Should a woman douche?

Douching

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.

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.

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.

Lisa Mihaly, a family nurse practitioner at the Women’s Community Clinic in San Francisco, says, “Most women who douche have been led to believe that there is something wrong with them. They think of douching almost as a medication that they can take home to ‘restore’ their vagina. Douching can seem like a quick fix to something that is not even a physical problem. The problem is really that women are made to feel this way about their bodies.”

This sort of logic seems to be at play in Mexico City. The term “vaginal shampoo” has entered the personal care market here disguised as a more medically conscious alternative to douching. The only aspect differentiating douching from vaginal shampoo is that douching has the option to be done with a nozzle-and-bag contraption—vaginal shampoo isn’t promoted with that function. Advertisements boast its abilities to balance a woman’s pH and prevent odor and irritation.

2001 was the first year that Mexican public high schools and middle schools began teaching sexual health, which means the oldest Mexican who has taken a sex-ed class is 34. According to schoolteachers, Carlos Alberto Lopez Flores, a middle-school teacher at Montes de Oca, and Citlalli Lopez Renón, a high-school teacher at Colegio Madrid, it wasn’t until 2011 that it became a requirement that elementary schools in Mexico teach parts of the body and basic hygienic practices. Elena Langurica Naves, a social worker at Clínica Especializada Condesa, the largest HIV/AIDS clinic in Latin America, says she’s frustrated with the state of sexual education in Mexico. “To many people here, teaching sexual education is practically a sin,” she says. “They believe it’s a sin that teachers are even talking about sexual issues. Families think that if you start talking about sexual health then their children are going to start having sex.”

Naves and the schoolteachers I spoke with told me that in the Distrito Federal there is a quiet disagreement going on over who should be teaching sexual health, parents or teachers. Youth and adults alike may fill in the gaps with whatever information they can find, including that of TV advertisements.

Font, the gynecologist, believes that television publicity is mainly responsible for vaginal shampoo’s rise in popularity. Yet, she believes that vaginal shampoo can be beneficial for maintaining good hygiene. “I recommend whatever brand of vaginal shampoo. However, it should only be used outside of the vagina, and daily, whenever you shower,” she says. “I can’t speak for Lactacyd’s abilities to balance the pH because I’ve never tried it myself, but there are many other cheaper brands out there that serve the same purpose.”

Font isn’t the only gynecologist who recommends vaginal shampoo to her patients. Gustavo Quiros Licona is another who remarked upon the benefits of daily use of Lactacyd. When Googling gynecologists in Distrito Federal, Licona’s clinic is one of the first search results, and the space is a true testament to its impressive SEO techniques. While in the waiting room, I stared in awe at the enormous sign advertising a promotion for 30 percent off consultations, 20 percent off prescription drugs, 5 percent off surgery, and 50 percent off spa treatments in exchange for a two-hour photo shoot for promotional photos for the clinic.

Many women claim that douching makes them feel cleaner, eliminates embarrassing odor and protects them against infection. But they may be doing harm to themselves along the way.

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I advise my patients not to douche on a regular basis. The vagina is a self-cleaning organ. When you try to cleanse it yourself by using a douche, you actually flush out the normal, healthy microbes as well as temporarily change the pH (acidic vs. basic nature of the vagina). Rather than providing protection, this sets up an environment that makes it easier for infections to develop.

Additionally, all douche formulations — save for the pure saline varieties — contain ingredients that could trigger an adverse or allergic reaction.

The term, douche, which means “to wash” or “to shower” in French, refers to cleansing the vagina using a solution of water mixed with another fluid — often vinegar, baking soda or some sort of perfume.

The odor dilemma

Women frequently tell me that they douche because they’re concerned about odor. I tell them it’s normal to have some odor. It’s also normal to have the odor change in nature and intensity throughout the menstrual cycle.

Some patients say they notice more odor after making a change in diet, such as eating garlic, tuna or beginning to take dietary supplements. Once they stop consuming the offending food or other products, the odor usually goes away.

Washing the outside area — the vulva — with deodorant soap can decrease the natural odor, but it may also dry out the sensitive tissue, so I advise women to use caution. Most physicians recommend washing only with water, especially if you’re experiencing dryness, itching or burning.

