Table 1.

Characteristics of included studies for SR&MA

#	Author	Year of Publication	Study Design	Sample size, n			Country	Recruitment period/year	Participants	Exposure	Main findings	Commonest method of grooming	Complications of grooming e.g. (STI, Rash, Folliculitis …etc.)
				Total	Groomer n (%)	Non-groomers n (%)
1	Toerein et al	2005	Cross-sectional study	678	581 (85.69)	97 (14.31)	UK	_	Female in any age groups who practiced PHR	PHR* using one or more depilatory methods	Significant relationship was observed between younger age and PHR* practices	Shaving (not specified)	_
2	Tiggemann et al	2008	Cross-sectional study	235	194 (74.5)	41 (25.5)	Australia	_	Female of various socioeconomic background aged between 17 and 40 years whom were undergraduate	PHR* using one or more depilatory methods	PHR* has different predictors than the removal of underarm or leg hair due to exposure to media	Shaving (not specified)	_
3	Herbenick et al	2010	Cross-sectional study	2451	1959 (79.9)	492 (20.1)	USA	2008	Women aged 18 to 68 years	PHR* using one or more depilatory methods	Association between total PHR* with younger age, being partnered	Shaving (not specified)	Genital pain
4	Smolak et al	2011	Cross-sectional study	148	96 (65)	52 (35)	USA	_	Women aged above 18 years, undergraduate students	PHR* using one or more depilatory methods	The relationships among normative, sexiness reasons and self-objectification	_	_
5	Bercaw-Pratt et al	2012	Cross-sectional study	171	120 (70.4)	51 (29.6)	USA	_	Adolescents and young women aged 12 to 20 years	PHR* using one or more depilatory methods	PHR* was more common in sexually active participants	Shaving and waxing	_
6	Braun et al	2013	Cross-sectional study	50	47 (94)	3 (6)	New-Zealand	_	Women aged 18 to 48 years, from diverse ethnically; predominantly heterosexual	PHR* using one or more depilatory methods	PHR* were not consistently gendered, With potential impacts on sexual and psychological well-being	_	_
7	Herbenick et al	2013	Cross-sectional study	2453	1410 (57.5)	1043 (42.5)	USA	2013	Women ages 18 to 68 years	PHR* using one or more depilatory methods	Relation between PHR* and their sexual experiences on a day-to-day level with Clinical and educational impact	Non-electric blade razors with shaving cream	Genital pain and irritation
8	DeMariaa et al	2013	Cross-sectional study	1677	1533 (91.4)	144 (8.6)	USA	2010–2011	Women aged 16–40 years whom low-income Hispanic, Black, and White women	PHR* using one or more depilatory methods	PHR* was common among white younger women of varying demographics with under or normal weight, and having 5 or more lifetime sexual partners	Non-electric blade razors and shaving cream	Folliculitis and ingrown hairs
9	DeMaria et al	2014	Cross-sectional study	333	333 (100)	0	USA	2012	Women aged 16 to 40 years	PHR* using one or more depilatory methods	Minor complications commonly occur as a consequence of PHR* and the findings supported the idea of visiting physician to receive health advice on PHR* particularly obese women	Non-electric blade razors	Epidermal abrasions, cuts, bumps, rashes, ingrown hairs, Severe itching and Infection
10	Butler et al	2015	Cross-sectional study	671	644 (96)	27 (4)	USA	_	College women aged above 18 years	PHR* using one or more depilatory methods	Genital grooming and PHR* are common practices among women of college-age. Stronger associations with feelings of cleanliness, comfort, sex appeal, social norms and affordability	Shaving (non-specified)	Genital pain, rash, Itching, cuts
11	Stone et al	2016	Cross-sectional study	126	126 (83.4)	25 (16.6)	_	2015	Women aged above 18 years	PHR* using one or more depilatory methods	Association between PHR* with women being younger, White and were more satisfied with their genitals	_	_
