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Use Of Panty Liner As A Risk Factor The Occurration Of Abnormal Vaginal Discharge

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p>Vaginal discharge or fluor albus is a problem that is often found in women. Daily use of panty liner is a predisposing factor of pathological/abnormal vaginal discharge. This paper reviews the correlation between the use of panty liner and vaginal discharge. The aims of this study were to analyze the effect of daily panty liner use as a risk factor of vaginal discharge. This research is done by using the cross-sectional method. The study population is students of the University of Pelita Harapan in the Faculty of Nursery. Sample size calculation was done using the categorical comparative analytical formula and a result of 46 samples were obtained for each population. A questionnaire was used in this research. Statistical analysis is done by using the SPSS 22.0 program with the Chi-Square method. Bivariate analysis on 92 respondents revealed that there is a significant association between the usage of a panty liner and abnormal vaginal discharge (p-value <0.05). Based on bivariate analysis panty liner material is not related to abnormal vaginal discharge (p-value >0.05).</p
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CLINICAL ARTICLE
27| U n i v e r s i t y o f P e l i t a H a r a p an
Use Of Panty Liner As A Risk Factor The Occurration Of Abnormal
Vaginal Discharge
Leviana Aurellia1, Julita Nainggolan2
1 Medicine Faculty of Pelita Harapan University
2Department of Obstetrics & Gynecology, Medicine Faculty of Pelita Harapan University
Citation : Leviana Aurellia, Julita Nainggolan.
Use Of Panty Liner As A Risk Factor
The Occurration Of Abnormal Vaginal Discharge
Medicinus. 2021 February; 9(1): 27-32
Keywords: panty liner; vaginal discharge; fluor
albus
*Correspondance : Julita Nainggolan,
Departement of Obstetrics & Gynecology,
Medicine Faculty of Pelita Harapan University.
E-mail : julita.nainggolan@uph.edu
Online First : September 2021
Abstract
Vaginal discharge or fluor albus is a problem that is often found in women.
Daily use of panty liner is a predisposing factor of pathological/ abnormal
vaginal discharge. This paper reviews the correlation between the use of
panty liner and vaginal discharge. The aims of this study were to analyze
the effect of daily panty liner use as a risk factor of vaginal discharge. This
research is done by using cross-sectional method. Study population is
students of University of Pelita Harapan in Faculty of Nursery. Sample size
calculation was done using the categorical comparative analytical formula
and a result 46 samples were obtained for each population. Questionnaire
was used in this research. Statistical analysis is done by using the SPSS
22.0 program with Chi Square method. Bivariate analysis on 92
respondents revealed that there is a significant association between the
usage of panty liner and abnormal vaginal discharge (p value <0.05).
Based on bivariate analysis panty liner material is not related to abnormal
vaginal discharge (p value >0.05).
Introduction
One of the factors that affect health
problems in the female reproductive organs
is abnormal vaginal discharge. Discharge
that comes from a woman's genitalia
outside the menstrual period and is not in
the form of blood is called vaginal discharge
or fluor albus.1 Vaginal discharge can be
both physiological and pathological. Vaginal
discharge is said to be physiological if it is
odorless, colorless/ whitish, and does not
feel itchy. A vaginal discharge is said to be
pathological if the discharge becomes
yellowish, itchy, and foul-smelling.2 Women
of all ages can experience vaginal
discharge-.Women aged 15-24 years
experienced vaginal discharge as much as
3l.8% according to a survey conducted by
the Indonesian Adolescent Reproductive
Health Survey (SKRRI). Based on the
results of research on women's reproductive
health, 75% of women in the world have
experienced vaginal discharge and 45% of
them experience recurrent vaginal
discharge.2 The prevalence of vaginal
discharge often increased, in 2002, 50% of
women experienced vaginal discharge. In
2003 this figure increased to 60% and to
70% in 2004.3 This increase in percentage
was due to the tropical climate in Indonesia.
