A new study has found that intimate vaginal products are commonly used for cleansing or during sex by two thirds of a racially and ethnically diverse group of sexually active women in Los Angeles. However, it also found that the practice is associated with an increased risk of a vaginal infection. Of particular concern is that the investigators found that women who use petroleum jelly intravaginally are more than twice as likely to develop a bacterial vaginal infection (bacterial vaginosis) than women who do not. Researchers affiliated with the University of California and the AIDS Research Alliance of America, Los Angeles, and the University of California, San Francisco, San Francisco reported their findings online on March 6 in the journal Obstetrics & Gynecology. It also will appear in the April print edition of the journal.
The objective of the study was to measure intravaginal practices among women of differing ages, ethnicities, and human immunodeficiency virus (HIV) status and the association between
intravaginal practices and bacterial vaginosis and candidiasis (yeast) infection. Between 2008 and 2010, the investigators recruited and followed sexually active women aged 18–65 years living in Los Angeles. The study group comprised 141 women. At the enrollment and the 12 month visit, the women completed a self-administered, computer-assisted questionnaire covering demographics, sexual behaviors, vaginal symptoms, and intravaginal practices over the past month. At each visit, bacterial vaginosis was diagnosed by Nugent criteria and candidiasis infection was diagnosed by DNA probe. The Nugent criteria is assessed by a microscopic examination of a stained slide from vaginal secretions.
The researchers found that two thirds (66%) of the womenreported an intravaginal practice over the past month; 49% reported insertion of an intravaginal product (other than tampons) and 45% reported intravaginal washing. The most commonly reported practices included insertion
of commercial sexual lubricants (70%), petroleum jelly (17%), and oils (13%). An analysis of the responses found that use of oils was associated with Candida species colonization (yeast infection; 44.4% compared with 5%). In a multivariable analysis (an analysis evaluating multiple factors and comparing them), women who reported intravaginal use of petroleum jelly over the past month were 2.2 times more likely to test positive for bacterial vaginosis (2.2-fold increased risk).
The authors concluded that intravaginal insertion of over-the-counter products is common among women in the United States and is associated with increased risk of bacterial vaginosis. They noted that the context, motivations for, and effects of intravaginal
products and practices on vaginal health are of concern and warrant further study.
Take home message:
This study notes that petroleum jelly is a poor choice as a vaginal lubricant. In addition, petroleum jelly is messy and can stain clothing and bedding. Water soluble products designed specifically as a vaginal lubricant are safer and more aesthetically pleasing. These products offer a benefit to women who do not produce adequate lubrication. Engaging in intercourse without adequate lubrication can result in chafing, which carries a risk of developing bacterial vaginosis. In general, douching is not necessary. It can wash out the normal vaginal flora and provide an opportunity for harmful bacteria or yeast organisms to become established. The vagina possesses an intrinsic ability to cleanse itself.