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Background: Bacterial vaginosis (BV) is a common vaginal condition produced by overgrowth of anaerobic bacteria. Consequences of the condition may include preterm birth and pelvic inflammatory disease (PID). Because stress can suppress immune function, increased stress might increase the risk of BV. Our objective was to determine whether life stress was associated with risk of bacterial vaginosis in a cohort of nonpregnant women., Methods: A total of 411 African American women receiving routine gynecological care were recruited from two New York City hospitals. They were asked to rate the pressure they felt over the last week as a result of change, relationships, sickness, and finances using the Global Assessment of Recent Stress scale. An overall measure of stress was created by summing the responses over the categories. Stress was categorized into low, intermediate, and high tertiles. BV was diagnosed by gram stain score., Results: In almost all domains of life stress, women with high stress were more likely to have BV than those with low stress; however, none of the differences reached statistical significance. Thirty-four percent of women with BV had high overall stress as opposed to 26% of women without BV, giving an adjusted relative risk (RR) of 1.4 (95% confidence interval, 0.95, 2.1)., Conclusions: In a cohort of African American women in New York City, perceived life stress showed no clear association with BV. Because of the prevalence of both the exposure and the disease, further study is warranted.

Objective: Frequent vaginal douching has been associated with bacterial vaginosis. We investigated whether infrequent douching is also a risk factor for bacterial vaginosis., Methods: In this cross-sectional study, we recruited 411 African-American women of reproductive age who were visiting gynecologic or family planning clinics of 2 hospitals in New York City from 1999 to 2001. Detailed information on demographic characteristics, feminine hygiene practice, contraceptive use, and reproductive and medical history was collected through in-person interview. Pelvic examinations and laboratory tests on vaginal secretions were performed. Bacterial vaginosis was defined as Gram stain score of 7 or greater., Results: The overall prevalence of bacterial vaginosis in this population was 27%, similar to the national average. Water-vinegar solution was the most common douche. Although one half of the subjects reported douching regularly, only 2% douched frequently (once per week or more). Frequent douching in the past 3 months had a prevalence ratio of bacterial vaginosis of 2.35 (95% confidence interval 0.98-5.63). However, douching less than once per week was not associated with bacterial vaginosis., Conclusion: Douching less than once per week, particularly with a water-vinegar douche, is not associated with bacterial vaginosis in this African-American population., Level of Evidence: III