Connecting the dots: Exploring the relationship between menstrual hygiene and bacterial vaginosis in eastern India

Menstruation is a normal physiological event that takes place in a rhythmic fashion during the reproductive period of a woman. Menstrual hygiene management (MHM) practices differ and depend on the individual's socioeconomic status, local traditions and beliefs, and access to water and sanitation resources. Insufficient and incorrect information regarding menstruation and lack of knowledge and awareness leads to poor personal hygienic practices, which further leads to many infections. Bacterial vaginosis, the most common RTI, is characterized by an alteration in the vaginal micro biome with a decline in hydrogen peroxide producing Lactobacillus colonization and an overgrowth of facultative anaerobic bacteria like Gardnerella spp., Mobiluncus spp., etc.

The primary objective of the study was to find out the association of bacterial vaginosis with menstrual hygiene practices. The secondary objective was to determine the prevalence of bacterial vaginosis among patients presenting with vaginal discharge to the outpatient department of a tertiary care hospital.

Women in the reproductive age group 18-45 years having regular menstrual cycles were included in the study. Participants were enquired for sociodemographic data, menstrual hygiene practices and symptoms of abnormal vaginal discharge. High vaginal swab was collected for the symptomatic patients and sent to investigate for presence of bacterial vaginosis.

The prevalence of BV was found to be 13% among symptomatic patients presenting with abnormal vaginal discharge. Apart from abnormal discharge, itching and burning sensation was also seen to have a positive association with bacterial vaginosis (p < 0.001). The women who used clothes as absorbent were more prone to develop BV than women using sanitary pad. The other parameters to have positive association with BV were decreased frequency of taking body bath. Unsatisfactory sanitation of latrine was found to be strongly associated with BV after adjusting for confounders.

In conclusion, the result of this study provided a strong association between poor MHM practices with BV.