Epidemiologic Reviews 24:109-124 (2002)
© 2002 by the Johns Hopkins Bloomberg School of Public Health
Vaginal Douching: Evidence for Risks or Benefits to Women’s Health
From the Schools of Public Health and Medicine, University of Alabama at Birmingham, Birmingham, AL.
Received for publication September 6, 2001; accepted for publication April 22, 2002.
Abbreviations: CI, confidence interval; OR, odds ratio; RR, risk ratio.
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INTRODUCTION |
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Vaginal douching is the process of intravaginal cleansing with a liquid solution. Douching is used for personal hygiene or aesthetic reasons, for preventing or treating an infection (1), to cleanse after menstruation or sex, and to prevent pregnancy (2). For at least 100 years, there have been conflicting views on the benefits or harm in douching. Although there is a broad consensus that douching should be avoided during pregnancy, there is less agreement regarding douching for hygiene and relief of vaginitis symptoms. Two earlier reviews of douching data in women (3) and adolescents (4) have concluded that douching is harmful and should be discouraged because of its association with pelvic inflammatory disease, ectopic pregnancy, and perhaps other conditions. Nonetheless, douching continues to be a common practice. We seek to review the evidence of the impact of douching on women’s health.
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METHODS |
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Studies included
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EPIDEMIOLOGY OF DOUCHING |
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HEALTH EFFECTS OF DOUCHING |
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PHYSIOLOGY |
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DOUCHING AND VAGINAL ECOLOGY |
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BACTERIAL VAGINOSIS |
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GONORRHEA, CHLAMYDIA, AND OTHER SEXUALLY TRANSMITTED DISEASES |
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PELVIC INFLAMMATORY DISEASE |
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REDUCED FERTILITY, INFERTILITY, AND ECTOPIC PREGNANCY |
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CERVICAL CANCER |
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HUMAN IMMUNODEFICIENCY VIRUS |
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DOUCHING FOR VAGINOSIS OR VAGINITIS |
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INTRAPARTUM OR ROUTINE HYGIENIC DOUCHING |
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MEDICAL AND PUBLIC HEALTH ORGANIZATIONS AND DOUCHING |
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FUTURE DIRECTIONS AND CONCLUSIONS |
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ACKNOWLEDGMENTS |
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