How to tell when an odor represents a red flag

Some odors may occur due to a health issue. If you smell a persistent and foul odor, or if any odor is accompanied by a thick or greenish discharge, you may have an infection. See your OB/GYN for a firm diagnosis and treatment. Also, definitely visit your doctor if you have pain, rawness or sores in your vaginal area.

These odors and accompanying symptoms can arise due to a serious infection like gonorrhea, trichomoniasis, or chlamydia.

But, most commonly, the cause isn’t an infection at all.

An imbalance of the various kinds of bacteria found in the vagina can cause discomfort and odor as well. This imbalance is known as bacterial vaginosis. If you have this problem, your physician will prescribe an antibiotic, which selectively affects only the anaerobic bacteria (bacteria that live without oxygen) and leaves the healthy bacteria intact.

Yeast vaginitis is what most people refer to as a yeast infection, but really occurs because of a bacterial imbalance that allows the yeast to flourish. Your doctor will prescribe one of several medications to treat the abundance of yeast and put the natural balance back in place.

Rarely, foul odor and discharge is caused by a retained foreign object, such as a tampon, condom or toilet paper.

If you’re young and haven’t started your periods, yet have an odor, please see a doctor before attempting to treat it with an over-the-counter remedy.

For those past menopause who experience vaginal odor, lack of estrogen could be the cause. See your doctor for an accurate diagnosis and to discuss treatment options.

RELATED: Tired of Tampons? Here Are Pros and Cons of Menstrual Cups

The big takeaway

Your vagina cleans itself, so avoid using a douche, which may actually harm vaginal health. See your OB/GYN annually for your well woman visit and in between visits if you have any pressing concerns.

Contributor: Elisa Ross, MD

Douching: Don’t Do It Despite These Common Myths

What Health Risks Can Douching Cause?

Once a recommended medical practice, vaginal douching is now known to upset the natural pH of the vagina. The vagina naturally maintains an acidic environment with a pH level of 3.5 to 4.5. This acidic environment is favorable to the healthy bacteria that naturally grow in the vagina, and unfavorable to harmful bacteria that might try to move in.

Douching with vaginal wipes, soaps, and perfumes raises the pH level of the vagina. An elevated pH means that the healthy flora of the vagina may struggle to survive, while harmful bacteria begin to thrive.

This elevated pH level caused by vaginal douching can cause immediate health problems for a woman, including:

  • Vaginal Dryness: Douching may remove or alter the natural mucous of the vaginal walls.
  • Bacterial Vaginosis: A painful inflammation of the vaginal tissue, bacterial vaginosis occurs when harmful bacteria flourish in the vagina, which is more likely if the natural, healthy bacteria are washed away with douching.
  • Yeast Infections: Yeast grows better in less acidic environments.

Douching can also put women at risk for longer-term health problems. In fact, the US Department of Health and Humans Services notes that women who douche are more likely to have a sexually transmitted disease. Douching can send the harmful bacteria of these infections higher into the reproductive system. Often, women can have chlamydia or gonorrhea without having any symptoms.

Women who douche also have an increased likelihood of developing pelvic inflammatory disease (PID). PID can cause long-term pain in the pelvic region and increase a woman’s chances of ectopic pregnancy and infertility. Some research suggests that even if a woman who douches regularly doesn’t have PID, she will still take longer to conceive than women who don’t.

Douching at least once a week has also been linked to a possible increased chance of developing certain types of cancer — including cervical cancer and ovarian cancer.

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

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.

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.”

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.

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.

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

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.

Douching, according to the US Department of Health and Human Services, is “washing or cleaning out the vagina with water or other mixtures of fluids.”

Douching, according to most of the women’s health professionals we’ve talked to (and HHS), is generally not a good idea.*

So let’s talk about where the notion of douching came from and why it’s generally unnecessary and potentially harmful.

Why do women douche?

Douching has been around for centuries, originally employed as a contraceptive method after sex (it doesn’t work) or as protection against infection (no good for that either).

The idea of douching as a cleansing method is relatively recent. Retailers in the US had been claiming their product “cleaned” since as early as the 1920s, but still the focus was on contraception.

