title: The effect of vaginal douching cessation on bacterial vaginosis: a pilot study.
abstract: OBJECTIVE
  The objective of the study was to evaluate the risk for bacterial vaginosis (BV) in a douching cessation trial.
  
  
  METHODS
  Thirty-nine reproductive-age women who reported use of douche products were enrolled into a 20-week study consisting of a 4 week douching observation (phase I) followed by 12-weeks of douching cessation (phase II). In phase III, participants then chose to resume douching or continue cessation for the remaining 4 weeks. Self-collected vaginal samples were obtained twice weekly in the first 16 weeks, and 1 sample was collected during week 20 (1107 samples total). BV was diagnosed by Nugent score of 7 or greater. Conditional logistic regression was used to evaluate douching cessation on the risk of BV.
  
  
  RESULTS
  The adjusted odds ratio (aOR) for BV in the douching cessation phase, as compared with the douching-observation phase was 0.76 (95% confidence interval [CI], 0.33 to 1.76). Among women who reported their primary reason for douching was to cleanse after menstruation, BV was significantly reduced in douching cessation (aOR:0.23; 95% CI, 0.12 to 0.44).
  
  
  CONCLUSIONS
  Vaginal douching cessation may reduce the risk for BV in a subset of women.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Brotman
authors.forename: Khalil G
authors.initials: KG
authors.lastname: Ghanem
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
authors.forename: Taha E
authors.initials: TE
authors.lastname: Taha
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Scharfstein
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Zenilman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010865:Pilot Projects; D012307:Risk Factors; D014621:Vagina / Q000382:microbiology*; D044364:Vaginal Douching / Q000009:adverse effects*; D016585:Vaginosis, Bacterial / Q000209:etiology* / Q000517:prevention & control*