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Role of women

Gynecologists have spent decades telling their patients not to douche, but a new survey suggests many women — nearly 80 percent — haven’t been listening.


Some health experts say douching, the flushing of the internal female genitals with a liquid, is dangerous because it washes away healthy bacteria. The theory is that the flushing “changes the environment of the vagina, and makes the lower genital tract susceptible to infections,” Oh says. Another theory suggests that douching solutions push unhealthy bacteria higher into a woman’s body. “In the cervix, you normally have a barrier, a mucous plug, so you can’t get things into the uterus very easily. Douching reduces that,” says Dr. Jeanne Marrazzo, an assistant professor of medicine at the University of Washington at Seattle. Studies have linked douching to pelvic inflammatory disease, chlamydia and ectopic pregnancies, Marrazzo says. On the other hand, many women douche and appear to suffer no negative effects. “Maybe it’s not harmful to them. I don’t know,” Oh says. Oh became interested in the topic when she realized that douching remains common, although she’d learned about the risks back in the 1950s when she attended medical school in Korea. So, she set out to find out how many women douche and why. She released her findings at the recent annual National STD Prevention Conference, sponsored by the Centers for Disease Control and Prevention .Oh and her fellow researchers surveyed 571 girls and women aged 14 to 63 in rural Alabama, urban Alabama and urban Ohio. Seventy-seven percent said they’d douched at least once in their lives — 70 percent of those were under 30, and 90 percent were over 30. Sixty percent of the women said they douched to feel fresh, 38 percent to get rid of odor, 36 percent to get rid of menstrual blood, 5 percent to please a partner and 1 percent to prevent pregnancy. The researchers also found older women were more likely to think — incorrectly — that douching prevents pregnancy and kills germs that cause sexually transmitted diseases (STDs). Oh says women appear to be willing to accept the risks of douching. “I think it’s a really small minority of women who have not heard anything about bad effects,” she says. “With teen-agers, it may be different.” Indeed, women who began douching before age 15 were more likely to be misinformed about the hazards of douching. Also, the researchers found early use of douching products “is very related to sexual behavior, having multiple partners, starting intercourse very early,” Oh says. Marrazzo says education is the key to reducing the practice of douching. “You have to be very sensitive to the fact that many women grew up with douching being part of regular hygiene,” she says. “Their grandmother and mothers did it. You need more education than just an admonition.” Women need to learn that they come with a built-in “self-cleansing system,” Marrazzo says. “It’s got its own regulation. But if women are going to persist in doing it douching, I try to get them to use something relatively benign, like water.”Words
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