Vaginal Product Use Common, Linked to Vaginosis

Karyn Hede

March 07, 2013

Although use of intimate vaginal products for cleansing or during sex is thought to be common among American women, little research has been done on the association between use of these products and rates of infection. One of the first community-based studies, published online March 6 and in the April issue of Obstetrics & Gynecology, now shows that two thirds of a racially and ethnically diverse group of sexually active women in Los Angeles, California, regularly use such products.

Of particular concern is that the researchers found that women who use petroleum jelly intravaginally are more than twice as likely to develop bacterial vaginosis as those who do not.

The prospective cohort study followed-up 144 women of diverse ages (median age, 32 years) and ethnicities for 1 year between 2008 and 2010, obtaining information on sexual behaviors, intravaginal practices, contraceptive use, and vaginal symptoms via a self-administered computerized questionnaire.

The study participants, who were recruited by the Los Angeles–based AIDS Research Alliance staff at women's health clinics and community-based HIV testing sites in Los Angeles, also received testing for HIV, herpes virus, and vaginal yeast and bacterial infection. Women who tested positive received referrals for counseling and/or treatment.

The survey revealed that nearly half (49%; 95% confidence interval, 40.4% - 57.5%) of women reported inserting an over-the-counter product (other than tampons) into their vagina within the previous month.

Petroleum jelly and sexual lubricants were the most commonly reported products used. Among ethnic groups, black women were more likely to report using petroleum jelly (33.3%) compared with Caucasian women (13.9%) or Latina women (7.7%). The research team found that women who used petroleum jelly during the past month were 2.2 times more likely to test positive for bacterial vaginosis than women who did not use petroleum jelly (adjusted relative risk, 2.2; 95% confidence interval, 1.3 - 3.9; P < .01), providing cause for health concern.

The Centers for Disease Control and Prevention report that 21.2 million women between the ages of 14 and 49 years have bacterial vaginosis, according to a nationally representative sample of women who participated in the National Health and Nutrition Examination Survey. Because women with bacterial vaginosis are at greater risk of developing additional health concerns, such as pelvic inflammatory disease, sexually transmitted infections, and HIV, the researchers suggest increasing public health education efforts to reduce use of products that may cause damage to the vaginal lining, increase vaginal pH, and encourage bacterial growth.

The study was funded by the California HIV/AIDS Research Program and the University of California, Los Angeles, AIDS Institute. The authors have disclosed no relevant financial relationships.

Obstet Gynecol. 2013;121:4:773-780. Abstract