title: Factors linked to bacterial vaginosis in nonpregnant women.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Epidemiology, College of Human Medicine, Michigan State University, 4660 S. Hagadorn, East Lansing, MI 48823, USA. holzman@pilot.msu.edu
authors.forename: C
authors.initials: C
authors.lastname: Holzman
authors.forename: J M
authors.initials: JM
authors.lastname: Leventhal
authors.forename: H
authors.initials: H
authors.lastname: Qiu
authors.forename: N M
authors.initials: NM
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008824:Michigan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000706:statistics & numerical data; D016585:Vaginosis, Bacterial / Q000208:ethnology* / Q000209:etiology*