However, when the birth control pill became widely available and socially acceptable, douche producers had to find another way to sell their product. Marketing teams then changed their sales pitch to women to focus on “freshness” and hygiene.

“The vagina is a self-cleaning organ”
– Tom Robbins, Even Cowgirls Get the Blues

As many as one in four or one in five women in the US uses douches, and the practice is most common among teenage girls and Latina and African American women.

The reasons given for douching are to cleanse and refresh, particularly after a period or after sex; to control vaginal odor; and to prevent or manage bacterial vaginosis.

Does douching work?

While douching may temporarily cover up vaginal odor, the answer to the question “Does douching work?” is pretty overwhelmingly “no.”

Bacterial vaginosis. BV is a vaginal infection that occurs when the good Lactobacilli bacteria are overwhelmed by anaerobic bacteria and Gardnerella vaginalis. All these organisms are normally found in the vagina, but sometimes the proportions get out of balance, resulting in infection.

One of the symptoms of BV is a fishy odor, so women may use douches to attempt to counteract the odor. Unfortunately, douching can make matters worse by helping to spread the bacteria up into the uterus, fallopian tubes, and ovaries.

Using douches to prevent BV doesn’t work either; douching upsets the normal bacterial balance and the healthy pH of the vagina, so it actually makes BV more likely rather than less.

Odor. Some vaginal odor is totally normal and healthy, and that odor may change as you move through your cycle, exercise, or engage in sexual activity. So first, let’s dismiss the myth that the vagina should be odorless or smell of strawberries and sunshine. It shouldn’t, and trying to force it to can lead to actual health problems.

A change in odor can result from several things: if you think you have an infection such as BV or trichomoniasis (an STD) or a yeast infection, you need to talk with a doctor. Douching won’t solve or prevent any of these and may well make them much worse.

Your period or menopause can cause changes in vaginal odor. Your period is actually your body’s natural cleansing process as the uterine lining is shed, so douching after is wholly unnecessary. Menopause can change the vagina’s pH and cause a change in odor. Topical estrogen may help with this, but as always when adding hormones, you should discuss the pros and cons with your doctor.

Exercise and diet can both affect vaginal odor. You’re familiar with asparagus pee? Well, welcome to broccoli vagina. Strongly scented foods can actually translate to a change in vaginal odor, so tracking what you eat and eliminating affecting foods can help. Equally, exercise can increase odor in the groin, just as it does in the armpits. Be sure to change out of sweaty exercise clothes right away, and if you feel you must “cleanse,” stick to the external parts of your lady bits and use a pH-balanced product like genneve’s Ultra-Gentle Body Wash or Cleansing Cloths.

If you’re experiencing a change in your vaginal odor that is strong and persistent, especially if it comes with a thicker discharge, you need to make an appointment with your ob/gyn. These can be indicators of an infection such as gonorrhea, BV, yeast vaginitis, or even a forgotten tampon or contraceptive sponge. Your doc will be able to diagnose the issue and set you on a course of treatment.

Cleanse and refresh. The idea that the vaginal area requires special “cleansing” comes more from our societal squeamishness about a woman’s body – and the desire of douche producers to make money –than it comes from any real need. Douching, many wipes, and feminine shampoos and sprays can destroy healthy bacteria and even change your body’s natural pH, allowing the bad bacteria to overwhelm the good.

Tom Robbins’ characters were right when they protested that the “vagina is a self-cleaning organ” – under most conditions, it does the job very nicely all by itself, thank you.

How douching causes problems

Instead of solving problems, douching can actively cause them, often resulting in the same problems women were hoping to avoid, namely infection, odor, and discharge. It can also impact fertility.

According to Dr. Lora Shahine, MD, FACOG at Pacific NW Fertility, “The vagina has a natural balance of bacteria, proteins, and more that get altered with douching. This can lead to overgrowth of certain organisms and lead to a higher risk of infection.

“Douching can also decrease chances of conception by decreasing the amount of cervical mucus that helps sperm gets through the cervix on their way to fertilized eggs.” So if you’re trying to get pregnant, douching can interfere.

