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Journal of Ethnopharmacology 116 (2008) 84–88

Dry sex in Suriname

Tinde van Andel a,∗ , Sanne de Korte b , Daphne Koopmans b ,
Joelaika Behari-Ramdas c , Sofie Ruysschaert d
a National Herbarium of the Netherlands, Utrecht University, Heidelberglaan 2, 3584 CS Utrecht, The Netherlands
bAcademic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam Zuidoost, The Netherlands
c National Herbarium of Suriname, Leysweg, Paramaribo, Suriname
d Laboratory of Tropical and Subtropical Agriculture and Ethnobotany, Ghent University, Coupure Links 653, 9000 Ghent, Belgium

Received 23 August 2007; received in revised form 28 October 2007; accepted 2 November 2007

Abstract
Ethnopharmacological relevance: Dry sex refers to the use of plants to dry and contract the vagina, a popular practice in Africa that damages vaginal
tissue and facilitates the spread of sexually transmitted diseases. Here we show that dry-sex practices are not limited to Africa. Afro-Surinamese
women frequently use genital steam baths that contain drying and tightening herbs.
Aim of the study: To assess the possible health consequences of this tradition, we quantified the diversity and trade in steam-bath ingredients and
described the reasons why Surinamese women use them.
Materials and methods: We collected botanical vouchers of steam-bath herbs, carried out a market survey and interviewed 140 women who used
these baths.
Results: No less than 177 different plant species were employed in vaginal steam baths, not only for dry sex, but also to cleanse the uterus after
childbirth and menstruation. Prohibiting the use of these baths is not an option. Moreover, they may save lives by preventing womb infection and
puerperal fever.
Conclusions: The lively trade in steam-bath herbs plays a role in the rapid increase in HIV among Surinamese citizens and migrants. We also have
reasons to believe that dry-sex practices are more widespread in the Caribbean than previously thought.
© 2007 Elsevier Ireland Ltd. All rights reserved.

Keywords: Afro-Surinamese; AIDS; Ethnobotany; HIV; Vagina; Women’s health

1. Introduction increase the likelihood of infection with sexually transmitted dis-

In many African cultures, plants and other intravaginal des-
iccants are used to minimise vaginal secretions. This practice,
known as ‘dry sex’, creates a vagina that is dry, tight, and heated,
which is supposed to generate an increased sensation for the
man during intercourse. Although this is uncomfortable and
painful, African women express the need to please their hus-
bands with dry sex in order to keep them from leaving and to
minimise the number of girlfriends (Baleta, 1998; Kun, 1998).
Previous research has shown that dry sex damages the epithe-
lium of the vagina and can lead to lacerations, inflammations,
and the suppression of the vagina’s natural bacteria, all of which
∗ Corresponding author. Tel.: +31 628 523329; fax: +31 30 251 8061.
E-mail address: T.R.vanAndel@uu.nl (T. van Andel).
eases (STDs), including HIV (Brown et al., 1993; Runganga and
Kasule, 1995; Kun, 1998; McClelland et al., 2006). Furthermore,
the practice of dry sex is generally incompatible with the use of
condoms, as they require lubrication to avoid breakage (Civic
and Wilson, 1996). Here we show that dry-sex practices are more
widespread than previously thought. Maroon women in Suri-
name frequently use genital steam baths that contain tightening
and drying herbs.
The Surinamese Maroons are descendants of African slaves
who escaped from plantations along the coast into the interior
forests in the 17th and 18th centuries. Since then, the Maroons
have lived in tribal societies and largely maintained their African
culture (Price, 1976; St.-Hilaire, 2000). As a result of the
1980s civil war and the subsequent economic malaise, many
Maroons moved to the Surinamese capital of Paramaribo, French
Guiana, and the Netherlands to look for safety, employment, and

