…that is the question.  The answer:  not to douche.  Have you seen it in magazine and tv ads?  Have you heard it from your mom or grandma?  “Douche to feel fresh and clean.” Sure, everyone wants to have a clean, fresh vagina, but here’s the great news:  the vagina is self-cleaning.  You don’t need to douche.  Furthermore, douching can actually be harmful.

Q:  What is douching?

A: Douching is the use of solution to rinse the inside of the vagina.  Solutions used to rinse the vagina may be homemade or commercial.  They usually consist of ingredients such as water and vinegar, baking soda, iodine, surfactant detergents, and fragrances.  Commercially available douches in the United States include Massengil and Summer’s Eve.

Q: Why do some women douche?

A: Douching is a traditional practice that has been passed from generation to generation.  Reasons cited for douching include cleanliness, odor control, and relief of vaginal itching or irritation.  Some women douche before or after sex, and some douche after menstruation.  Some even mistakenly think douching will prevent pregancies or STDs.

Q: What are the benefits of douching?

A: There are no known health benefits to douching.

Q: What are the harmful effects of douching?

A: Douching is associated with increased risks for:

1.  Bacterial Vaginosis (BV) – Douching alters the normal pH and flora of the vagina.  The vagina does a really good job of maintaining its own balance of bacteria and pH.  Douching disturbs this balance, which can lead to overgrowth of harmful bacteria.  Most studies show that women who douche are up to 5 times more likely to develop BV than women who don’t douche.

2.  Pelvic Inflammatory Disease (PID) – Douching can force bacteria into the uterus, fallopian tubes, and ovaries.  Most studies show an assocation between PID and douching.  In fact, commercially available douche products contain a warning about the risk of PID with douching.  See what the American College of Obstetrics and Gynecology has to say about PID and douching.

3.  HIV and other sexually transmitted diseases – Douching is an independent risk factor for HIV.  The surfactant detergents found in douches can irritate and disrupt mucosal cell surfaces, which then increases susceptibility to genital tract infections.

4.  Ectopic pregnancy – In a CDC case-controlled study, women with a history of douching were almost four times more likely to have an ectopic pregnancy than women who never douched.  An ectopic pregnancy is a pregnancy that occurs outside of the uterus.  It is potentially life-threatening to the mother.

5.  Preterm birth – Several studies have found that douching is associated with as much as a fourfold increase in preterm birth.  Regular douching is also associated with a risk of having a low-birth-weight infant.  Preterm and low-birth weight infants are more likely to have serious health problems.

Q: So, how should vaginas be cleaned?

A: Let the vagina clean itself.  The vagina is smart – it uses its own mucous secretions to clean inside of it.  Clean the outer area of the vagina with warm water and unscented soap.  Avoid use of feminine hygiene products such as powders and sprays.  These products lead to irritation and are unnecessary.

Vaginal symptoms, such as itching or unusual odor, should be evaluated by your healthcare provider.    Douching is not part of good vaginal hygiene, will not help with infections, and in fact can cause harm.  So, the answer is most definitely… Not to douche.