According to research by Jenny L Martino and Dr. Sten Vermund, douching has been associated with a higher risk of infection and higher risk of pelvic inflammatory disease, BV, cervical cancer, fertility and pregnancy concerns, HIV transmission, STDs, ectopic pregnancy (where the fertilized egg attaches in the fallopian tube rather than continuing to the uterus), recurrent and vulvovaginal candidiasis. It can also contribute to a higher rate of urinary tract infections (UTIs).

Removing the natural vaginal flora by douching leaves the body vulnerable; forcing infections and bacteria further up into the body can complicate and worsen existing issues. In some cases, douching can actually be quite dangerous: in women who douche more than once a week, there appears to be an increased risk of cervical cancer.

When is douching a good or useful practice?

There are times when douching serves a useful purpose. Trans women who have had vaginoplasty may find that douching helps manage post-operative healing, for example. For the most part, however, douching is an unnecessary practice that says more about society’s stigmas around the female body than it does about your personal hygiene.

If you have any questions or concerns about douching, ask your ob/gyn to talk though the pros and cons with you. *Remember, this blog is never intended to replace the care of a qualified health care practitioner.

Have you had negative or positive experiences with vaginal douches or other hygiene products? Share your story with the genneve community. You can talk with us in the comments below, in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.

Somewhere down the aisle from the tampons and pads are “feminine cleansing washes.” You’ve probably heard of them or may even be using them. The thing is, if you are, you shouldn’t. Through the years, millions of women have been duped into douching — the practice of washing out one’s vagina using vinegar or a feminine product — to stay fresh. But it can actually have the opposite effect.

According to OBGYN Dr. Draion Burch, known as Dr. Drai to his celebrity clientele, using this technique on your private parts is a huge mistake — and potentially harmful.

“Your vagina has a balance of good and bad bacteria,” he explains. “When you douche, you wipe out the good bacteria and allow the bad bacteria to overgrow, leading to bacterial vaginosis.” So ironically, instead of the fresh and clean smell you’re going for, you’re more likely to be left with the strong fishy odor that accompanies bacterial vaginosis.

Shockingly, the Office of Women’s Health estimates that one in four women in America currently douche. “Women over 40 tend to douche more,” notes Dr. Drai. “It’s often a generational thing, with the grandmother teaching the mother that she should douche after sex or menstruation, then the mother teaches her daughter the same, and so on.” But the problem with douching is that your body doesn’t actually need it, explains Dr. Drai — no matter what advertisers lead you to believe.

“The douching product industry preys on women’s insecurities,” Dr. Drai says. “The vagina is a self-cleaning body part that has its own system it place. Leave it alone.”

So, what does he recommend for women who want to keep their lady parts fresh and clean? Dr. Drai recommends skipping the soap, as it can cause irritation to your vulva and vagina. Instead, gently use water on the vulva — that’s all you need.

Sam Escobar Contributor Sam’s enthusiasm for makeup is only rivaled by their love of all things relating to cats.

Do Women Need to Douche?

Ironically, though many women still believe douching will “clean out” the vagina, douching actually increases the risk of bacterial overgrowth and associated vaginal infections. Douching may also cause pre-existing vaginal infections to travel deeper into the female reproductive system, flushing the infection into the uterus, fallopian tubes, and ovaries. Recent studies have even found that douching can increase the risk of contracting sexual transmitted diseases (STDs).

Myths About Douching

So, why do women douche? Experts say it may be due to a number of myths about douching that have taken root. These myths include:

  • Douching is “hygienic,” and part of a woman’s normal cleansing process. Again, no. Douching will wash away menstrual blood and other matter, but it also changes the pH, or the acidity, of the vagina, leaving it vulnerable to infection.
  • I need to douche because my vagina has a bad odor. In fact, douching acts like an air freshener — it only hides odors, but doesn’t make them go away. An unusual vaginal odor could be the sign of a bacterial infection, bladder infection, or STD. Only treatment will clear it up, so see your doctor as soon as possible. Also, keep in mind that your vagina may simply have a mild odor — this doesn’t mean that you’re “unclean.”
  • Douching can prevent pregnancy or sexually transmitted diseases. Douching after sex does not wash semen out of the vagina or prevent pregnancy. Douching has, however, been linked to infertility, and has also been associated with a higher risk of ectopic pregnancy. An ectopic pregnancy occurs when the fetus begins developing anywhere outside of the womb, often in the fallopian tube. This is a serious, potentially life-threatening condition. Douching may also increase the risk that a woman will have a low birth-weight baby.
  • Douching can help treat a bacterial infection. Unfortunately, douching can spread vaginal infections further into your pelvis. It may also make it more difficult for your doctor to find and treat your infection since douching disrupts the normal vaginal environment.

