title: Douching and sexually transmitted diseases in pregnant women in Surabaya, Indonesia.
abstract: OBJECTIVE
  Our purpose was to investigate the association between douching (douching agents and timing) and sexually transmitted disease.
  
  
  METHODS
  A cross-sectional survey of sexually transmitted diseases and habits of vaginal douching was performed on 599 pregnant women who visited a prenatal clinic in Surabaya, Indonesia.
  
  
  RESULTS
  Of the 599 pregnant women, 115 (19.2%) had at least one sexually transmitted disease (gonorrhea, chlamydia, syphilis, trichomoniasis, or herpes simplex virus-2). Most women had douched with water (19%) or water and soap (63%) at least once in the preceding month. Approximately 10% of the women had douched in the preceding month with a commercial agent (2%) or betel leaf (8%). Douching with water alone after sex was not associated with sexually transmitted disease. Douching with water and soap or with a betel leaf or commercial agent after sex was associated with sexually transmitted disease; adjusted odds ratios were 2.6 (95% confidence interval 1.0 to 7.1) and 2.7 (95% confidence interval 0.5 to 14.5), respectively. The association was enhanced if the women douched before sex or both before and after sex; adjusted odds ratio were 2.7 (95% confidence interval 1.0 to 7.3) for douching with water and soap and 5.2 (95% confidence interval 1.6 to 16.7) for douching with betel leaf or a commercial agent. Compared with women who never douched, women who always douched with betel leaf or a commercial agent had a substantially increased risk for sexually transmitted disease (adjusted odds ratio 9.4, 95% confidence interval 1.8 to 50.3).
  
  
  CONCLUSIONS
  We found a significant association between sexually transmitted disease and douching habits (douching with betel leaf, commercial agents, or water and soap). However, further prospective investigations are needed to evaluate the temporal relationship between douching and sexually transmitted disease.
authors.affiliation: Division of Sexually-Transmitted Disease/Human Immunodeficiency Virus Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Joesoef
authors.forename: H
authors.initials: H
authors.lastname: Sumampouw
authors.forename: M
authors.initials: M
authors.lastname: Linnan
authors.forename: S
authors.initials: S
authors.lastname: Schmid
authors.forename: A
authors.initials: A
authors.lastname: Idajadi
authors.forename: M E
authors.initials: ME
authors.lastname: St Louis
mesh_terms: D001114:Areca; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006558:Herpes Genitalis / Q000453:epidemiology; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D010946:Plants, Medicinal; D011247:Pregnancy; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012996:Solutions; D013587:Syphilis / Q000453:epidemiology; D007507:Therapeutic Irrigation / Q000009:adverse effects*; D014247:Trichomonas Vaginitis / Q000453:epidemiology; D014621:Vagina
chemical_list: D012996:Solutions