12	Rowen et al	2016	Cross-sectional study	3316	2778 (83.8)	538 (16.2)	USA	2013–2015	Women aged 18 to 65 years	PHR* using one or more depilatory methods	There were demographic differences in grooming practice, which may reflect cultural variations in preference, also no association between grooming, income and relationship status	Non-electric blade razors	_
13	Demaria et al	2016	Cross-sectional study	663	642 (96.8)	21 (3.2)	USA	2013	Young women aged 18–24 years	PHR* using one or more depilatory methods	Education regarding safe PHR* methods is needed, especially for those who initiate pubic hair removal and sexual behaviors concurrently	Non-electric blade razors	Burn, In-grown hairs, severe itching, cuts, rash
14	Sangiorgi et al	2017	Cross-sectional study	52,787	51,386 (97.34)	14,01 (2.65)	Brazil	2015	Women aged above 18 years	PHR* using one or more depilatory methods	Most Brazilian younger women prefer the complete PHR*, especially sexually active women with a stronger preference for complete PHR	Hot wax	_
15	Truesdale et al	2017	Cross-sectional study	3372	3204 (85.3)	168 (14.7)	USA	2014–2017	Women aged 18 to 65 years	PHR* using one or more depilatory methods	Grooming frequency and degree of grooming are independent risk factors for injury	Non-electric blade razors	Lacerations (most common minor injury) serious injuries rare
16	Rouzi et al	2018	Cross-sectional study	400	400 (100)	0	Saudi Arabia	2015–2016	Women aged 16 to 60 years	PHR* using one or more depilatory methods	PHR* common in Saudi women who initiate PHR in early adolescence	Non-electric blade razors	Cuts, bruise, abrasion, severe itching, ingrown hair, rash, burn, allergy, hyperpigmentation
17	Luster et al	2019	Cross-sectional study	214	209 (98.1)	5 (2)	USA	2017–2018	Female university students, at least 18 years of age	PHR* using one or more depilatory methods	PHR* was common among female university students but the findings do not support it as an STI risk factor in this population	Non-electric blade razors	STI (Gonorrhea/chlamydia)
18	obst et al	2019	Cross-sectional study	270	220 (81.6)	50 (18.3)	Australia	2019	Young adult women aged 17 to 25 years	PHR* using one or more depilatory methods	Association between social image and young women decision to engage in behavior that associated with their body image	Shaving (not specified)	_
19	Enzlin et al	2019	Cross-sectional study	1735	1683 (97)	52 (3.1)	Belgium	2011	Women aged 15 to 60 years, they self-identified as heterosexual, bisexual, or homosexual	PHR* using one or more depilatory methods	PHR* is a widespread practice with strongly association with personal, partner-related, sexual, and relational factors	_	Skin rash, itching, bumps
20	Gaither et al	2020	Cross-sectional study	58	54 (93)	4 (7)	USA	2018	Women aged above 18 years received STI testing in the study period, sexually active within the past 3 months	PHR* using one or more depilatory methods	No association between recent grooming and genital STIs	All methods used with no specification	_
21	Beksinska et al	2020	Cross-sectional study	1211	705 (58.2)	506 (41.8)	South Africa	2017–2018	Women aged 16 to 35 years. All were tested for STIs	PHR* using one or more depilatory methods	The practice of PHR* is common among in KwaZulu-Natal, South Africa population with association of high reporting of side effects as injuries.These injuries could put women at a higher risk of STIs	Non-electric blade razors	Itching, pimples, blisters, rash, bleeding, burns and STI (STI (C. trachomatis or N. gonorrhea or HSV2)
22	DeMaria et al	2021	Cross-sectional study	46	46 (100)	0	Italy	2017	Women aged 18 to 45 years	PHR* using one or more depilatory methods	Women engaging in more frequent and earlier waxing PHR* with early onset during adolescence, often upon puberty which influenced by Sexual partners, cultural norms and the desire for cleanliness	Waxing	Burning pain, cuts, ingrown hairs, scarring, swelling, bruising

* abbreviation for Pubic Hair Removal