Douching in relation to bacterial vaginosis, lactobacilli, and facultative bacteria in the vagina

Obstet Gynecol. 2002 Oct;100(4):765. doi: 10.1016/s0029-7844(02)02184-1.


Objective: To study how frequency, recentness, and reason for douching impact bacterial vaginosis-related vaginal microflora and the occurrence of cervical pathogens. Douching has been linked to bacterial vaginosis as well as to chlamydial cervicitis in some, but not all, studies.

Methods: A total of 1200 women at high risk for sexually transmitted infections were enrolled from five clinical sites around the United States. Cross-sectional, structured interviews were conducted and vaginal swabs were self-obtained for Gram stain, culture, and DNA amplification tests for Neisseria gonorrhoeae and Chlamydia trachomatis.

Results: Douching at least once per month was associated with an increased frequency of bacterial vaginosis. Those who douched recently (within 7 days) were at highest risk [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.3, 3.1]. Douching for symptoms (OR 1.7, 95% CI 1.1, 2.6) and for hygiene (OR 1.3, 95% CI 1.0, 1.9) both related to bacterial vaginosis risk. The associations between douching and Gardnerella vaginalis, Mycoplasma hominis, and lack of hydrogen peroxide-producing lactobacilli were similar to those between douching and bacterial vaginosis. Gonococcal or chlamydial cervicitis was not associated with douching.

Conclusion: Douching for symptoms or hygiene, particularly frequent or recent douching, was associated with bacterial vaginosis and bacterial vaginosis-associated vaginal microflora, but not with gonococcal or chlamydial cervicitis.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Lactobacillus / isolation & purification
  • Logistic Models
  • Risk Factors
  • Therapeutic Irrigation* / adverse effects
  • Time Factors
  • United States / epidemiology
  • Uterine Cervicitis / epidemiology
  • Uterine Cervicitis / microbiology
  • Vagina / microbiology*
  • Vaginosis, Bacterial / epidemiology*
  • Vaginosis, Bacterial / microbiology