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It’s best to avoid vaginal douching

Dear doctor, I have come across products being marketed for vaginal cleansing. Should I use them frequently to maintain optimal vaginal health?

Douching is cleaning of the inside of the vagina with water or other cleansing fluids. It is estimated that about one in every four women regularly douche. Douches are sold as prepackaged mixtures of water and vinegar, baking soda or iodine. The mixture is squirted upwards into the vagina, then washes itself outwards. There are also other vaginal cleansers labelled as ‘organic’ or ‘natural’, which are inserted into the vaginal for periods of time. You do not need a prescription to buy a douching product.

Douching is not necessary, and is unhealthy. Just washing the outside of the vagina is good enough. Why then is douching so common? Some women just feel ‘unclean’ on the inside. Others erroneously think they need to wash their insides after sexual intercourse, or to prevent infections or pregnancy. Yet others have reported the need to wash off vaginal odors. Well, all these and whatever other reasons are false beliefs. The vagina is self-regulatory, with an acidic environment maintained by a natural balance of bacteria and mucous production. This fends off infections and reduces irritation.

Vaginal cleansers labelled as ‘natural’ have special attraction to women. These should however be viewed in the same way as a multitude of other so called ‘natural’ remedies for various conditions. Such products are unregulated, and haven’t been subjected to objective scientific scrutiny for effectiveness and possible side effects. Their popularity hinges on clever marketing using testimonials from undisclosed, or even non-existent users. Be wary of any product that claims magical vaginal benefits.

Douching has been linked with both bacterial and fungal infections. If you already have an infection, douching can push up the infective organisms into your uterus, fallopian tubes and ovaries. You may end up with pelvic inflammatory disease, which is a serious condition. You also get predisposed to sexually transmitted infections and even HIV. Longer term effects include vaginal dryness and irritation, ectopic pregnancy and infertility. Newer studies have even linked douching with an increased risk of gynecological cancer.

Don’t douche with the notion that you will prevent infections. It’s useless to try to prevent pregnancy by douching. The vagina has a natural odor which changes as the day advances, and with your cycle. When you douche, you inevitably interfere with the healthy bacterial balance in the vagina. This may worsen anything that you were trying to remedy.

If you are worried about an odor, discharge or unusual irritation, it’s better to get a formal diagnostic evaluation. Then use a proven and specific remedy. If you decide to douche, this is entirely up to you.

Dr Alfred Murage is a Consultant Gynecologist and Fertility

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