Douching or Perineal Talc Use and Prevalent Fibroids in Young African American Women

Background: Black women are at an increased risk of developing fibroids, but the cause is unclear. Douching and perineal talc use are common lifestyle exposures among Black women, and may be risk factors for fibroid development. Materials and Methods: This cross-sectional study consisted of Black women 23-35 years of age in the metropolitan Detroit area (n = 1693) without prior diagnoses of fibroids and intact uteri. Main exposures were ever douching (yes/no) and any perineal talc use (ever/never). Main outcomes were prevalent fibroids at baseline (yes/no) and total fibroid volume at baseline (no fibroids/<median total volume (2.00 cm³)/≥median total volume). We used log binomial regression to estimate prevalence ratios (PRs) and confidence intervals (95% CI) for fibroid prevalence and multinomial logistic regression to estimate odds ratios (ORs) and 95% CI for total fibroid volume. Result(s): Fibroid prevalence was 23%. Forty-three percent of women reported ever douching and 15% reported ever using perineal talc. We did not observe an association between ever douching and fibroid prevalence [PR (95% CI):1.05 (0.89-1.23)] or total fibroid volume [OR (95% CI) ≤2:00 cm³: 1.04 (0.66-1.42)] and [OR (95% CI) ≥2:00 cm³: 1.06 (0.77-1.44)]. Women who ever used perineal talc had an increased prevalence of fibroids [PR (95% CI): 1.19 (0.97-1.46)]. This association was seen with both large and small total fibroid volume [OR (95% CI) volume ≤2:00 cm³: 1.23 (0.81-1.86)] and [OR (95% CI) volume ≥2:00 cm³: 1.39 (0.93-2.09)]. Conclusion(s): Our results suggest that perineal talc use is associated with increased fibroid prevalence. Additional research is warranted to investigate perineal talc in relation to fibroid risk in a prospective setting and to conduct laboratory work on potential tumorigenic effects of talc in the myometrium.