Background: Various products are common in the market for vaginal hygiene purpose, such as povidone iodine vaginal douche, extract of betel leaf, and other herbal internal vaginal hygiene products. However, it is hypothesized that these hygiene products may hamper female fertility. This study aimed to examine the effect of vaginal hygiene product use on female fertility, while controlling for the level of physical activity, age at marriage, and body mass index. Subjects and Method: This was an observational analytic study with case control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, Indonesia. A sampel of 110 women aged 15-49 years old were selected for this study by fixed diseases sampling. This sample consisted of 55 infertile women and 55 pregnant or post-partum women were selected as cases and controls. The dependent variable was infertility. The independent variables were external and internal use of vaginal hygiene product, level of physical activity, age at marriage, and body mass index (BMI). The data were analyzed using a multiple logistic regression. Results: External use of vaginal hygiene product decreased the risk of infertility, but it was statistically not significant (OR= 0.62; 95%CI= 0.22 to 1.74; p= 0.366). Internal use of vaginal hygiene product (OR= 14.97; 95%CI= 1.66 to 135.16; p= 0.016), heavy physical activity (OR= 7.95; 95%CI= 1.54 to 41.08; p= 0.013), age at marriage ≥29 years (OR=3.66; 95%CI= 0.68 to 19.76; p= 0.131), BMI<18.5kg/m 2 (OR= 1.62; 95%CI= 0.31 to 8.56; p= 0.572), and BMI ≥25kg/m 2 (OR= 23.17; 95%CI= 4.05 to 132.40; p<0.001) increased the risk of infertility. Conclusion: Internal use of vaginal hygiene product, heavy physical activity, age at marriage >29 years, underweight, and overweight, are risk factors of infertility in women. Women who use vaginal hygiene product internally should be aware that this practice significantly increased the risk of infertility.