INTERNAL VAGINAL DOUCHING INCREASES THE RATE OF VAGINAL INFECTION IN INTRAUTERINE CONTRACEPTIVE DEVICE USERS: A CROSS SECTIONAL STUDY

Abstract

To compare the frequency, type, and severity of vulvovaginitis in women who are performing vaginal douching (VD) or not while using an intrauterine contraceptive device (IUCD). This study was a cross-sectional study conducted on 604 consecutive IUCD users presented to an outpatient clinic in a tertiary hospital in Egypt. They should have been using the cupper IUCD for at least 6 months before recruitment. Women were stratified into two groups according to if they were performing internal VD or not. Group I (302 women) performing internal VD and Group II(302 women)not practicing this habit (NVD). The primary outcome of the study was to compare the frequency of vaginal infections in IUCD users who perform VD compared to women who were abstaining from this habit. Secondary outcomes included the type and severity of infection in both groups. Women who were using IUCD and performing internal VD had a past history of more frequent episodes of vaginal infection compared with NVD IUCD users {260 (88.1%) versus 151(43.4%); respectively} (P<0.001). Current vaginal infection was significantly higher in VD (275; 91.05%) compared to NVD (115; 38.1%) (P<0.001). Bacterial vaginosis was the most common clinical detected type of infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infection were significantly more common in VD versus NVD groups (p<0.001). Internal VD while using IUCD is associated with a higher risk of vulvovaginal infections. In these women bacterial vaginosis is more common than candida vulvovaginitis.