affects Bacterial Vaginosis in Women J. Nutr., September 1, 2007; 137(9): 2128 - 2133. [Abstract] [Full Text] [PDF]

				L Brabin, S A Roberts, E Fairbrother, D Mandal, S P Higgins, S Chandiok, P Wood, G Barnard, and H C Kitchener Factors affecting vaginal pH levels among female adolescents attending genitourinary medicine clinics Sex Transm Inf, December 1, 2005; 81(6): 483 - 487. [Abstract] [Full Text] [PDF]

				L Morison, G Ekpo, B West, E Demba, P Mayaud, R Coleman, R Bailey, and G Walraven Bacterial vaginosis in relation to menstrual cycle, menstrual protection method, and sexual intercourse in rural Gambian women Sex Transm Inf, June 1, 2005; 81(3): 242 - 247. [Abstract] [Full Text] [PDF]

				R. B. Ness, S. L. Hillier, K. E. Kip, H. E. Richter, D. E. Soper, C. A. Stamm, J. A. McGregor, D. C. Bass, P. Rice, and R. L. Sweet Douching, Pelvic Inflammatory Disease, and Incident Gonococcal and Chlamydial Genital Infection in a Cohort of High-Risk Women Am. J. Epidemiol., January 15, 2005; 161(2): 186 - 195. [Abstract] [Full Text] [PDF]

				D. B. Nelson and G. Macones Bacterial Vaginosis in Pregnancy: Current Findings and Future Directions Epidemiol. Rev., December 1, 2002; 24(2): 102 - 108. [Full Text] [PDF]

				J. L. Martino and S. H. Vermund Vaginal Douching: Evidence for Risks or Benefits to Women's Health Epidemiol. Rev., December 1, 2002; 24(2): 109 - 124. [Full Text] [PDF]