0378-8741/$ – see front matter © 2007 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.jep.2007.11.003
 T. van Andel et al. / Journal of Ethnopharmacology 116 (2008) 84–88
education (St.-Hilaire, 2000). This urbanization fuelled a lively
trade in medicinal plants, in particular species that are used in
steam baths to tighten and dry the vagina in order to increase
sexual pleasure (Behari-Ramdas, 2005; van Andel and van ’t
Klooster, 2007). At the same time, the rapid spread of STDs
and HIV among the Maroons has caused researchers to investi-
gate their sexual behaviour (Terborg, 2001; Terborg et al., 2005).
Although genital baths must have been a common practice in the
Guianas since the first African slaves were brought to the region,
apart from a detailed description of vaginal hygiene among the
Aluku Maroons in French Guiana (Fleury, 1996) very little has
been published on this sensitive issue. Given the lack of informa-
tion on genital steam baths and the fact that dry sex enhances the
transmission of STDs, we wanted to assess the cultural impor-
tance of this tradition in Suriname. We did so by quantifying
the diversity and trade in steam-bath herbs and investigating the
reasons why Surinamese women use them. With this paper, we
want to inform the medical society about the influence of dry-sex
practices on the spread of HIV under Afro-Caribbean citizens
and migrants in Europe and the US.
2. Methodology
Fieldwork was conducted from January to July 2006 and
took place in Paramaribo and several Maroon communities
around Rijsdijkweg (Pará District), Bigiston (Marowijne) and
Klaaskreek (Brokopondo). After explaining to our informants
the nature and possible consequences of our research and obtain-
ing their prior informed consent, we collected botanical vouchers
of nearly all plants mentioned as genital steam-bath ingredients.
We recorded the vernacular names, the methods of preparation,
the doses, the associated beliefs and the perceived effects of
the plants. In addition, we conducted a systematic survey of
Fig. 1. Woman taking a genital steam bath. Drawing by H.R. Rypkema.
85
46 market stalls selling herbal medicine in Suriname and St.
Laurent du Maroni, the main border town in French Guiana.
On these markets we quantified the diversity and estimated the
volumes of steam-bath herbs being sold. Duplicates of botanical
vouchers were deposited at the National Herbarium of Suriname
(BBS) and the National Herbarium of the Netherlands (U). We
also conducted semi-structured interviews with several Maroon
and Creole healers, one traditional midwife, and 18 Maroon
and two Creole mothers, whom we asked to list the plants they
used for menstruation problems and obstetric care. Finally, we
discussed the topic of genital steam baths with gynaecologists,
public-health workers, pharmacologists, physicians, and HIV-
researchers in both Suriname and the Netherlands. Additional
data were obtained from a pilot market survey conducted in 2005
(Behari-Ramdas, 2005), and a hectare plot study combined with
interviews (using pictures of plants and free-listing) with 120
women in Brownsweg (Brokopondo), carried out by the last
author in 2005 and 2006. We merged the data concerning geni-
tal steam baths from all the interviews, resulting in a total of 140
respondents.
3. Results
To prepare a steam bath, the woman boils plant material,
pours the decoction in a bucket, sits on the rim with her legs
spread and lets the hot vapour enter her inner parts (Fig. 1).
We recorded 177 plant steam-bath species (see Appendix),
belonging to 55 families, most prominently Melastomataceae
(17 species), Fabaceae (15) and Myrtaceae (12). We were unable
to collect a corresponding voucher or a scientific name for 16
vernacular names (see Appendix). Although most of the plants
were common secondary forest or shrubland species, the women
actively cultivated the plants so that they would not have to walk
to the forest each morning to gather them. At the medicinal
plant markets in Paramaribo, 31% of the species sold and 39%
of the daily stock consisted of genital bath herbs. About 43%
of the steam-bath species we recorded were commercialised.
More than 2000 kg of steam-bath ingredients were offered for
sale on an average day in Paramaribo (Table 1). The plants cited
most frequently by the 140 women we interviewed were Vis-
mia macrophylla Kunth (Hypericaceae, 106 respondents), Piper
marginatum Jacq. (Piperaceae, 105), and Xylopia frutescens
Aubl. (Annonaceae, 101). Many plants were cited for more than
one purpose (Table 2). The true multi-function species (>11
purposes) were among the most profitable ones (Piper margina-
tum, Siparuna guianensis Aubl. (Siparunaceae), Campomanesia
aromatica (Aubl.) Griseb. (Myrtaceae).
Genital steam baths are regarded as aphrodisiacs for both
men and women. This is reflected in the vernacular names of
the herbal ingredients, which often suggest abrasiveness (e.g.,
‘sandpaper’ for Davilla sp. (Dilleniaceae)), tightness (‘broken
penis’, Bellucia grossularioides (L.) Triana (Melastomataceae)),
a good sex life (‘hug in the early morning’, Miconia tomentosa
(Rich.) D.Don ex DC. (Melastomataceae)), or a pleased husband
(‘what do you want me to buy for you?’, Hirtella paniculata Sw.
(Chrysobalanaceae)). Not all intimate baths, however, are meant
for the purpose of dry sex (Table 2). Women of different ethnic-
86 T. van Andel et al. / Journal of Ethnopharmacology 116 (2008) 84–88

