Does douching increase risk for sexually transmitted infections? A prospective study in high-risk adolescents

Am J Obstet Gynecol. 2009 Jan;200(1):38.e1-8. doi: 10.1016/j.ajog.2008.06.026. Epub 2008 Jul 30.


Objective: The objective of the study was to examine the association between douching and 4 sexually transmitted infections (STIs).

Study design: We followed up 411 high-risk human immunodeficiency virus-infected and uninfected female adolescents aged 12-19 years over a median 3-year period, both by time from study entry/first STI-free visit until an incident STI for participants who never, intermittently, and always douched and also by reported douching at a given STI-free visit and incidence of STI at the next visit, using adjusted Cox proportional hazards models to calculate hazard ratios (HR).

Results: The time to STI was shorter for adolescents who always (HR, 2.1; 95% confidence interval [CI], 1.2-3.4) and intermittently (HR, 1.5; 95% CI, 1.0-2.2) douched, compared with never-douchers. An adjusted hazard for STI was 1.8 times larger for always-douchers (95% CI, 1.1-3.1) and 1.4 times larger for intermittent douchers (95% CI, 0.9-2.0), compared with never-douchers. When classifying by follow-up after an STI-free visit, always-douchers had a shorter STI-free time than never-douchers (HR(adj), 2.1; 95% CI, 1.5-3.1).

Conclusion: Counseling to discourage douching may reduce STI risk in adolescents.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Child
  • Chlamydia trachomatis / isolation & purification
  • Cohort Studies
  • Female
  • Herpesvirus 2, Human / isolation & purification
  • Humans
  • Incidence
  • Interviews as Topic
  • Kaplan-Meier Estimate
  • Neisseria gonorrhoeae / isolation & purification
  • Proportional Hazards Models
  • Prospective Studies
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / etiology
  • Sexually Transmitted Diseases / microbiology*
  • Trichomonas vaginalis / isolation & purification
  • Vaginal Douching*
  • Young Adult