Biggest study so far backs douching, infection link

October 10, 2002

Last Updated: 2002-10-04 13:00:05 -0400 (Reuters Health)

By Dana Frisch

NEW YORK (Reuters Health) - Women who douche at least once a month are 40%

more likely to have a mild bacterial infection of the vagina than women who

do not douche at all, researchers report.

The study, in the October issue of Obstetrics & Gynecology, found that the

risk of having such an infection, known as bacterial vaginosis, was more

than doubled among women who reported douching within the previous week. The

researchers found no association between douching and sexually transmitted

diseases (STDs) such as gonorrhea and chlamydia, however.

Bacterial vaginosis is typically found in 5% to 50% of women, particularly

those who are sexually active. It is the result of excessive amounts of a

certain type of anaerobic bacteria, or bacteria that does not require oxygen

to survive, colonizing the vagina. When present in large amounts, these

bacteria crowd out other, healthier bacteria normally found in the vagina,

particularly a type called lactobacilli. Symptoms include odor and a

discharge.

Douching is suspected to be associated with bacterial vaginosis because it

can change the vagina's bacterial balance.

In an interview with Reuters Health, Dr. a Ness, lead author of the

study and a professor of epidemiology at the University of Pittsburgh,

Pennsylvania, said that this study with 1,200 women at high risk of

contracting an STD is the largest to date on the topic. Results, she said,

are strengthened by the association she and her colleagues found between

douching and having bacterial vaginosis-associated bacteria in the vagina.

Ness cautions that it is difficult to determine whether women douched

because of the odor and discharge of bacterial vaginosis, or whether

douching resulted in those symptoms. They found that even when women douched

for hygienic reasons, rather than for such abnormal symptoms, they were more

likely to have bacterial vaginosis, indicating that the symptoms occurred

after, and not before, douching.

" I certainly would say that women who don't douche, from a health

perspective, it would not be recommended to start, " said Ness. " For women

who do douche, if they can stop, it is certainly advantageous. "

Studies indicate that for many women, she noted, douching is " a very deeply

held hygiene behavior, " much like brushing one's teeth. Some women who

douche might feel as unclean if they stopped douching, she added, as they

would if they stopped brushing their teeth.

SOURCE: Obstetrics & Gynecology 2002;100:765-772.

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