This condition causes the feminine area to
become moist so that the fungus can easily
develop and cause vaginal discharge.4
Abnormal vaginal discharge can be caused
by infection or non-infection. Non-infectious
causes that can cause vaginal discharge
Leviana Aurellia
28| U n i v e r s i t y o f P e l i t a H a r a p a n
include abnormalities of the reproductive
organs that can be caused by tumors or
malignancy. There are also factors that
trigger vaginal discharge, such as diabetes,
urinary tract infections, use of contraceptive
pills and use of panty liners.5, 6
Indonesian women still think that the use of
panty liners can protect their feminine area.7
In fact, the use of panty liners can make the
use of panty liners moist and can cause
vaginal discharge. Based on research by
Farage (2007), 10-30% of women in North
America and Western Europe always use
panty liners outside of their menstrual
period, this is based on their desire to keep
their female area clean and dry.8 However,
there is no data that states the percentage
of panty liner users in Indonesia. The panty
liner does not have a significant difference
with ordinary pads, what distinguishes the
two is the size of the panty liner which is
thinner than ordinary pads.9 In addition,
according to research by Farage (2007), the
use of panty liners can reduce the number
of Lactobacillus species which are normal
flora in the vagina, and can increase the
number of bad bacteria in the vagina,
namely Eubacterium species. The use of
panty liners can also cause intestinal flora
such as Eschericia coli to enter the vagina.9
Research that has been conducted at the
Faculty of Medicine, University of Andalas
Padang (UNAND) and Aisyiyah University
Yogyakarta, the use of panty liners can
trigger vaginal discharge. It is stated that
there is a relationship between the use of
panty liners and the incidence of vaginal
discharge (69.2%).10 The results of research
conducted by Aisyiyah University Health
Sciences Yogyakarta also showed 56% of
women who use panty liners experience
vaginal discharge.6 According to the
International Journal of Gynecology &
Obstetrics, from four studies on the use of
panty liners, there was no effect on the
appearance of vaginal discharge, only one
study supported the influence between the
use of panty liners and vaginal discharge.11
Another journal research conducted by the
International Journal of Gynecology &
Obstetrics, also stated that 95% of women
who use panty liners do not experience
problems with vaginal discharge.12 There
are still pro and contra regarding this
problem, so further research is needed to
prove the effect between the two.
Research Design and Sample
This research was conducted with a
quantitative analytic research type with
cross sectional method with case control.
The sample size estimation of this study
was calculated using unpaired categorical
comparative analytic method. The total
sample required in this study was 92
people.
In this study, samples that use panty liners
and those who do not use panty liners are
needed. The inclusion criteria in this study
included female students of the Faculty of
Nursing, Pelita Harapan University, 18-25
years. Subjects with Diabetes Mellitus and
organic reproductive organ disorders
(uterine tumors) were excluded.
Data and Statistical Analysis
Data obtained using primary data, where
data is taken directly through questionnaires
The data obtained from the study will be
tabulated and analyzed.data tabulation will
be performed using Microsoft Excel 2010
program and data analysis will be
performed using SPSS 22.0 program.
Statistical tests are conducted to prove the
hypothesis. The method used for normal
distribution is Chi2. The method for
abnormal distribution will be analyzed using
Fisher's Test
Leviana Aurellia
29| U n i v e r s i t y o f P e l i t a H a r a p an
Results and Discussion
Characteristics of Research Subjects:
Table 1. Age Distribution in the Panty Liner User Group
The age distribution in the majority of panty
liner users is 20 years old, as many as 22
people. Then followed by the age of 19
years, totaling 11 people. A total of ten
respondents were 2l years old and there
were three respondents who were 18 years
old. There were no respondents aged 22
years who used panty liners (Table 1).
Table 2. Age Distribution in the Non-Panty Liner User Group
Age
(n=46)
Percentage (%)
18 Years
2
4
19 Years
18
40
20 Years
16
35
21 Years
8
17
22 Years
2
4
For the age distribution in the non-wearing
panty liner group, it was found that the
majority of respondents were 19 years old
as many as 18 respondents. 16
respondents aged 20 years and eight
respondents aged 2l years. There are two
respondents aged 18 years and also two
respondents aged 22 years (Table 2).
Table 3. Results of Bivariate Analysis of Pantv Liner and Abnormal Vaginal Discharge
Age
(n=46)
Percentage (%)
18 years
3
6
19 years
11
24
20 years
22
48
21 years
10
22
22 years
0
0
No
Abnormal
Vaginal
Discharge
%
Abnormal
Vaginal
Discharge
(n)
%
Total
(n)
%
OR (95%CI)
P value
Non-
panty
liner
35
76.1%
11
23.9%
46
100%
5.428 (2.198-
13.450)
0.001
Panty
liner
17
37%
29
63%
46
100%
Total
52
56.5%
40
43.5%
92
100%
Leviana Aurellia
30| U n i v e r s i t y o f P e l i t a H a r a p a n
Data from research results that have been
statistically tested with Chi Square, obtained
a P value of 0.001 where the P value is less
than 0.05. This has a positive meaning, so it
can be concluded that the use of panty
liners can be a risk factor for abnormal
vaginal discharge (Table 3).
