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O04.2 Effects of over-the-counter lactic acid-containing vaginal douching products on the vaginal microbiota
  1. Charlotte Van Der Veer1,
  2. Sylvia Bruisten1,
  3. Robin Van Houdt2,
  4. Juul Rutten1,
  5. Amy Matser1,
  6. Janneke Van De Wijgert3,
  7. Henry De Vries4,
  8. Jannie Van Der Helm5
  1. 1Public Health Service, Ggd, Department Infectious Diseases, Amsterdam, The Netherlands
  2. 2Vu University Medical Centre, Amsterdam, The Netherlands
  3. 3University of Liverpool, Liverpool, UK
  4. 4Sexually Transmitted Infections Outpatient Clinic, Amsterdam, The Netherlands
  5. 5National Institute for Public Health and The Environment, Bilthoven, The Netherlands


Introduction Of female visitors to the STI clinic in Amsterdam, 31% report use of vaginal cleansing products (including douches). Vaginal douching may negatively affect vaginal microbiota compositions (VM). We report the effect of intra-vaginal douching on the VM in a prospective study.

Methods Through advertisements, we recruited 25 healthy women, aged 18–36 years, from 2015–2016. Participants were followed over 3 menstrual cycles and were instructed to use an intra-vaginal lactic-acid-containing douche 3 times a week during the 2nd cycle. Participants self-collected a median of 68 [IQR: 64–68] vaginal swabs. Baseline characteristics were collected through questionnaires. All participants kept a daily diary in which they reported douching, menstruation, sexual activity, etc. VM were assessed by 16S rRNA (V3-V4 region) sequencing. Associations between douching and VM were assessed by multivariable logistic regression, using generalised estimating equations to account for multiple observations within the same individual.

Results As of December 2016, a median of 42 [IQR:40–44] vaginal swabs from 10/25 women were analysed. These 10 women had a median age of 25 years [IQR: 21.8–29.3], 9 women were Dutch-Caucasian, 9 used hormonal contraceptives and all were highly educated. At baseline, 8 women had lactobacilli-dominated VM (Lactobacillus crispatus (n=6), L. iners (n=1) or L. iners/L. jensenii (n=1)) and 2 women had polybacterial Gardnerella vaginalis-containing VM (GV-VM). The latter 2 women continued to have GV-VM throughout the study period. The VMs of 2 women, dominated either by L. crispatus or L. iners at baseline, shifted to GV-VM during the 2nd cycle, which persisted in the 3rd cycle. Having GV-VM was more likely in the 2nd and 3rd cycle, compared to the 1 st cycle, after adjusting for sex and menses (odds ratio (OR)=1.7 (95% CI: 0.9–3.1) and OR=2.1 (95% CI: 0.7–6.1), respectively), though not statistically significanctly so.

Conclusion Our interim analyses suggest that regular intra-vaginal douching may promote a shift from lactobacilli-dominated VM to GV-VM.

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