To Douche or Not to Douche?

Infrequent Douche With Vinegar and Water Appears Safe, Study Shows

From the WebMD Archives

Oct. 15, 2004 -- What is the truth about douches? Most experts say frequent douches increase a woman's risk of developing vaginal infections, but new research shows this might not be true for those who douche less than once a week with a simple vinegar and water solution.

The study showed no association between infrequent douches with vinegar and water and vaginal infections in a population of black women of childbearing age being seen at two New York City women's health centers.

Douches: Harmful to Your Health?

The research appears to contradict previous studies linking regular douches to vaginal infections. Study researcher Albert George Thomas, MD, tells WebMD those prior studies have some flaws.

"The past studies are helpful but not conclusive," he says. "Douching has been linked to all kinds of bad outcomes, including ectopic pregnancy and STDs, but the rigorously designed studies that are needed to prove these associations have not been done."

The nation's top women's health groups do not recommend regular douches. According to the National Women's Health Information Center, a division of the Department of Health and Human Services, research shows that "women who douche on a routine basis tend to have more problems than women who do not douche or who rarely douche." A statement by the group links regular douches with an increased risk of vaginal irritation, pelvic inflammatory disease, bacterial infection, sexually transmitted diseases, low birth-weight babies, and ectopic pregnancy.

In its recommendations for lowering vaginal infection risk, The American College of Obstetricians and Gynecologists (ACOG) warns against douches and the use of feminine hygiene sprays and scented deodorant tampons.

ACOG spokesman David Soper, MD, says douches are potentially harmful because they change the delicate chemical balance of the vagina, destroying the good bacteria called lactobacilli, which protect against infections. Soper is vice chairman of obstetrics and gynecology at the Medical University of South Carolina in Charleston.

"The whole issue of douching is ill advised because it assumes the vagina is dirty and needs regular cleaning, which is the farthest thing from the truth," Soper tells WebMD. "If you douche frequently you run the risk of destroying the protective bacteria and you set yourself up for problems."

Mid-Cycle Douches Discouraged

In the new study by Thomas and colleagues, published in the October issue of the ACOG journal Obstetrics and Gynecology, roughly half of the 360 women who participated reported using a douche regularly but only 2% douched once a week or more.

Frequent douches over the previous three months were found to double a woman's risk of developing a vaginal infection called bacterial vaginosis. But women who douched less than once a week were no more likely to get the vaginal infection than women who never douched.

The investigators cited earlier research showing that vinegar and water douches have a minimal and transient impact on the natural chemical balance of the vagina. Thomas does recommend that women avoid douches in the middle of their menstrual cycle, however, when the cervix is more open and vulnerable to bacteria.

"Douching with vinegar and water does not seem to be unsafe if it is done infrequently, especially if it is not done midcycle," he says.

Show Sources

SOURCES: Zhang et al. Obstetrics and Gynecology, October 2004; vol 104; pp 756-759. Albert George Thomas, MD, director, obstetrical services; and director, family planning services, Mount Sinai Medical Center, New York City. David Soper, MD, vice chairman, ob-gyn, Medical University of South Carolina, Charleston.
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