Table 4. Comparison of The Incidence of Abnormal Vaginal Discharge for The Non-users &
Users of Panty Liner
n
Abnormal Vaginal
Discharge
%
Non-Panty Liner
46
11
24%
Panty Liner
46
29
76%
Based on table 4, regarding the comparison
of the incidence rate of vaginal discharge in
panty liner users and those who do not use
panty liner, it is found that the number of
abnormal vaginal discharge in panty liner
users are 29 respondents and 11
respondents in non-panty liner users.
Respondents without abnormal discharge in
non-panty liners more than those with panty
liners as many as 35 respondents. A total of
17 respondents did not have abnormal
vaginal discharge even when using panty
liners.
Table 5. Data Distribution in Antiseptic & Non Antiseptic Panty Liner User
Jenis Panty Liner
Total
Antiseptic
Non-Antiseptic
n
%
n
%
Panty liner
2
4.2%
44
95.8%
46
Two respondents used panty liners
containing antiseptic and 44 respondents
used panty liners without antiseptics (Table
5).
Table 6. Bivariate Analysis of Panty Liner Types and Abnormal Vaginal Discharge
Abnormal Vaginal Discharge
P value
Yes (n)
Percentage
(%)
No (n)
Percentage
(%)
Total
Types of
Panty
Liner
Antiseptic
1
3%
1
6%
2
Non-
antiseptic
28
97%
16
94%
44
Total
29
100%
17
100%
46
0.614
From the results of the bivariate analysis in
table 6, 28 respondents experienced
abnormal vaginal discharge when using
non-antiseptic panty liners and 16
respondents did not experience abnormal
vaginal discharge when wearing non-
antiseptic panty liners. There is one
respondent who has vaginal discharge
when wearing an antiseptic panty liner but
another respondent does not have vaginal
discharge when using an antiseptic panty
liner. The p-value for non-antiseptic-based
panty liners was 0.608. The p value for
panty liner containing antiseptic is 0.709.
The total p-value is 0.614. It can be
concluded that the type of panty liner is not
a risk factor that affects vaginal discharge
Leviana Aurellia
31| U n i v e r s i t y o f P e l i t a H a r a p an
because the p value is not significant (p
value> 0.05).
In this study, there is a relationship between
the used of panty liners on the risk of
abnormal vaginal discharge. Using panty
liners increased the risk of abnormal vaginal
discharge five times compared to those who
did not use panty liners. Types of panty
liners that contain antiseptic or not contain
antiseptic; does not have a significant
relationship with vaginal discharge. The use
of panty liners has a significant effect on the
risk of vaginal discharge with a bivariate
analysis value (p value 0.001; OR 5.428).
Too often use panty liners can trigger
vaginal discharge because it can make the
feminine area becomes moist. Based on
research conducted by Runeman et al in
2003, the use of panty liners raises the
temperature of 1.50C in the vulvar area and
can also increase the pH by 0.6.4 The moist
feminine area is also a predisposing factor
for candidiasis.3 Other than that, panty liner
that is containing chlorine can kill the normal
flora in the vagina (Lactobacillus). Reduced
levels of Lactobacillus in the vagina can
make the vaginal acidity unstable and
become alkaline. An alkaline vaginal pH will
make it easier for bad bacteria to grow and
thrive.23
This research is supported by previous
research conducted in the Faculty of
Medicine, Andalas University, Padang.
Previous research stated that there was a
significant relationship between the used of
panty liners on abnormal vaginal discharge.
The difference between previous studies
and this research is that this study
examines whether there is an effect of the
basic ingredients of the panty liner on the
abnormal discharge itself. The results show
that there is no significant relationship
between the basic ingredients of panty
liners on vaginal discharge.
The type of panty liner is not a risk factor for
vaginal discharge. Neither panty liner
containing antiseptic nor antiseptic did not
have a significant effect because the
p value > 0.05. This may be because only
two people used the type of panty liner that
contained antiseptic. Because only two
people used the type of panty liner that
contained antiseptic, it couldn't cover the
entire population, so it's not proven that the
type of panty liner that contains antiseptic
can prevent vaginal discharge.
In this study it can be said that the bias is
quite large. This is due to many confounding
factors, including cleanliness vulva, stress,
Sexually Transmitted Diseases, wearing
tights, and antiseptic. Vulvar hygiene itself
includes the direction of cleaning the area
femininity, drying of the feminine area, the
number of pads used at the time
menstruation, underwear material, and
number of underwear changes.
