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Don't Douche: It's Very Bad for Women's Sexual Health

Douching is completely unnecessary, and surprisingly harmful.

Behind "that clean, fresh feeling" touted in ads for feminine hygiene products is the nasty implication that the vagina is a dirty, smelly organ that turns men off during sex. The ads have struck a nerve. An estimated 15 percent of U.S. women douche regularly. Some use home-made water-vinegar solutions, but most spring for disposable, commercial products that ring up sales of $150 million a year.

The ads don't mention that douching is not only completely unnecessary, it's also surprisingly harmful. The vagina contains many different bacteria that live in complex relationships with each other. Within 10 minutes of douching, some get killed, which upsets the ecological balance. The vagina reverts to normal within 72 hours. But before it does, bacteria no longer held in check by those that have been eliminated may multiply and cause a variety of ills:

Chlamydia. It's the nation's most prevalent sexually transmitted infection. University of Washington researchers correlated douching and chlamydia risk in 1,692 women. Compared with those who never douched, those who did even once in the previous year had double the risk. Among those who douched weekly risk almost quadrupled.

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Pelvic Inflammatory Disease (PID). Chlamydia can move from the vagina through the cervix into the uterus and fallopian tubes, where it may cause pelvic inflammatory disease (PID), a threat to women's fertility and possibly even their lives. Researchers at Mount Sinai School of Medicine in New York City discovered that monthly douching doubled PID risk. And a study at the University of Washington School of Medicine in Seattle showed that weekly douching almost quadrupled it.

Why would douching the vagina be linked to PID, which infects the uterus and fallopian tubes? Researchers believe that in addition to altering the vagina, the douche stream pushes bacteria into the uterus and fallopian tubes, where they can cause PID.

Bacterial Vaginosis (BV). Talk about odor, douching increases risk of this infection, which causes an unpleasant fishy discharge. University of Pittsburgh researchers surveyed 1,200 women. As douching increased, so did BV risk. Compared with those who did not douche at all, women who douched once a month, were 40 percent more likely to develop BV. In those who douched weekly, risk doubled.

Trichomonas. CDC researchers tested 3,754 women, aged 14 to 49, for this common vaginal infection. Compared with those who were uninfected, women who douched regularly were significantly more likely to have it.

Yeast Infection. Italian researchers surveyed 931 women about their douching and history of yeast infections. Frequent douching was associated with significantly increased risk.

Cervical Cancer. U.S. military researchers investigated the douching habits of 266 women who developed cervical cancer, and 408 matched controls who did not. Compared with the nondouchers, those who douched more than once a week had four times the risk of this cancer.

Infertility. Washington, D.C. researchers followed 840 couples who were trying to get pregnant. After a year of unprotected intercourse, 90 percent of the women who never douched conceived, but among women who douched weekly, the figure was 83 percent.

Ectopic Pregnancy. In ectopic pregnancy, the fetus grows in a fallopian tube instead of the uterus. As it grows, it ruptures the tube, a medical emergency that puts the mother's life at risk. In one study, compared with women who never douched, those who did had 3.8 times the risk of ectopic pregnancy.

Preterm Delivery. CDC researchers surveyed 812 pregnant women. Compared with those who never douched, those who did during pregnancy had nearly double the risk of preterm delivery, which may cause a host of medical problems in the newborn, some of them potentially life-threatening.

What about the ads' claims that douching contributes to personal hygiene? Nonsense. Cervical mucus and other natural secretions--including vaginal lubrication during sex--keep it clean. Douching is unnecessary.

"The vagina is a self-cleansing organ," says David Eschenbach, M.D., a professor of gynecology at the University of Washington. "With regular bathing, douching is completely unnecessary."

"There is no good reason to douche and many good reasons not to," says, Johns Hopkins gynecologist Jean Anderson, M.D. "Douching should be discouraged."

References:

Annang, L. et al. "Vaginal Douching Practices Among Black Women at Risk: Exploring Douching Prevalence, Reasons for It, and Sexually Transmitted Diseases," Sexually Transmitted Diseases (2006) 33:215.

Brotman, R.M. et al. "A Longitudinal Study of Vaginal Douching and Bacterial Vaginosis: A Marginal Structural Modeling Analysis," American Journal of Epidemiology (2008) 168:188.

Bruce, F.C. et al. "Is Vaginal Douching Associated with Preterm Delivery?" Epidemiology (2002) 13:328.

Corsello, S. et al. "An Epidemiological Survey of Vulvovaginal Candidiasis in Italy," European Journal of Obstetrics, Gynecology, and Reproductive Biology (2003) 119:66.

Cottrell, B.H. "Vaginal Douching," Journal of Obstetrics, Gynecology, and Neonatal Nursing (2003) 32:12.

Fiscella, K. et al. "Risk of Preterm Birth Associated with Vaginal Douching," American Journal of Obstetrics and Gynecology (2002) 186:1345.

Holtzman, C. et al. "Factors Linked to Bacterial Vaginosis in Nonpregnant Women," American Journal of Public Health (2001) 91:1664.

Koumans, E.H. "Prevalence of Bacterial Vaginosis in the U.S., 2001-2004: Associations with Symptoms, Sexual Behaviors, and Reproductive Health," Sexually Transmitted Diseases (2007) 34:864.

Ness, R.B. et al. "Douching, Pelvic Inflammatory Disease, and Incident Gonococcal and Chlamydial Genital Infection in a Cohort of High-Risk Women," American Journal of Epidemiology (2005) 161:186.

Rothman, K.J. et al. "Randomized Field Trial of Vaginal Douching, Pelvic Inflammatory Disease, and Pregnancy," Epidemiology (2003) 14:340.

Rupp, R. et al. "Intergenerational Transfer of Douching Information," Journal of Pediatric and Adolescent Gynecology (2006) 19:69.

Sutton, M. et al. "Prevalence of Trichomonas Vaginalis Among Reproductive-Age Women in the U.S., 2001-2004," Clinical Infectious Disease (2007) 45:1319.

Thorp, J.M. et al. "Alteration in Vaginal Microflora, Douching Prior to Pregnancy, and Preterm Birth," Pediatric and Perinatal Epidemiology (2008) 22:530.

Tsai, C.S. et al. "Does Douching Increase Risk for Sexually Transmitted Infections? A Prospective Study in High-Risk Adolescents," American Journal of Obstetrics and Gynecology. (2009) 200:38.

San Francisco journalist Michael Castleman, M.A., has written about sexuality for 36 years. more...

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