Breaking Down Vaginal Douching: Pros and Cons
Douching, according to the US Department of Health and Human Services, is “washing or cleaning out the vagina with water or other mixtures of fluids.”
Douching, according to most of the women’s health professionals we’ve talked to (and HHS), is generally not a good idea.*
So let’s talk about where the notion of douching came from and why it’s generally unnecessary and potentially harmful.
Why do women douche?
Douching has been around for centuries, originally employed as a contraceptive method after sex (it doesn’t work) or as protection against infection (no good for that either).
The idea of douching as a cleansing method is relatively recent. Retailers in the US had been claiming their product “cleaned” since as early as the 1920s, but still the focus was on contraception.
However, when the birth control pill became widely available and socially acceptable, douche producers had to find another way to sell their product. Marketing teams then changed their sales pitch to women to focus on “freshness” and hygiene.
“The vagina is a self-cleaning organ”
– Tom Robbins, Even Cowgirls Get the Blues
As many as one in four or one in five women in the US uses douches, and the practice is most common among teenage girls and Latina and African American women.
The reasons given for douching are to cleanse and refresh, particularly after a period or after sex; to control vaginal odor; and to prevent or manage bacterial vaginosis.
Does douching work? Should women douche?
While douching may temporarily cover up vaginal odor, the answer to the question “Does douching work?” is pretty overwhelmingly “no.”
BV is a vaginal infection that occurs when the good Lactobacilli bacteria are overwhelmed by anaerobic bacteria and Gardnerella vaginalis. All these organisms are normally found in the vagina, but sometimes the proportions get out of balance, resulting in infection.
One of the symptoms of BV is a fishy odor, so women may use douches to attempt to counteract the odor. Unfortunately, douching can make matters worse by helping to spread the bacteria up into the uterus, fallopian tubes, and ovaries.
Using douches to prevent BV doesn’t work either; douching upsets the normal bacterial balance and the healthy pH of the vagina, so it actually makes BV more likely rather than less.
Some vaginal odor is totally normal and healthy, and that odor may change as you move through your cycle, exercise, or engage in sexual activity. So first, let’s dismiss the myth that the vagina should be odorless or smell of strawberries and sunshine. It shouldn’t, and trying to force it to can lead to actual health problems.
A change in odor can result from several things: if you think you have an infection such as BV or trichomoniasis (an STD) or a yeast infection, you need to talk with a doctor. Douching won’t solve or prevent any of these and may well make them much worse.
Your period or menopause can cause changes in vaginal odor. Your period is actually your body’s natural cleansing process as the uterine lining is shed, so douching after is wholly unnecessary. Menopause can change the vagina’s pH and cause a change in odor. Topical estrogen may help with this, but as always when adding hormones, you should discuss the pros and cons with your doctor.
Exercise and diet
Exercise and diet can both affect vaginal odor. You’re familiar with asparagus pee? Well, welcome to broccoli vagina. Strongly scented foods can actually translate to a change in vaginal odor, so tracking what you eat and eliminating affecting foods can help. Equally, exercise can increase odor in the groin, just as it does in the armpits. Be sure to change out of sweaty exercise clothes right away, and if you feel you must “cleanse,” stick to the external parts of your lady bits and use a pH-balanced product like Gennev’s Ultra-Gentle Body Wash or Cleansing Cloths.
If you’re experiencing a change in your vaginal odor that is strong and persistent, especially if it comes with a thicker discharge, you need to make an appointment with your ob/gyn. These can be indicators of an infection such as gonorrhea, BV, yeast vaginitis, or even a forgotten tampon or contraceptive sponge. Your doc will be able to diagnose the issue and set you on a course of treatment.
Cleanse and refresh.
The idea that the vaginal area requires special “cleansing” comes more from our societal squeamishness about a woman’s body – and the desire of douche producers to make money –than it comes from any real need. Douching, many wipes, and feminine shampoos and sprays can destroy healthy bacteria and even change your body’s natural pH, allowing the bad bacteria to overwhelm the good.
Tom Robbins’ characters were right when they protested that the “vagina is a self-cleaning organ” – under most conditions, it does the job very nicely all by itself, thank you.
How douching causes problems
Instead of solving problems, douching can actively cause them, often resulting in the same problems women were hoping to avoid, namely infection, odor, and discharge. It can also impact fertility.
According to Dr. Lora Shahine, MD, FACOG at Pacific NW Fertility, "The vagina has a natural balance of bacteria, proteins, and more that get altered with douching. This can lead to overgrowth of certain organisms and lead to a higher risk of infection.
"Douching can also decrease chances of conception by decreasing the amount of cervical mucus that helps sperm gets through the cervix on their way to fertilized eggs." So if you're trying to get pregnant, douching can interfere.
According to research by Jenny L Martino and Dr. Sten Vermund, douching has been associated with a higher risk of infection and higher risk of pelvic inflammatory disease, BV, cervical cancer, fertility and pregnancy concerns, HIV transmission, STDs, ectopic pregnancy (where the fertilized egg attaches in the fallopian tube rather than continuing to the uterus), recurrent and vulvovaginal candidiasis. It can also contribute to a higher rate of urinary tract infections (UTIs).
Removing the natural vaginal flora by douching leaves the body vulnerable; forcing infections and bacteria further up into the body can complicate and worsen existing issues. In some cases, douching can actually be quite dangerous: in women who douche more than once a week, there appears to be an increased risk of cervical cancer.
When is douching a good or useful practice?
There are times when douching serves a useful purpose. Trans women who have had vaginoplasty may find that douching helps manage post-operative healing, for example. For the most part, however, douching is an unnecessary practice that says more about society’s stigmas around the female body than it does about your personal hygiene.
If you have any questions or concerns about douching, ask your ob/gyn to talk though the pros and cons with you. *Remember, this blog is never intended to replace the care of a qualified health care practitioner.
Have you had negative or positive experiences with vaginal douches or other hygiene products? Share your story with the Gennev community. You can talk with us in the comments below, in our community forums, on our Facebook page, or in Midlife & Menopause Solutions, our closed Facebook group.
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