Conclusion
In this study, it is known that the use of
panty liners can increase the risk of vaginal
discharge. It can be seen that the incidence
of vaginal discharge in female students who
use panty liners is 76% o. The rate of
vaginal discharge in female students who
did not wear panty liners but vaginal
discharge was 24%. Using panty liners can
cause vaginal discharge five times greater
than not using panty liners. However, the
type of panty liner did not have a significant
relationship with the occurrence of vaginal
discharge.
Leviana Aurellia
32| U n i v e r s i t y o f P e l i t a H a r a p a n
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Geriatri. KSDAI; 2009. p.2240.
2. Marhaeni GA. Keputihan pada wanita. Jurnal Skala Husada. 2016;13 (1): 30-8.
3. Runeman B. The vulva skin microclimate:influence of panty liner on temperature,
humidity, and pH. Act Derm Venerol. 2003. p.88-92.
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Keputihan Patologis pada Siswi SLTA atau Sederajat di Kota Banjarbaru. 2012.
5. Liyana Sopian, Sa'adiah Shahabudin, Mowaffaq Adam Ahmed, Leslie Than Thian Lung
DS. Yeast Infection and Diabetes Mellitus among Pregnant Mother in Malaysia. 2016.
6. Astuti DW. Hub Pengguna Panty Liner Dengan Kejadian Keputihan di SMA
Muhammadiyah 3 Yogyakarta. 2016.
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10. Persia A, Gustia R, Bahar E. Hubungan Pemakaian Panty Liner dengan Kejadian Fluor
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ResearchGate has not been able to resolve any citations for this publication.
Article
AbstrakPenyebab tersering fluor albus (keputihan) patologis adalah infeksi. Proses infeksi dapat dipicu oleh banyak hal, salah satunya adalah karena pemakaian panty liner. Tujuan penelitian ini adalah menentukan hubungan antara pemakaian panty liner dengan kejadian fluor albus pada siswi SMA. Penelitian dilakukan pada siswi di enam SMA di kota Padang. Penelitian ini menggunakan desain cross sectional study dengan responden sebanyak 289 orang. Pengumpulan data responden dilakukan dengan wawancara terpimpin (pengisian kuisioner). Analisis statistik yang digunakan adalah uji chi-square. Hasil penelitian didapatkan bahwa lebih dari separuh responden yang memakai panty liner mengalami fluor albus (69,2%) dan 80% diantaranya mengganti panty liner <2 kali perhari. Uji statistik chi- square menunjukkan ada hubungan yang bermakna antara pemakaian panty liner dengan kejadian fluor albus (p<0,05) dan frekuensi penggantian panty liner perhari dengan kejadian fluor albus (p<0,05). Terdapat hubungan bermakna antara pemakaian panty liner dengan fluor albus pada siswi SMA di Kota Padang.Kata kunci: fluor albus, panty liner, siswi SMA AbstractThe most common of pathology fluor albus is infection. Infection can be cocked by panty liner uses. The objective of this study was to determine relationship between panty liner uses and the incidence of fluor albus in female student of Senior High School. The research was executed to female student of senior high school in Padang. There are six schoosl was chosen as sample. This research used cross sectional study design to 289 respondent. Data was collected by guided interview. Statistic analysis use chi-square test. The result of research found more than half respondent who use panty liner experience of fluor albus (69.2%) and 80% of them just replace panty liner<2 times a day. Chi-square test showed that there is significant relationship between panty liner uses with fluor albus experience (p<0.05) and frequency of panty liner uses replacement with fluor albus experience (p<0.05). There is a significant relationship between panty liner uses and the incidence of fluor albus in female student of senior high school at Padang.Keywords: fluor albus, panty liner, female student of senior high school
Article
Background: Vaginal yeast infection refers to irritation of the vagina due to the presence of opportunistic yeast of the genus Candida (mostly Candida albicans). About 75% of women will have at least one episode of vaginal yeast infection during their lifetime. Several studies have shown that pregnancy and uncontrolled diabetes increase the infection risk. Reproductive hormone fluctuations during pregnancy and elevated glucose levels characteristic of diabetes provide the carbon needed for Candida overgrowth and infection. The goal of this study was to determine the prevalence of vaginal yeast infection among pregnant women with and without diabetes. Methods: This was a case-control study using cases reports from Kepala Batas Health Clinic, Penang State, Malaysia from 2006 to 2012. In total, 740 pregnant ladies were chosen as sample of which 370 were diabetic and 370 were non-diabetic cases. Results: No relationship between diabetes and the occurrence of vaginal yeast infection in pregnant women was detected, and there was no significant association between infection and age group, race or education level. Conclusion: In conclusion, within radius of this study, vaginal yeast infection can occur randomly in pregnant women.