Remember that the vagina has built in, self-cleaning abilities. Experts agree that douching is unnecessary and in many cases, may even be harmful.

Your friend is right. Douching (cleaning your vagina with just water, vinegar or a pre-packaged liquid) isn’t necessary and can actually be harmful. A woman’s body naturally makes a fluid that flushes out harmful bacteria, menstrual blood and semen. Douching changes the normal environment (pH) which upsets the balance of bacteria that normally exist in the vagina. This can lead to a vaginal infection such as BV- bacterial vaginosis. If a woman has a sexually transmitted infection, douching puts her at a much higher risk of developing a serious condition called “pelvic inflammatory disease” or PID. Douching can also cause problems trying to become pregnant and preterm labor if a woman douches during her pregnancy.

Doctors don’t recommend douching. Rather they advise women to wash their vulva and the area around the vaginal opening with warm water and mild soap. Nothing should be placed in the vagina such as soap, or any scented or unscented liquids. See your health care provider if your vagina has an unpleasant odor and/or discharge from your vagina that’s different for you, redness/swelling around the opening to your vagina or burning when you pee. If you have “vaginitis” (BV or yeast infection), or a sexually transmitted infection (STI), your HCP will prescribe treatment.

Dr Sindisiwe van Zyl

The dangers of vaginal douching

11th May 2018 | Spotlight

Dr Sindi van Zyl, General Practitioner

Ever heard of using plain yoghurt, or a mixture of Stoney and Lemon Twist, or

Dr Sindisiwe van Zyl

cinnamon and milk? Well, these are some of the ‘remedies’ that have been recommended to help women douche and get their vaginas to be ‘tight and clean’.

Some people might be shocked by this; but these are just some of the extremes that people go to.

Let’s start off by understanding what douching is.

According to WomensHealth.gov, the word ‘douche’ means to wash or soak. Douching is washing or cleaning out the inside of the vagina with water or other fluids. Most women make their own douching concoctions using water, vinegar, baking soda, yoghurt, cinnamon or iodine.

This last is commonly used by gynaecologists after major surgery.

Douching can lead to infection

The vagina is a self-cleaning organ – it doesn’t need anything to be done to assist it in the cleaning process. When you start douching, you strip the vagina of the bacteria that help it to clean. This leads to infections, the most common being bacterial vaginosis.

The symptoms of bacterial vaginosis are a watery/milky vaginal discharge with a very fishy smell. It smells like tinned pilchards; it’s unmistakeable.

The other infections associated with this practice include vaginal thrush and pelvic inflammatory disease. Women who douche regularly may also have difficulty falling pregnant.

Infections linked to douching

Vaginal Thrush

Vaginal thrush is a common infection caused by an overgrowth of Candida albicans yeast. The yeast lives naturally in the bowel, and in small numbers in the vagina. It is mostly harmless, but symptoms can develop if yeast numbers increase. About 75 per cent of women will have vaginal thrush in their lifetime.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. The Pelvic inflammatory disease often causes no signs or symptoms. As a result, you might not realise you have the condition, and will not get the treatment needed. The condition might only be detected later if you have trouble getting pregnant, or if you develop chronic pelvic pain.

There are a lot of myths regarding vaginal ‘freshness’, and they are passed down from the elders to us. But oh my word, they are not true. Stay away from douching and ‘intimate washes’ – your vagina does not need them. Water will do the trick: yes, the one we get from the tap.

STIs

Moving on, to another important topic: Sexually Transmitted Infections (STIs). (These were previously called Sexually Transmitted Diseases.) There are different categories of STIs. The trick with STIs is that they must be detected early, and treated accordingly; you need to know what those categories are, so that you can seek treatment timeously. Failure to do so increases the risk of HIV infection. This is why we treat them aggressively.

