Introduction
Vaginal douching, or douching, refers to the process of vaginal irrigation with a liquid solution. It is a common practice among women and is performed for hygiene maintenance and other reasons. A special device called a douche bag is used to introduce water or a liquid solution into the vagina. Though douching helps in hygiene maintenance, it should be avoided because of its association with various health risks.
What Is Vaginal Douching?
Vaginal douching is the process of cleansing the vagina with water or a liquid solution. It is performed using a special device called a douchebag. A douche bag is an equipment that holds the fluid used for douching. This device is used to introduce a liquid solution or water into the vagina. It aids in vaginal irrigation or intravaginal cleansing. Vaginal douching helps with hygiene maintenance and prevents vaginal odor. It is used to cleanse the vagina after sex or menstruation and to prevent pregnancy.
What Are the Benefits of Douching?
Vaginal douching has been associated with various adverse effects rather than health benefits. It includes the following adverse effects:
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Bacterial vaginosis (overgrowth of harmful bacteria in the vagina).
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Pelvic inflammatory disease.
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Low birth weight.
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Preterm birth.
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Sexually transmitted diseases.
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HIV (human immunodeficiency virus) transmission.
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Ectopic pregnancy (a fertilized egg implants and grows in the fallopian tube).
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Recurrent vulvovaginal candidiasis (recurring yeast infection of the vagina).
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Infertility.
Frequent douching may cause an imbalance in the vaginal pH (potential of hydrogen) and increase the risk of vaginal infections.
How Does Douching Increase the Risk of Diseases?
Vaginal douching may contribute to various diseases. Intravaginal cleansing alters the vaginal flora and permits the overgrowth of pathogens. Douching may act as a fluid vehicle for pathogen transport, helping the infections from the lower genital tract to reach the cervix, uterus, fallopian tubes, or abdominal cavity. Frequent douching causes endometritis (inflammation of the lining of the uterus) and upper genital tract infections. If the density of the normal vaginal flora reduces due to douching, bacterial vaginosis may develop or predispose the individual to the colonization of pathogens that cause sexually transmitted diseases. The pathogenic bacteria may enter the reproductive tract and cause endometritis, salpingitis (inflammation of the fallopian tubes), or peritonitis (inflammation of the membrane that lines the abdominal wall and covers the abdominal organs), the main causes of infertility, early miscarriage, and ectopic pregnancy.
What Are the Effects of Douching on Vaginal Flora?
A healthy vaginal environment is composed of lactobacilli. Hydrogen peroxide-producing lactobacilli protects the vagina against the overgrowth of potentially harmful pathogens. Also, the lactic acid produced by the lactobacilli maintains the vaginal pH at less than 4.5, making it unfavorable for the growth of pathogenic bacteria. In addition, lactobacilli adhere to the cells and block the adhesion of pathogenic bacteria, thereby stimulating the immune system. Studies showed that frequent vaginal douching was associated with the presence of pathogenic bacteria such as Trichomonas vaginalis and Gardnerella vaginalis.
Various types of douching liquids cause varying antimicrobial effects. Researchers found that antiseptic douches inhibited all vaginal microorganisms, including lactobacilli. Vinegar-containing douches selectively inhibited the pathogens associated with candidiasis, bacterial vaginosis, and group B streptococcal vaginosis. Four percent acetic acid and povidone-iodine solutions cause a significant reduction in the total bacterial counts. Therefore, it was concluded that douching may decrease the vaginal flora (bacteria), and allow a rapid proliferation of pathogenic bacteria, increasing the risk of infections.
What Are the Diseases Associated With Vaginal Douching?
Vaginal douching alters the vaginal flora, promotes the growth of pathogenic bacteria, and increases the risk of infections. It includes the following:
- Bacterial Vaginosis: Bacterial vaginosis refers to the excessive growth of bacteria in the vagina. It causes malodorous vaginal discharge in women. In bacterial vaginosis, lactobacilli are greatly decreased, and an overgrowth of pathogenic bacteria occurs. Bacterial vaginosis can be caused by various factors that affect the vaginal flora, such as sexually transmitted diseases, menstruation, vaginal medications, multiple sexual partners, and frequent vaginal intercourse. Also, vaginal douching has been associated with bacterial vaginosis, although the cause is not known.
- Sexually Transmitted Diseases: Sexually transmitted diseases caused by gonorrhea and chlamydia infections (sexually transmitted bacterial infections) are the major cause of pelvic inflammatory disease. Douching was found to increase the risk of chlamydial infection. Studies have shown that douching after sex increases the risk of sexually transmitted diseases. Vaginal flora abnormalities due to sexually transmitted diseases and bacterial vaginosis alter the pH of the vagina, thereby increasing the susceptibility to HIV infection.
- Pelvic Inflammatory Disease: Pelvic inflammatory disease refers to the polymicrobial infection caused by infections that reach the upper reproductive tract. The pressure exerted by the douching liquid can cause the pathogens from the lower genital tract to travel and reach the upper reproductive tract, causing pelvic inflammatory disease.
- Ectopic Pregnancy, Infertility, and Reduced Fertility: Ectopic pregnancy is a condition in which the fertilized egg is implanted outside the uterine cavity. Vaginal douching transfers the lower genital tract infections to the upper reproductive tract, resulting in pelvic inflammatory disease, thereby causing ectopic pregnancy, infertility, and reduced fertility.
- Cervical Cancer: Vaginal douching products containing tar (a brown viscous liquid) may increase the risk of invasive cervical cancer. However, a definite relation between vaginal douching and cervical cancer has not been established.
What Are the Benefits of Douching During Pregnancy?
Vaginal douching during pregnancy reduces the risk of mother-to-child transmission of vaginal microorganisms. Douching has also been used during labor. Douching with 0.2 percent chlorhexidine reduces the risk of transmission of microorganisms to the fetus. Douching with 0.5 grams of chlorhexidine was found to suppress the growth of group B Streptococci. Though intrapartum vaginal antiseptic irrigation is highly beneficial, it is different from vaginal douching.
Is Vaginal Douching Significant?
Women perform douching for hygiene maintenance, to prevent vaginal odor, to cleanse after sex and menstruation, and to prevent infection. However, vaginal douching is not essential as the vagina is a self-cleansing organ; it does not require additional cleansing. Therefore, the practice of douching is not recommended except when advised by a physician for medical reasons.
Conclusion
Vaginal douching is the practice of cleansing the vagina using water, liquid solutions, or various douching products. Vaginal douching predisposes a woman to bacterial vaginosis and pelvic inflammatory disease. Douching also increases the risk of sexually transmitted diseases. As douching fluid acts as a vehicle and transports the lower genital tract infections to the upper reproductive tract, it is strongly not recommended. It should be avoided as it alters the vaginal flora and increases the susceptibility to infections rather than preventing the infections. Vaginal douching should not be practiced unless recommended by a physician for medical purposes.
