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When it comes to avoiding infection, health care professionals consistently recommend regular washing. It follows then, that regular vaginal douching would be a healthy practice, right? Wrong. Most doctors recommend that you do not douche. Vaginal douching does not protect you from STDs or pregnancy, and yet in the United States nearly one in five women[1] 15 to 44 years old do it regularly[2]. So, how has this practice persisted even through all signs point towards it being unhealthy?

What is douching and why do people do it?

Vaginal douching* is the act of flushing out the vagina with a fluid usually comprised of water and vinegar, baking soda, or iodine. The mixtures can be purchased over the counter and are squirted up into the vagina through a tube or nozzle[2]. In many communities, douching is introduced to young people by relatives and friends for hygienic reasons. Some douche after their period, and others after sex in an effort to prevent odor, pregnancy, or sexually transmitted infections (STDs)[3],[4]. However, douching actually causes more harm than good.

Why shouldn’t I douche?

The following negative health consequences have been associated with douching:

• STDs
• Bacterial Vaginosis (BV)
• Pelvic Inflammatory Disease (PID)
• Issues with pregnancy, including preterm birth, ectopic pregnancy, and reduced fertility

Though it may seem counterintuitive, douching can actually increase rates of these negative health outcomes. One study showed that those who always douched had nearly twice as high of a risk for getting an STD as non-douchers[5]. Even more staggering is that those who douche once a week are five times more likely to develop BV than women who do not douche2. Similar correlations have been found between douching and PID, ectopic pregnancy, as well as cervical cancer[6],[7],[8],[9].

With regards to douching as a form of contraception, not only is it ineffective but it potentially could increase the likelihood of conception by pushing the sperm further up the vagina

Why does douching make me more susceptible to STDs, PID, etc.?

A healthy vagina contains a delicate balance of bacteria. Although different douching solutions have varying effects on the vaginal microbiome, they are all disruptive. By removing certain protective bacteria from the vagina, they leave it more vulnerable to infection[11]. Not to mention, if there is already any infection present, the pressure from the douching may push it further into the body[12].

So then how do I clean my vagina?

Vaginas are unique in that they can self-clean! The membranes of the vaginal walls secrete mucus which washes away blood, semen, and vaginal discharge. You can help your vagina do its job by washing the outside of it (the vulva) with warm water or mild soap. Note that if you have particularly sensitive skin, even a mild soap could cause irritation. Also, be sure to steer clear of any scented feminine hygiene products such as tampons, pads, sprays, and powders2. The chemicals used to scent the products can disrupt the vaginal environment leaving it more susceptible to infection.

But it smells!

Even clean, healthy vaginas have a mild odor that fluctuates throughout the day. The smell can change with your menstrual cycle or physical activity. Although douching and products that promise to make your vagina smell like roses may seem tempting, they will only conceal a scent temporarily. These products are actually more likely to cause irritation, infection, and more pungent odors long term.

If you notice a stronger vaginal odor than you are used to or an odor that is accompanied by additional symptoms (burning, itching, thick discharge, etc.) see a health care provider. Bacterial Vaginosis, also known as BV, is the most common vaginal infection that causes odor. Trichomoniasis is a common STD that can cause a fishy vaginal odor. Both of these infections can be easily cured with antibiotics once you are diagnosed. Other common vaginal infections like chlamydia, gonorrhea, and yeast infections are usually odorless. Be sure to avoid douching before going into the clinic because doing so may impair the clinician’s ability to detect your infection[13].

So what is the truth behind douching? The truth is that rather than protecting you from STDs or unwanted pregnancy, it can leave you more vulnerable to infection. Want to learn more about other common causes of vaginal odor or discomfort? Check out this blog on some of the most common genital infections. Looking for convenient, discreet, at-home STI Testing? Take our simple quiz to find the right test for you.

*Rectal douching is also practiced, but not addressed in this blog post. All mentions of douching here refer to vaginal douching.

Sources:

[1] Not only women douche. Anyone with a vagina can douche.

[2] Office on Women’s Health

[3] Martino JL, Vermund SH. Vaginal douching: evidence for risks or benefits to women’s health. Epidemiol Rev. 2002;24(2):109–124. doi:10.1093/epirev/mxf004

[4] Ness, R. B., Hillier, S. L., Richter, H. E., Soper, D. E., Stamm, C., Bass, D. C., . . . Aral, S. (2003). Why Women Douche and Why They May or May Not Stop. Sexually Transmitted Diseases, 30(1), 71-74. doi:10.1097/00007435-200301000-00014

[5] Tsai CS, Shepherd BE, Vermund SH. Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents. Am J Obstet Gynecol. 2009;200(1):38.e1–38.e388. doi:10.1016/j.ajog.2008.06.026

[6] Wølner-Hanssen P, Eschenbach DA, Paavonen J, et al. Association Between Vaginal Douching and Acute Pelvic Inflammatory Disease. JAMA. 1990;263(14):1936–1941. doi:10.1001/jama.1990.03440140062032

[7] Ness, R. B., Soper, D. E., Holley, R. L., Peipert, J., Randall, H., Sweet, R. L., . . . Bass, D. C. (2001). Douching and Endometritis. Sex Transm Dis, 28(4), 240-245. doi:10.1097/00007435-200104000-00010

[8]Kendrick, J. S., Atrash, H. K., Strauss, L. T., Gargiullo, P. M., & Ahn, Y. W. (1997). Vaginal douching and the risk of ectopic pregnancy among black women. American Journal of Obstetrics and Gynecology, 176(5), 991-997. doi:10.1016/s0002-9378(97)70391-0

[9]Gardner, J. W., Schuman, K. L., Slattery, M. L., Sanborn, J. S., Abbott, T. M., & Overall, J. C. (1991). Is Vaginal Douching Related to Cervical Carcinoma? American Journal of Epidemiology, 133(4), 368-375. doi:10.1093/oxfordjournals.aje.a115890

[10] Case Western Reserve university

[11] Obstet Gynecol. 1992 Sep;80(3 Pt 1):333-8. Quantitative and qualitative effects of douche preparations on vaginal microflora.Onderdonk AB1, Delaney ML, Hinkson PL, DuBois AM.

[12] Ness R, Brooks-Nelson D. Pelvic inflammatory disease. In: Goldman MB, Hatch MC, editors. Women & health. Academic Press; San Diego, CA: 2000. pp. 369–80.

[13] Mayo Clinic