Article
Background Whether panty liners predispose to vulvovaginitis is unclear. Objectives To clarify the effects of the use of panty liners on the female genital tract. Search strategy Several electronic databases (including PubMed and Embase) were searched to identify studies published in English before May 3, 2012. Selection criteria Case–control studies, randomized controlled trials, and cohort studies comparing young women who did and did not use panty liners in the intermenstrual period were included. Data collection and analysis The quality of the studies was assessed using the Newcastle–Ottawa Scale or the Jadad Scale. Data from suitable studies were extracted for analysis. Main results Five articles met the inclusion criteria. Four studies—all of which included only healthy women—found no significant clinical implications arising from the use of panty liners. The fifth study was of women with recurrent candidiasis and showed that use of panty liners was associated with new candidiasis episodes. Conclusions The intermenstrual use of panty liners does not seem to have a negative effect on the vulvovaginal area.
Article
Many women use panty liners between menstrual periods. The aim of this study was to investigate whether the use of such products might influence the vulva skin. Twelve healthy women were studied on four occasions with three different product constructions and on one occasion without products. Temperature, surface wetness and surface pH were measured on vulva skin. Mean skin temperature when the women were wearing a conventional panty liner (with a non-breathable back sheet) was 35.9 degrees C, compared to 34.4 degrees C when wearing no panty liner at all (p < 0.01) and 34.5 degrees C when using a panty liner with a breathable (i.e. vapour permeable) back sheet (p < 0.01). Skin humidity was significantly higher when the conventional panty liner was used compared to no panty liner or to the breathable panty liner (both cases p < 0.01). The mean pH value at the exterior aspect of the labium majus was 5.8 with the conventional panty liner, 5.2 with no panty liner and 5.3 with the breathable panty liner (p < 0.001 and p < 0.01, respectively). The results indicate that the conventional panty liner changes the vulva skin microclimate, but that the breathable panty liner to a substantial degree keeps the microclimate at an undisturbed level. The actual effect of these differences on microbiological flora will be addressed in a subsequent study.
Article
Panty liners are used to absorb light menstrual flow, vaginal discharge, or urine leakage, or to maintain a clean, dry feeling. Allegations that panty liners may trap heat and moisture to promote vulvovaginal candidiasis (VVC) or promote colonization by microbes that contribute to urinary tract infections appear to be unfounded. As reviewed herein, measurements of the impact of panty liners on skin temperature and skin surface moisture had no clinically meaningful effect on cell densities of genital microflora. Epidemiological investigations of a potential link to VVC were either negative or were inconclusive because of confounding factors. Although enteric microbes reside on the vulva and perineum, no evidence exists that panty liner use promotes urethral colonization by enteric microbes. Moreover, a series of 13 randomized prospective trials of panty liners or ultra-thin pads demonstrated no clinically significant adverse effects either on the skin or on isolation frequencies or cell densities of representative genital microflora. Post-market surveillance systems suggest a low incidence of complaints. Evidence from vulvar clinic patients reveals no significant contribution of these products to persistent vulvar symptoms. Taken together, the scientific evidence supports the conclusion that panty liners are safe when used as intended and do not promote VVC or urinary tract infections.
Keputihan pada wanita
  • G A Marhaeni
Marhaeni GA. Keputihan pada wanita. Jurnal Skala Husada. 2016;13 (1): 30-8.
Hub Pengguna Panty Liner Dengan Kejadian Keputihan di SMA Muhammadiyah 3 Yogyakarta
  • D W Astuti
Astuti DW. Hub Pengguna Panty Liner Dengan Kejadian Keputihan di SMA Muhammadiyah 3 Yogyakarta. 2016.
Fitriani Nur Damayanti dan IAP. Faktor-Faktor yang Berhubungan dengan Keputihan pada Wanita Usia Subur (WtJS) di RT 04 RW 03 Kelurahan Rowosari Semarang
  • Rahayu Rika Puji
Rika Puji Rahayu, Fitriani Nur Damayanti dan IAP. Faktor-Faktor yang Berhubungan dengan Keputihan pada Wanita Usia Subur (WtJS) di RT 04 RW 03 Kelurahan Rowosari Semarang. 2013;11-6.