Douching

By Laurie Udesky

What is vaginal douching?

Vaginal douching is the ancient practice of rinsing the vagina for hygienic purposes. Millions of women around the world do it, and a recent survey found that in the United States nearly 30 percent of women between the ages of 20 and 40 douche regularly. Both store-bought preparations and homemade ones often consist of vinegar and water, although some women douche with water alone. Others may use a mixture of water and medicinal herbs.

Is douching important for feminine hygiene?

No. The vagina has its own self-cleaning mechanism -- good bacteria that help keep it healthy. These bacteria (most of which go by the name Lactobacilli) do that by controlling the growth of bad bacteria that can cause infection. Douching disturbs this delicate balance by reducing the number of protective Lactobacilli, thus creating an environment in which bad bacteria can flourish.

Some women say they like to douche because it makes them feel cleaner, particularly after menstruation or sexual intercourse. But washing your outer genital area daily is enough for good hygiene. If you don't feel clean because you notice an unpleasant vaginal odor or unusual discharge, or if you're experiencing itching, redness, or burning, you should see your doctor; an infection may be the culprit.

Can douching do any harm?

Yes. Doctors discourage douching because it can lead to serious infections. If good bacteria like Lactobacilli are washed out of the vagina as a result of douching, bad bacteria can multiply uncontrolled. That leaves you open to infections such as bacterial vaginosis, which is associated with a serious condition known as pelvic inflammatory disease. The symptoms of bacterial vaginosis include vaginal itching, excessive discharge, and a fishy odor.

Douching can also increase the likelihood of vaginal yeast infections, which three out of four women contract at least once before they reach menopause. Yeast is naturally present in a woman's vagina, but if douching destroys too many Lactobacilli, it can grow rapidly and cause intense discomfort. A yeast infection is characterized by burning or itching, a thick cottage-cheese-like discharge, and redness or swelling of the vulva (the outer lips of the vagina). The symptoms may also include pain or soreness during sexual intercourse and burning during urination.

Women who douche more than once or twice a month are also at increased risk of pelvic inflammatory disease, reports the National Institute of Allergy and Infectious Diseases. Some researchers believe the reason is that the upward stream of fluid introduced into the vagina by douching helps carry bad bacteria into the Fallopian tubes and uterus. Pelvic inflammatory disease, which is usually caused by a sexually transmitted disease like chlamydia, is a serious infection of the upper reproductive tract, uterus, or Fallopian tubes. It can also result in permanent scarring or blockage of the tubes. The most common symptoms of pelvic inflammatory disease are a persistent stomachache and abdominal pain; some women also experience chills, fever, and nausea. If you douche regularly and have any of the symptoms described above, consult your doctor immediately.

Can douching affect my fertility?

If you're trying to get pregnant, don't douche. A study by the National Institute of Environmental Health Sciences found that women who douche are less likely to conceive in any given month. The practice was linked to a whopping 50 percent decrease in monthly fertility in women between the ages of 18 and 24, and a nearly 30 percent decrease in fertility among women aged 25 to 29. Those who douched more than once a week had the lowest pregnancy rate. After a year of trying to get pregnant, 27 percent of women who douched failed to conceive, compared with 10 percent of those who didn't douche or douched only rarely. (Though the National Womens Health Information Center cautions not to use douching as birth control because it may make pregnancy easier by pushing sperm further into the cervix.)

For pregnant women, douching poses other dangers. A study published in the journal Obstetrics and Gynecology suggests that there's a correlation between frequent douching and low-birthweight babies -- infants who weigh less than 5.5 pounds and are likely to suffer more serious health problems than babies of normal size. Researchers discovered that in a group of nearly 4,700 women, the 650 who douched two to three times a week had a 40 percent greater chance of delivering underweight babies than women who didn't douche. Some experts have speculated that this is because a woman who douches is more likely to get an infection that can penetrate the fluid-filled membrane surrounding the fetus.

Other studies show douching may increase a woman's chance of an ectopic pregnancy, when a woman's fertilized egg attaches to the inside of her fallopian tubes. Left untreated, this condition can be life-threatening and make it more difficult for a woman to get pregnant in the future, according to the National Women's Health Information Center

Is douching ever recommended?

Some doctors occasionally recommend douching for certain vaginal infections. In the majority of cases, they suggest a douche consisting of Lactobacilli-rich Acidophilus, which can be found in health food stores. The best advice is to douche only if your doctor recommends it.

References

Douching Frequently Asked Questions. Womens Health.gov. last updated May 18, 2010

Baird DD, et al. Vaginal douching and reduced fertility. Am J Public Health 1996 Jun;86(6):844-50.

Jeffrey T. Kirchner. Prevalence of Vaginal Douching Despite its Adverse Effects. American Family Physician Feb 1, 2000.

Ness RB, et al. Douching and endometriosis: results from the PID evaluation and clinical health (PEACH) study. Sex Transm Dis 2001 Apr;28(4):240-5.

Zhang J, et al. Vaginal douching and adverse health effects: a meta-analysis. Am J Public Health 1997 Jul;87(7):1207-11.

National Womens Health Information Center. Douching. December 2005.

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