pmc logo image
Logo of amjphAmerican Journal of Public Health Web SiteAmerican Public Health Association Web SiteSubmissionsSubscriptionsAbout Us

Formats:

Am J Public Health. 1997 July; 87(7): 1207–1211.
PMCID: PMC1380899
Vaginal douching and adverse health effects: a meta-analysis.
J Zhang, A G Thomas, and E Leybovich
Department of Community Medicine, Mount Sinai School of Medicine, New York City 10029-4571, USA.
Abstract
OBJECTIVES: The meta-analysis described here reviewed the current literature on adverse health effects of vaginal douching. METHODS: Papers published in English from 1965 through 1995 were potentially eligible. RESULTS: One third of White women and two thirds of Black women of reproductive age reported douching regularly. Analyses indicated that vaginal douching increases the overall risk of pelvic inflammatory disease by 73% and the risk of ectopic pregnancy by 76%. Frequent douching was shown to be highly associated with pelvic inflammatory disease and modestly associated with cervical cancer. CONCLUSIONS: Current literature suggests that frequent douching increases the risk of pelvic inflammatory disease, ectopic pregnancy, and, possibly, cervical cancer.
Full text
Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
  • DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. [PubMed]
  • Smith SJ, Caudill SP, Steinberg KK, Thacker SB. On combining dose-response data from epidemiological studies by meta-analysis. Stat Med. 14(5-7):531–544. [PubMed]
  • Aral SO, Mosher WD, Cates W., Jr Vaginal douching among women of reproductive age in the United States: 1988. Am J Public Health. 1992 Feb;82(2):210–214. [PMC free article] [PubMed]
  • Rosenberg MJ, Phillips RS, Holmes MD. Vaginal douching. Who and why? J Reprod Med. 1991 Oct;36(10):753–758. [PubMed]
  • Chacko MR, McGill L, Johnson TC, Smith PB, Nenney SW. Vaginal douching in teenagers attending a family planning clinic. J Adolesc Health Care. 1989 May;10(3):217–219. [PubMed]
  • Forrest KA, Washington AE, Daling JR, Sweet RL. Vaginal douching as a possible risk factor for pelvic inflammatory disease. J Natl Med Assoc. 1989 Feb;81(2):159–165. [PMC free article] [PubMed]
  • Washington AE, Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000. JAMA. 1991 Nov 13;266(18):2565–2569. [PubMed]
  • Wølner-Hanssen P, Eschenbach DA, Paavonen J, Stevens CE, Kiviat NB, Critchlow C, DeRouen T, Koutsky L, Holmes KK. Association between vaginal douching and acute pelvic inflammatory disease. JAMA. 1990 Apr 11;263(14):1936–1941. [PubMed]
  • Scholes D, Daling JR, Stergachis A, Weiss NS, Wang SP, Grayston JT. Vaginal douching as a risk factor for acute pelvic inflammatory disease. Obstet Gynecol. 1993 Apr;81(4):601–606. [PubMed]
  • Chow WH, Daling JR, Weiss NS, Moore DE, Soderstrom R. Vaginal douching as a potential risk factor for tubal ectopic pregnancy. Am J Obstet Gynecol. 1985 Dec 1;153(7):727–729. [PubMed]
  • Daling JR, Weiss NS, Schwartz SM, Stergachis A, Wang SP, Foy H, Chu J, McKnight B, Grayston JT. Vaginal douching and the risk of tubal pregnancy. Epidemiology. 1991 Jan;2(1):40–48. [PubMed]
  • Chow JM, Yonekura ML, Richwald GA, Greenland S, Sweet RL, Schachter J. The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study. JAMA. 1990 Jun 20;263(23):3164–3167. [PubMed]
  • Phillips RS, Tuomala RE, Feldblum PJ, Schachter J, Rosenberg MJ, Aronson MD. The effect of cigarette smoking, Chlamydia trachomatis infection, and vaginal douching on ectopic pregnancy. Obstet Gynecol. 1992 Jan;79(1):85–90. [PubMed]
  • Graham S, Schotz W. Epidemiology of cancer of the cervix in Buffalo, New York. J Natl Cancer Inst. 1979 Jul;63(1):23–27. [PubMed]
  • Peters RK, Thomas D, Hagan DG, Mack TM, Henderson BE. Risk factors for invasive cervical cancer among Latinas and non-Latinas in Los Angeles County. J Natl Cancer Inst. 1986 Nov;77(5):1063–1077. [PubMed]
  • Brinton LA, Hamman RF, Huggins GR, Lehman HF, Levine RS, Mallin K, Fraumeni JF., Jr Sexual and reproductive risk factors for invasive squamous cell cervical cancer. J Natl Cancer Inst. 1987 Jul;79(1):23–30. [PubMed]
  • Stone KM, Zaidi A, Rosero-Bixby L, Oberle MW, Reynolds G, Larsen S, Nahmias AJ, Lee FK, Schachter J, Guinan ME. Sexual behavior, sexually transmitted diseases, and risk of cervical cancer. Epidemiology. 1995 Jul;6(4):409–414. [PubMed]
  • Gardner JW, Schuman KL, Slattery ML, Sanborn JS, Abbott TM, Overall JC., Jr Is vaginal douching related to cervical carcinoma? Am J Epidemiol. 1991 Feb 15;133(4):368–375. [PubMed]
  • Herrero R, Brinton LA, Reeves WC, Brenes MM, Tenorio F, de Britton RC, Gaitan E, Garcia M, Rawls WE. Sexual behavior, venereal diseases, hygiene practices, and invasive cervical cancer in a high-risk population. Cancer. 1990 Jan 15;65(2):380–386. [PubMed]
  • Brinton LA, Nasca PC, Mallin K, Schairer C, Rosenthal J, Rothenberg R, Yordan E, Jr, Richart RM. Case-control study of in situ and invasive carcinoma of the vagina. Gynecol Oncol. 1990 Jul;38(1):49–54. [PubMed]
  • Rosenberg MJ, Phillips RS. Does douching promote ascending infection? J Reprod Med. 1992 Nov;37(11):930–938. [PubMed]
  • HIRST DV. Dangers of improper vaginal douching. Am J Obstet Gynecol. 1952 Jul;64(1):179–183. [PubMed]
  • PERLOFF WH, STEINBERGER E. IN VIVO SURVIVAL OF SPERMATOZOA IN CERVICAL MUCUS. Am J Obstet Gynecol. 1964 Feb 15;88:439–442. [PubMed]
  • Spinillo A, Pizzoli G, Colonna L, Nicola S, De Seta F, Guaschino S. Epidemiologic characteristics of women with idiopathic recurrent vulvovaginal candidiasis. Obstet Gynecol. 1993 May;81(5 ):721–727. [PubMed]