Table 1 The Maroon males we spoke to were all positive about genital
Most popular vaginal steam-bath herbs sold in Paramaribo, Suriname baths. Their only concern was that some women used not only
Species Daily market Frequency on Estimated annual tightening herbs in the baths but also ‘dangerous’ plants in order
stock (kg) market stalls sales (US$) to acquire magic power over them.
(%) Why are so many different species used for intimate hygiene?
Campomanesia aromaticaa 182 22 1,222 Our informants explained that every woman must try out a num-
Scoparia dulcis 172 23 1,357 ber of species until she finds the plants that suit her best and
Costus scaber 144 9 474 do not cause unwanted side effects, like itching, burning, or
Siparuna guianensis 117 20 1,755
Vismia guianensisa 99 15 661
excessive discharge. Most Surinamese medical practitioners we
Parkia pendula 93 18 3,040 interviewed knew of the dry-sex practices and were concerned
Renealmia floribunda 72 18 1,077 about the possible relationship between these genital baths and
Piper marginatum 60 14 598 the spread of STDs, HIV/AIDS, cervical carcinoma, and ectopic
Bellucia grossularioidesa 48 12 479 pregnancy in their country.
Maprounea guianensis 45 9 199
Ludwigia nervosaa 45 11 301
Plants for genital steam baths are also exported to the
Miconia prasinaa 42 12 348 Netherlands, where they are popular among Surinamese migrant
Miscellaneous (65 spp.) 1173 ≤6 30,672 women. Several Surinamese enterprises started with an on-line
Total 2292 – 42,183 market of steam-bath mixtures. Some of them receive orders
a Species sold exclusively for steam baths. Remaining species are also sold
from as far as the US. Remarkably, none of the Dutch medical
professionals that we questioned were aware of the dry-sex prac-
for other medicinal purposes.
tices among Surinamese women in the Netherlands. In general,
Dutch doctors discourage the use of vaginal douches and other
ities told us they took vaginal steam baths after childbirth. They treatments that alter the vaginal pH, which normally serves as a
said they had learned this from their (grand)mothers, and that protective factor against bacteria, fungi, and viruses.
it helped to remove blood clots from the uterus and eliminate
the foul smell. These baths also caused the uterus to return to its 4. Discussion
former shape and prevented childbed fever and a sagging waist.
If a woman refrained from cleansing her uterus after childbirth, Being clean is essential in the Afro-Surinamese culture and
she ran the risk of contracting ‘cold in the belly’. According to is reflected in its ethnobotany. Menstruating women and moth-
our respondents, this dangerous illness, caused by ‘dirty blood’ ers in childbed are considered unclean (Price, 1993; Fleury,
left in the uterus after delivery, could lead to severe abdomi- 1996). Vaginal baths are seen as a way to purify the female
nal pains, fever, and ultimately death. This description suggests body and make it attractive again for the opposite sex (Fleury,
serious uterine infections and puerperal fever. 1996). Moreover, by pleasing their partner and disinfecting
None of our respondents were aware that a dry, tight vagina themselves, the women think that genital hygiene will minimise
is a risk factor for STDs. On the contrary, they were convinced the occurrence and limit the consequences of adultery. Maroon
that a regular cleansing of their intimate parts would protect men generally spend long periods away from their communities
them against such infections and ensured their partner’s fidelity. to engage in wage labour. When the men finally return home, it
is essential that their wives give them a warm welcome to ensure
Table 2 their continual love and material and economic support (Price,
Reasons for taking a genital steam bath and the number of species involved 1993).
Reason for taking a genital steam bath No. of plant species with this effecta The type of application and the herbal ingredients used in
Suriname are different from those used in Africa. Surinamese
Cleanse vagina (general) 108
Tighten vagina 105 women generally do not insert stones, herbs, antiseptics, or
Cleanse uterus after birth 54 newspaper directly into their vagina like African women do
Disguise bad smell 47 (Runganga and Kasule, 1995). The perceived effects and the
Enhance sexual pleasure 46 motivation to practise dry sex, however, are strikingly simi-
Dry out vagina 45
lar. Maroons of both sexes, who were interviewed by Terborg
Prevent and treat fever after birth 44
Strengthening woman after birth 34 (2001), explained that vaginal dryness and tightness during inter-
Refreshment 26 course was not only preferred, but without it sexual pleasure was
Contract uterus after delivery 24 not possible. When asked if dry sex caused contact bleeding
Slimming after birth 20 and pain, the majority of respondents answered positively. Suri-
Cleanse uterus after menstruation 18
name is currently experiencing a serious AIDS epidemic, with
Keep partner (pleased) 15
Feel good, feel free 14 HIV being prevalent in more than 1% of the adult population
Stop menstruation 12 (UNAIDS/WHO, 2005). The vast majority of the HIV-positives
Reduce uterus pain after delivery 12 are found among the Maroons (Terborg, 2001; Terborg et al.,
Magic (luck charms, love charms) 10 2005). Several initiatives on the national level are being under-
Non-specific genital bath species 29
taken to fight this epidemic, including a discussion on the cultural
