Abstract

Despite the long history of vaginal douching and its estimated practice by more than 67 million U.S. women, little is known about who those women are or why they douche. We addressed these questions by studying 618 women from urban gynecology practices. Fifty-nine percent had douched at some time, with the most frequent reason given as hygiene. The solutions used were evenly divided between commercial and home preparations. Three characteristics stood out among the women who douched: lower socioeconomic status, greater risk of sexually transmitted diseases and symptoms suggestive of vaginal infection. These characteristics were most common among women who douched frequently. The results suggest that douching has a strong cultural component but also raise the possibility that douching may be done in response to a perceived infection, possibly one transmitted through sexual contact.

PIP:

Although an estimated 67 million US women douche, little is known about who practices vaginal douching and for what purposes. These questions were addressed in a study of 618 women 18-50 years of age who sought gynecological care at 4 sites (a hospital-based academic practice, 2 private practices, and a women's center) between July 1986-June 1987. 366 (59%) of these women had douched at some time. Of these women, 85% douched less than once a month, 12% douched at least once a month but less often than once a week, and 3% douched at least once a week. Women who douched were more likely to be black, less educated, younger, and of lower socioeconomic status and less likely to use spermicides or barrier contraceptives than their counterparts who did not report this practice. A comparison of the symptoms and reproductive histories of the subgroups in this study revealed two main trends. First, symptoms indicative of vaginal infection were significantly more common among women who douched; discharge was 3 times as common and vaginal irritation and abdominal or pelvic pain were twice as frequent than in non-douchers. Second, women who douched were more likely to have characteristics reflecting a high risk of sexually transmitted diseases (STDs); a history of prior gonorrhea, trichomoniasis, pelvic inflammatory disease, or other STD and the existence of 2 or more sexual partners in the previous month were reported significantly more frequently than in nondouchers. All of these characteristics increased in prevalence with increases in the frequency of douching. Two thirds of women stated they douched for reasons of hygiene. Although douching does not appear to be adopted to prevent or treat infection, symptoms of infection may affect the frequency of this practice.