Vulvovaginal symptoms and intimate hygiene behaviors of Brazilian women: a cross-sectional study

Imbalances in the vaginal microbiome influenced by women’s health behaviors, particularly intimate hygiene practices, can lead to vulvovaginal symptoms. Understanding women’s health behaviors, particularly intimate hygiene practices, is fundamental to identifying modifiable factors related to these symptoms. The aim of this study is to identify the intimate hygiene practices of Brazilian women and their association with vulvovaginal symptoms. This cross-sectional study was conducted from November 2023 to November 2024 at the Federal University of São Carlos (UFSCar). Women aged ≥ 18 years who resided in Brazil and completed a structured online questionnaire assessing sociodemographic variables, intimate hygiene practices, and the Brazilian version of the Vulvovaginal Symptoms Questionnaire (VSQ-Br) were included in the study. Descriptive statistics were used for participants’ characterization. A linear regression model was used to evaluate associations between intimate hygiene behaviors (binary independent variable) and vulvovaginal symptoms (continuous dependent variable), assessed by the total score and domains of the VSQ-Br (symptoms, impact on emotions, impact on activities of daily living, and impact on sexual activity). Analyses were conducted using Jamovi. A total of 2,574 women participated. The most frequent symptom was vaginal discharge, reported by 44.6% of participants. Use of homemade solutions, anti-itch creams, vaginal deodorants, foams, and body perfumes was associated with higher VSQ-Br scores, while intimate soap was linked to lower scores. Not changing panties daily and using disposable external pads were associated with higher vulvovaginal symptom scores, while changing panties at least once a day showed minor improvements in emotional, daily, and sexual health. Most Brazilian women use some type of feminine hygiene product. Statistically significant associations were observed between hygiene practices and vulvovaginal symptoms occurrence, but it is fundamental to highlight that many of the observed practices may reflect reactive behaviors to alleviate existing symptoms, rather than being causal factors.