Douching

Abstract

To compile available published data on the prevalence of douching practices in adolescent girls and young women and the effects of douching on gynecologic health, including studies of gynecologic changes due to douching in adolescent girls and young women, surveys that demonstrated the prevalence of douching in the populations, and policy statements or lack thereof from professional and medical organizations with regard to the practice of douching.Data Sources: We did Internet searches, including a MEDLINE search, a literature review, and used the telephone, mail, and e-mail to contact professional organizations.Results: Douching has been found to be strongly associated with increased risk for pelvic inflammatory disease, bacterial vaginosis, and ectopic pregnancy, the former of which is especially prevalent in adolescent girls and young women. Douching is practiced by 15.5% of adolescent girls and young women in the United States, with significantly higher prevalences in certain groups in the population. We have not found any official position of professional and medical organizations on the practice of douching.Conclusions: Because vaginal douching has been shown to be associated with bacterial vaginosis, pelvic inflammatory disease, and ectopic pregnancy, and because no benefits are conferred on those who practice it, douching should be discouraged among adolescent girls and young women. There is a great need for further studies, particularly prospective ones, to determine if there is evidence of a direct causative influence of douching on pelvic inflammatory disease, ectopic pregnancy, and/or bacterial vaginosis, and to determine why adolescent girls and young women douche.

A report on the reproductive health of women after the massive 2008 Wenchuan earthquake

“…Vaginal douching remains controversial. It has often been linked to increased risks of pelvic inflammatory disease, ectopic pregnancy, reduced fertility, and bacterial vaginosis [5][6][7]. However, recent studies in low-income countries concluded that, in certain circumstances, it may be beneficial [8][9][10][11][12], and our study results are consistent with these findings.…”

Vaginal Microbiota of Adolescent Girls Prior to the Onset of Menarche Resemble Those of Reproductive-Age Women

“…Without a frame of reference for “normal” vaginal microbiota in healthy adolescents, the clinical relevance of microbiota resembling that associated with bacterial vaginosis is uncertain. Furthermore, as girls progress into menarche, menstrual hygiene behaviors, including use of menstrual pads and tampons, bathing habits, and douching, may alter existing vaginal microbiota ( 20 , 25 – 30 ). Finally, changes in the early vaginal microbiota may have lasting influences on subsequent vaginal health, but our understanding of the complex interactions of immune tolerance of indigenous bacterial populations, immune surveillance for vaginal pathogens, variability in vaginal microbiota, and reproductive health outcomes remains primitive ( 31 , 32 ).…”

Prevalence and Correlates of Recent Vaginal Douching among African American Adolescent Females

“…For example, some studies have identified no significant association between vaginal douching and PID 47 , bacterial vaginosis 13, 48 , Chlamydia 2, 36, 38 , trichomonasis 13, 36–37 , or gonorrhea. 2, 36, 38 The apparent discrepancy between studies may be attributable, in part, to inconsistencies between study samples in the types of products used for vaginal douching 44 , reasons for vaginal douching 49 , frequency and duration of vaginal douching 14, 19, 42–43 , and timing in relation to sexual activity and menses. 49 For example, certain studies have specifically identified that the association between vaginal douching and PID 19 , bacterial vaginosis 14 and Chlamydia 42–43 is dependent on frequency of douching.…”

“…2, 36, 38 The apparent discrepancy between studies may be attributable, in part, to inconsistencies between study samples in the types of products used for vaginal douching 44 , reasons for vaginal douching 49 , frequency and duration of vaginal douching 14, 19, 42–43 , and timing in relation to sexual activity and menses. 49 For example, certain studies have specifically identified that the association between vaginal douching and PID 19 , bacterial vaginosis 14 and Chlamydia 42–43 is dependent on frequency of douching. Outcomes may also vary as a function of type of solution used to douche; one study suggests that vaginal douching with non-commercial preparations is associated with an increased prevalence of HIV, while vaginal douching with commercial preparations is associated with decreased HIV prevalence.…”