Douching helps explain MEP disparities
In NHANES 2001–2004, frequent douching associated with 152% higher urinary MEP; Black women douched more and had higher MEP, linking a product-use pathway to exposure disparities.
Source
Vaginal douching and racial/ethnic disparities in phthalates exposures among reproductive-aged women: National Health and Nutrition Examination Survey 2001-2004
Study at a glance
- Design
- Cross-sectional — NHANES 2001–2004 feminine-hygiene use linked to urinary MEP and MnBP
- N
- N=739 · Final analytic sample 739 reproductive-aged women (805 with phthalates before race exclusions)
- Population
- Reproductive-aged US women in NHANES 2001–2004
- Outcome
- Urinary MEP (and MnBP) associated with douching frequency and race/ethnicity
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Douching helps explain MEP disparities
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
Were other feminine-hygiene products significantly linked to MEP/MnBP?
There were no other significant associations between the other feminine hygiene products and either MEP or MnBP although effect estimates were large for feminine spray, feminine powder, and other products.
Did Black women have higher metabolite concentrations?
Black women also had significantly higher geometric mean concentrations (ng/mL) of MEP and MnBP when compared to white or Mexican-American women
What they did
Reproductive-aged NHANES women reported feminine-hygiene product use; urinary MEP and MnBP were modeled by race/ethnicity and douching frequency.
What they found
37% of Black women douched in the past month vs 14% White and 10% Mexican-American; 20% vs 7% and 3% douched frequently. Past-month douching: 51.6% higher MEP; frequent use: 152.2% higher. Dose–response p-trend <0.001. Other products were not significant.
The limits
What it doesn't show
2001–2004 product formulations may differ from today; self-reported douching and spot urine cannot prove a single product brand caused the disparity.
Key terms
- MEP
- Monoethyl phthalate, a urinary metabolite of diethyl phthalate (DEP).
- MnBP
- Mono-n-butyl phthalate metabolite of DnBP.
- Vaginal douching
- Use of a vaginal rinse/douche product, a potential DEP source.
- NHANES
- US national health survey with biomonitoring.
- Exposure disparity
- Higher chemical body burden in one racial/ethnic group.
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Past-month douching among Black women was about:
Common questions
Who douched most?
Black women (37% past month; 20% frequent).
MEP after past-month douching?
51.6% higher vs non-users.
Frequent douching?
152.2% higher MEP.
Other products?
No significant MEP/MnBP links.
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