STIs are passed from one person to another through unprotected sex or genital contact.

Common STIs that affect women in South Africa:

Human papillomavirus

Human papillomavirus (HPV) is a viral infection that is passed between people through skin-to-skin contact. There are more than 100 varieties of HPV, 40 of which are passed through sexual contact and can affect your genitals, mouth, or throat.

Genital herpes

Genital herpes is a common infection caused by the herpes simplex virus (HSV), which is the same virus that causes cold sores. There are two types of HSV: type 1 and 2. Type 1 causes cold sores on the lip. Type 2 causes genital lesions. Some people develop symptoms of HSV a few days after coming into contact with the virus. Small, painful blisters or sores usually develop, which may cause itching or tingling, or make it painful to urinate.

Gonorrhoea

Gonorrhoea is a bacterial STI easily passed on during sex. About half of women and one in 10 men don’t experience any symptoms, and are unaware that they’re infected. In women, gonorrhoea can cause pain or a burning sensation when urinating, a vaginal discharge (often watery, yellow or green), pain in the lower abdomen during or after sex, and bleeding during or after sex or between periods. It can sometimes cause heavy periods.

Chlamydia

Chlamydia is passed on during sex. Most people don’t experience any symptoms, so they are unaware they’re infected. In women, chlamydia can cause pain or a burning sensation when urinating, vaginal discharge, pain in the lower abdomen during or after sex, and bleeding during or after sex or between periods. It can also cause heavy periods.

These are just a few of the STIs that exist. The World Health Organisation (WHO) estimates that more than one million people get an STI every day. The danger is that most people with sexually transmitted infections do not have any symptoms, and are therefore often unaware of their ability to pass infections on to their sexual partners.

Regular check-ups enable you to know what you have and how best to treat it. There are many risks posed by STIs. If left untreated, they can cause serious health problems including cervical cancer, liver disease, pelvic inflammatory disease (PID), infertility, and pregnancy problems.

The Well Project (thewellproject.org) says having some STIs (such as chancroid, herpes, syphilis, and trichomoniasis) can increase the risk of getting HIV if you are HIV-negative and are exposed to HIV. People living with HIV may also be at greater risk of getting or passing on other STIs.

But there is no need to fear. If you suspect that you might have contracted an STI, you must see your doctor and get it checked out. There are tests that can be performed to ascertain exactly what it is you might have. The tests include:

Blood tests, which can confirm a diagnosis of HIV, or the later stages of syphilis.

Urine samples: some STIs can be confirmed with a urine sample.

Fluid samples: if you have active genital sores, testing of fluid and samples from the sores may be done to diagnose the type of infection. Laboratory tests of material from a genital sore or discharge are used to diagnose some STIs.

Screening: testing for a disease in someone who doesn’t have symptoms is called screening. Most of the time, STI screening is not a routine part of health care; but there are exceptions:

It is advisable for women who are sexually active to test regularly. Once you are sexually active, you must go for PAP smear screening. The PAP smear screens for cervical abnormalities, including inflammation, pre-cancerous changes and cancer, which is often caused by certain strains of human papillomavirus (HPV).

All sexually active women should be tested for chlamydia infection. The chlamydia test uses a sample of urine or vaginal fluid you can collect yourself. Some experts recommend repeating the chlamydia test three months after you’ve had a positive test and been treated; the second test is needed to confirm that the infection is cured, as re-infection by an untreated or undertreated partner is common. A bout of chlamydia doesn’t protect you from future exposure; you can catch the infection again and again, so get retested if you have a new partner.

Screening for gonorrhoea is also recommended for sexually active women. If you happen to find yourself in a new relationship, it is of paramount importance that you both test for STIs.

Going to the clinic can be daunting. Remember that your health comes first! Keep that in mind when you go to seek assistance at any clinic.

Dr Sindisiwe van Zyl is a GP with a special interest in HIV. She is passionate about sharing health-related information, and has used social media extensively for this purpose. Dr Sindi – as she is affectionately known – is in private practice in Johannesburg. Twitter: @sindivanzyl

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