A scientific journey into cultural traditions and women's well-being
Imagine a health practice passed down through generations, woven into the cultural fabric of a community, yet viewed with skepticism by modern medicine. For many women in Suriname, vaginal steam baths with herbs are exactly that—a traditional ritual believed to cleanse, heal, and restore. But does this ancient practice increase the risk of sexually transmitted infections? A groundbreaking study from Suriname set out to find answers, uncovering a fascinating story where cultural tradition meets scientific inquiry.
In the diverse ethnic landscape of Suriname, a small country on the northeast coast of South America, vaginal herb use represents a deeply rooted cultural practice particularly among Afro-Surinamese women (Creoles and Maroons) 1 .
These practices serve multiple purposes beyond mere hygiene—women use herbal steam baths for "drying and tightening the vagina, cleansing after menstruation or after birth to prevent puerperal fever, 'placing the uterus back into position', or preventing a flabby abdominal wall" 1 .
For a typical herbal steam bath, "a woman sits with spread legs on a bucket or bidet containing warm water with certain herbs to steam her inner genital parts" 1 . The cooled-down bath may then be used to wash the genital parts after steaming.
This practice reflects a broader global pattern where women engage in various vaginal hygiene practices for reasons ranging from feeling clean and fresh to enhancing sexual pleasure and securing relationships with partners 1 .
In 2009-2010, researchers embarked on a cross-sectional study to examine whether vaginal herb use was associated with Chlamydia trachomatis infection 1 . The study recruited 1,040 women from two locations in Paramaribo, Suriname: the Dermatological Service (an STI clinic) and the Lobi Foundation (a family planning clinic) 1 .
Women aged 18 years and older were subsequently included, representing Suriname's major ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%), and mixed descent (19.7%) 1 .
Trained nurses conducted interviews using a structured questionnaire that asked about demographic characteristics, sexual behavior, STI history, and vaginal hygiene practices, including the use of herbs and other products 1 .
Nurses collected vaginal swabs that were stored and shipped to the Public Health Laboratory in Amsterdam, where they were tested for Chlamydia trachomatis using nucleic acid amplification testing (APTIMA CT) 1 .
Researchers used univariable and multivariable logistic regression analyses to identify determinants associated with both vaginal herb use and Chlamydia trachomatis infection 1 .
| Research Tool | Function in the Study |
|---|---|
| Structured questionnaire | Collected standardized data on demographics, sexual behavior, and vaginal practices |
| Vaginal swabs | Obtained samples from participants for pathogen testing |
| APTIMA CT test | Detected Chlamydia trachomatis rRNA via nucleic acid amplification |
| Nucleic acid amplification | Amplified genetic material for highly sensitive pathogen detection |
| Logistic regression analysis | Identified factors significantly associated with herb use and infection |
The study uncovered striking patterns in herb use across different ethnic groups. Vaginal herb use was most common among Maroon women (68.8%) and Creole women (25.2%), but far less frequent in other ethnic groups 1 .
Multivariable analysis focusing only on Maroon and Creole women identified several factors significantly associated with vaginal herb use 1 :
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Visualizing odds ratios for herb use determinants
The most surprising finding emerged when researchers examined the potential link between vaginal herb use and Chlamydia trachomatis infection. After controlling for various factors, the analysis revealed that vaginal herb use was not a significant determinant of Chlamydia trachomatis infection 1 .
Instead, other factors showed significant association with Chlamydia infection 1 :
Contrary to initial hypotheses, traditional vaginal herb use did not increase the risk of Chlamydia infection among the studied population.
The study's findings challenge common assumptions about vaginal practices. While previous research had suggested that certain intravaginal practices might increase STI risk by disrupting the vaginal microbiome or causing epithelial damage 1 , this large-scale study found no such link between vaginal herb use and Chlamydia trachomatis infection.
It's worth noting that the researchers acknowledged several limitations—they "did not assess if vaginal herbs were used intravaginally and/or externally" and "did not study the effect of vaginal herb use on the vaginal microbiota" 1 .
This highlights the complexity of studying traditional health practices and the need for more nuanced research approaches.
The findings take on additional significance considering the known ethnic variations in vaginal microbiome composition 6 .
Future research exploring how specific herbal practices interact with individual vaginal ecosystems could yield more personalized insights into women's health.
The Suriname study represents just the beginning of understanding the complex relationship between cultural practices and women's health. The researchers explicitly called for future studies to "focus on the effect of herb use on the vaginal microbiome and mucosal barrier" 1 .
This direction seems particularly promising given what we now know about how vaginal microbiome composition varies among ethnic groups 6 , and how these differences might interact with traditional practices. Future research might explore:
What makes this research particularly compelling is its respect for traditional knowledge while applying rigorous scientific methods—a combination that may ultimately lead to more culturally sensitive and effective women's healthcare approaches worldwide.
The journey to understand the complex relationship between cultural traditions and health continues, but this study has undoubtedly moved the scientific conversation forward in a meaningful direction.