Do Women Need to Douche?
Experts say it’s not necessary. So why do so many women keep up this centuries-old practice?
Douche means "to wash" or "to soak" in French and refers to the practice of washing or rinsing out the vagina using water or some other fluid. Vaginal douches were first commercially produced in the 1800s, but douching itself was practiced long before that, says Fatima Daoud Yilmaz, MD, an ob-gyn at Stony Brook Medicine in New York.
Typically found in the feminine care aisle of most pharmacies and grocery stores, douche solution is usually a mix of water and vinegar, baking soda, or iodine. Douching is performed by squirting the solution into the vagina through a tube or nozzle, and the water mixture then comes back out through the vagina.
In 2002, more than 30 percent of women ages 15 to 44 reported douching, according to the National Survey of Family Growth by the Centers for Disease Control and Prevention (CDC). By 2019, that figure had dropped to about 11 percent.
Does douching have benefits for some women in some situations? None whatsoever, says Dr. Daoud Yilmaz. “Douching is not necessary for any women. There is no medical reason to douche,” she says.
Douching Leaves the Vagina Vulnerable to Unhealthy Bacteria, Viruses, and Yeast
Douching is not only unnecessary but can actually do more harm than good, says Daoud Yilmaz.
The vagina is a self-cleaning organ, according to Michigan Women’s Health. The cervix and the walls of the vagina create a small amount of mucous that carries menstrual blood, old cells, and other matter out of the vagina. “These cell layers are constantly sloughing away, and when they do, they take the bacteria and viruses along with them,” says Daoud Yilmaz.
Many douching products alter the pH, or acidity, inside the vagina to abnormally high levels, according to Michigan Women’s Health. This can leave the vagina more vulnerable to unhealthy bacteria, viruses, and yeast, says Daoud Yilmaz.
Douching can also disturb antibodies that produce antimicrobial proteins, found in the outer layer of cells that line a healthy vagina. Disrupting this defensive layer of the vagina can predispose one to infection, including bacterial vaginosis, yeast, and sexually transmitted infections, says Daoud Yilmaz.
Douching Linked With Pelvic Inflammatory Disease and UTIs
When you douche, you can also push pathogens (things like bad bacteria and viruses) upwards toward the cervix, uterus, and fallopian tubes, says Daoud Yilmaz.
“This can lead to a condition called pelvic inflammatory disease (PID),” she says.
PID can cause scarring in the fallopian tubes and lead to infertility or ectopic pregnancy, says Daoud Yilmaz. In some cases, an abscess can form in the reproductive tract as a result of PID and potentially cause a life-threatening infection if left untreated, according to the Mayo Clinic.
Douching may also increase the risk of developing a urinary tract infection (UTI). While UTIs are usually caused by fecal bacteria entering the urethra as opposed to vaginal bacteria, douching can still irritate the lining of the urethra and result in infection, says Daoud Yilmaz.
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Busting the Most Common Myths About Douching
So why do some women still choose to douche? Experts say it may be due to a few myths about douching that have taken root. These myths include:
Douching is a hygienic part of a woman's normal cleansing process. Again, no. The vagina is designed to clean itself, says Daoud Yilmaz. Douching will wash away menstrual blood and other matter, but it also changes the pH of the vagina, leaving it vulnerable to infection.
Douche is needed to get rid of a vagina's odor. All vaginas create discharge and have a slight odor that can fluctuate throughout the month. That’s normal and natural, says Daoud Yilmaz.
“The vulva and vagina should not smell like vanilla or whatever the feminine care aisle is telling you it should smell like,” she says.
An unusual vaginal odor could be a sign of a bacterial infection, bladder infection, or sexually transmitted infection (STI), according to the CDC. “If you think there is something wrong, rather than masking it with douching, feminine washes, or deodorants, seek medical attention to determine what, if anything, is wrong,” says Daoud Yilmaz.
Douching can prevent pregnancy or sexually transmitted diseases. Douching after sex does not wash semen out of the vagina or prevent pregnancy. Douching has, however, been linked to infertility and associated with a higher risk of ectopic pregnancy, according to the Office on Women's Health (OWH).
An ectopic pregnancy occurs when the fetus begins developing anywhere outside of the womb, often in the fallopian tube. This is a serious, potentially life-threatening condition. Douching during pregnancy may also increase the risk that a woman will have a preterm baby.
Douching doesn’t prevent sexually transmitted infections either. In fact, it can increase your risk of getting an STI, including HIV, per the OWH.
Douching can help treat a bacterial infection. As stated earlier, douching can spread vaginal infections further into your pelvis. It may also make it more difficult for your doctor to find and treat your infection, since douching disrupts the normal vaginal environment.
“Often, underlying medical conditions and lifestyle choices can also lead to conditions such as bacterial vaginosis and yeast infections,” says Daoud Yilmaz. In addition to douching, these can include poorly controlled diabetes, recent antibiotic use, daily use of panty liners, spermicide use, and wearing of tight synthetic underwear, which can create environments that pathogens love, she says.
“This is why consultation with a physician is always recommended to get to the root cause of the issue and create a treatment plan that is tailored for you,” she says.
How to Clean Your Vagina
Women should never try to clean their vaginas, says Daoud Yilmaz. “If a woman feels that there is something wrong, such as an unusual odor, new discharge, pain, abnormal bleeding, or itching, she should seek medical attention,” she says.
“If someone is looking to clean their vulva (the outer part of the female genitalia), I would recommend using lukewarm water only. There are times when more than water may be needed, such as during menstruation, after working out, or after intercourse,” she says.
In those cases, using a gentle, undyed plain soap without any fragrance externally on an as-needed basis is safe, though this may still be too harsh for those with sensitive skin, says Daoud Yilmaz.