a Including 16 unidentified species. aspects of certain sexual behaviour (Terborg et al., 2005). As
 T. van Andel et al. / Journal of Ethnopharmacology 116 (2008) 84–88
both men and women highly appreciate dry sex, education and
awareness programmes should discuss the risks of genital steam
baths and encourage safe methods, such as avoiding contact
bleeding during intercourse by means of a ‘good warming up’
and promoting the use of condoms (Terborg, 2001).
Studies on HIV prevalence among ethnic minorities in the
Netherlands report considerable sexual risk behaviour among
migrant males: they have many sexual partners, concurrent part-
nerships, a low rate of condom use, and sexual contacts during
frequent travels to their country of origin (Kramer et al., 2005;
van Veen et al., 2006). None of these reports, however, men-
tions dry sex or genital steam baths. HIV prevalence among
Surinamers in Amsterdam is 1%, but, given their high mobility,
the increasing HIV rates in Suriname will have serious conse-
quences for the Netherlands in the near future (Gras et al., 1999;
Kramer et al., 2005).
We have reasons to believe that dry-sex practices are also
common in the rest of the Guianas. We noticed steam-bath herbs
offered for sale on a French Guianese market along the Maro-
wijne River. Grénand et al. (1987) and Fleury (1996) reported
that Maroon and Creole women in French Guiana took inti-
mate baths to tighten and disinfect their vagina, but they did not
seem to realise the dangers of this practice. On the contrary,
Fleury (1996) emphasised the promising potential of genital
baths to offer protection against STDs. Remarkably, Tortevoye
et al. (2005) reported a high incidence of HIV (more than 4%
of all pregnant women) among French Guianese Maroons in the
same Marowijne region.
In Guyana, traditional midwifes prepare steam baths to con-
tract the uterus and prevent post-partum haemorrhage, while
market women sell many herbs to clean the uterus and minimise
vaginal discharge (van Andel, 2000). Dry-sex practices are also
recorded in the Dominican Republic and Haiti (Halperin, 1999).
These observations strengthen our idea that the use of herbs for
dry-sex practices is more common than previously thought and
that this practice could play an important role in the rapid spread
of HIV in the Caribbean.
Given the popularity of dry sex, its important role in Afro-
Surinamese culture, and the limited understanding of infective
mechanisms in Maroon society, a general prohibition of genital
steam baths in Suriname is no option. Moreover, prohibiting
traditional midwife practices could have negative effects on
women’s health, especially in remote areas where health cen-
tres are poorly staffed and equipped (Terborg, 2001; Ticktin and
Dalle, 2005). The maternal mortality ratio in Suriname was 226
per 100,000 live births in the early 1990s (Mungra et al., 1999).
Our results show that genital steam baths are frequently used
to facilitate the removal of placental remains after birth, mis-
carriage or abortion. In the major Maroon settlements, where
58% of the deliveries take place without an officially trained
birth attendant (United Nations Population Fund, 2007), knowl-
edge of medicinal plants that contract the uterus and prevent
puerperal fever can save lives. Cleaning out the uterus after a
miscarriage by means of steam and herbs is preferable to receiv-
ing no treatment at all. We hope that our results can help to
design education programmes that clearly indicate the positive
and negative aspects of such intimate baths. More research is
87
needed on the pharmacological effects of genital steam baths
in order to make a distinction between plants that are harmless,
beneficial, or potentially dangerous.
5. Conclusions
Given the astonishing number of steam-bath herbs used and
traded, we can conclude that taking an intimate bath is a com-
mon practice in Suriname. The main purposes of these baths
are to clean and tighten the vagina, to mask a bad odour, and to
remove blood remains from the uterus. In particular those herbs
used to shrink and dry could damage the vaginal tissue during
intercourse and thus facilitate the transmission of STDs. Pro-
hibiting such baths, however, could also have negative effects
on women’s health, as they may facilitate the removal of pla-
cental remains after birth, miscarriage or abortion. Education
programmes should clearly indicate the positive and negative
aspects of such intimate baths. Medical personnel in the Nether-
lands must be informed about these practices, since they form
an integral part of Afro-Surinamese culture.
Acknowledgements
We thank all Surinamese women who shared their knowledge
with us, and S. Groenendijk, R. Havinga, K. van Kerckhove and
K. van de Putte for their help with the fieldwork. We are grateful
to F. van der Hoeven and several other medical doctors and public
health professionals in Suriname and the Netherlands for their
discussions. We thank L. Cobb, P. Maas, E. van Andel and M.
Werger for their comments on our manuscript. This research was
funded by the Netherlands Organisation for Scientific Research
(NWO), the van Eeden Fund, the Alberta Mennega Stichting,
BOF Ghent University, VLIR-UIS, Leopold II fund and CWO
Faculty of Bio-Engineering (Ghent).
Appendix A. Supplementary data
Supplementary data associated with this article can be found,
in the online version, at doi:10.1016/j.jep.2007.11.003.
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