Objective: To review reports on the use and effects of traditional intravaginal substances and practices.
Method: The medical and social science literature of the past 50 years regarding use and effects of traditional intravaginal substances and practices is reviewed.
Results: Traditional intravaginal practices have been described in 11 countries of sub-Saharan Africa, and also in Qatar, Indonesia, Thailand, Haiti, the Dominican Republic, and the United States. Women's reasons for the practices include personal hygiene, disease prevention or treatment, and enhancement of sexual experience. Few studies document damage to the vaginal epithelium or changes in vaginal flora due to these practices. No prospective studies link these practices to disease transmission.
Conclusion: The determination of how these practices affect disease transmission will require precise definition of independent variables, which is difficult because of the diversity of the practices. It is appropriate to search for intervening variables; specifically, the effects on the vaginal pH, flora, and epithelium.