Intravaginal washing causing fertility problems, say KNH medics

January 2022 theStar; A large number of women who practise douching, an unnecessary process that involves intravaginal washing, are struggling to conceive, medics at the Kenyatta National Hospital report.

The medics include gynaecologists and obstetricians who have been attending to clients at the hospital.

They studied 458 women who were struggling to conceive and saw them through 1,376 menstrual cycles and 255 pregnancies.

At enrolment, a third (161 of 458) of women reported vaginal washing with the majority using water only (73.9 per cent).

These clients, all HIV negative, reported no history of infertility and were followed prospectively for incident pregnancy for up to six months.

“After adjustment for age, frequency of unprotected intercourse and study site, vaginal washing in the prior four weeks was associated with a 29 per cent lower fecundability,” the authors report.

Fecundability is the probability of achieving a pregnancy within one menstrual cycle.

The medics said at each monthly visit, the women reported the first day of last menstrual period, sexual behaviour, vaginal washing behaviour, underwent pregnancy testing and provided vaginal swabs for detection of a change in the balance of bacteria in the birth canal.

The experts said while intravaginal washing might make you feel cleaner at the moment, it is probably useless and harmful.

“Vaginal washing has no known health benefits, and cessation may improve women’s likelihood of conceiving.”

They explained how it affects the body.

“Potential mechanisms include vaginal washing-associated changes in the vaginal microbiota, inflammation, disruption of cervical mucus and effects on sperm function,” they reported.

They include Anne Pulei from the Department of Obstetrics and Gynaecology of the University of Nairobi and the Kenyatta National Hospital.

Others are Brenda Oyaro, Prof Walter Jaoko and Scott McClelland from the UoN.

Maureen Nyaigero and John Kinuthia from the Kenyatta National Hospital; and Kishor Mandaliya and  Erica Lokken from the University of Washington, Seattle, also took part in the study.

Their study – titled “Vaginal washing behaviour and fecundability among Kenyan women in a prospective preconception cohort” – is published in the Paediatric and Perinatal Epidemiology journal.

There are few studies on intravaginal washing In Africa, although a past study by the World Health Organization – titled “A multi-country study on gender, sexuality and vaginal practices” – found that the practice is prevalent.

Those who practised said it makes them feel fresher, get rid of unpleasant smells, wash away menstrual blood after periods, and avoid getting sexually transmitted diseases.

However, medics say the practice is not effective for any of these purposes.

The magnitude of infertility in Kenya is not well established but past surveys show infertility cases comprise approximately 30 per cent of all gynaecological consultations at national referral hospitals.

past assessment by Dr Charles Ondieki showed 41 per cent of all infertility was due to female factors only, 16 per cent malefactors, 35.4 per cent combined factors and 6.3 per cent unexplained causes.

The majority of female infertility (55.6 per cent) was primary infertility compared to secondary infertility at 44.3 per cent.

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