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To douche or not to douche?
There are women who swear by it. Some just like the feeling of a douche or the perception of internal cleanliness, especially after menstruation. Douching can also help reduce some vaginal itching and soothe minor irritations.
But a douche cannot prevent pregnancy, not even a little. Sperm swim much too fast for a douche after intercourse to have much effect. In fact, if you've used a spermicide, diaphragm, or cervical cap, douching within eight hours after intercourse will render the spermicide agent ineffective. Douching can also seriously mess with the delicate chemical balance of your vagina.
So while the occasional douche can offer a little topical comfort or relief, it does not provide any substantive benefit for hygiene or birth control. Really, you can trust Mother Nature. The natural cleansing action of the body -- and your normal pH balance -- are best left alone.
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Heed Your Body's Warning Signs
Douching may be a part of some women's routines, but douching every day is not recommended. While a douche may give you a feeling of "freshness," washing the external folds of your vagina daily with soap and water goes a long way toward keeping it clean and healthy. The occasional douche may wash out secretions, but frequent douching alters the normal bacterial environment of your vagina, increasing your risk of infections.
Persistent itches, soreness, or secretions may be signs of problems that need a doctor's care. The best advice is to proceed with caution. In general, don't douche more than twice a week unless your doctor recommends otherwise. If symptoms remain after a week, or if you experience side effects like swelling or pain, let your doctor decide what to do from there.
Decisions, Decisions
Douching solutions come in various forms: liquids, liquid concentrates, and powders. Some require mixing, others don't, and some come premixed in their own throwaway applicator -- the height of douching convenience. Short of that, you can choose between a douche bag or a bulb syringe; both will do the job.
- Acidic douches, while fairly diluted, complement the natural acidic environment of the vagina, so they are a good choice for most women.
- Alkaline douches act as a detergent, so they are helpful in breaking up and washing secretions out of the vagina.
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Acid-base balancers
These chemicals claim to help keep the acidic environment of the vagina intact, either as an acidifier or a buffer. They were originally classified as category II (conditionally approved) by an FDA mongraph in 1983. But in 1994, the FDA withdrew its proposed rule and recommended that these chemicals follow rulings set forth in other mongraphs. These chemicals are basically acids or salts such as acetic acid, lactic acid, and sodium carbonate. Sometimes douches wash out acidic compounds and make the vaginal environment temporarily more basic.
Antiseptics
These chemicals claim to kill microbes and soothe vaginal irritation. There is little evidence that these products can help reduce the likelihood of a vaginal infection. Originally the FDA classified all ingredients claiming to be anti-irritants as category II, with the exception of povidone-iodine. However, the FDA withdrew that monograph, stating that the product evaluation could be based upon rulings in other monoraphs. These chemicals are highly concentrated enough to function as preservatives, but not as antiseptics.
Astringents
Astringents pull proteins and irritants out of solution and may tighten skin. They are often the component of douche products that soothe and refresh, however, their refreshing powers are subjective. They can also reduce irritation. Some common astringents are alum, zinc sulfate, and boric acid.
Surfactants
Surfactants are employed to loosen vaginal secretions and facilitate their discharge; they allow water to spread out. However, their effectiveness in vaginal hygiene is questionable. They can also cause irritation and allergy.
Counterirritants
Counterirritants are used to reduce itching and irritation. They are often aromatic compounds such as thymol, menthol, and eucalyptol. Their effectiveness in preventing or reducing itching and irritation has not yet been substantiated. But they do leave a cooling/warming sensation and many have a pleasant scent.
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Appropriate Uses
Douches
Temporarily relieves vaginal itching, soreness, and irritation; washes out vaginal secretions and mucous; and reduces vaginal odor.
Common Misconceptions
Douches
Should not be used to prevent pregnancy because they do not remove or kill sperm. They also do not prevent STDs. Douches cannot be used to treat symptoms of a yeast infection. Consult a doctor if you are experiencing prolonged vaginal irritation.
The ingredients in douches are not all mild and gentle and may cause irritation. Douches do not offer antimicrobial activity; the antimicrobial agents within are too low to offer effective protection against bacteria and germs.
Douche Do's and Don'ts
- Keep all douching supplies clean to avoid contamination and risk of infection.
- Never forcefully squeeze douche solutions into the vagina.
- Do not use for eight hours after intercourse.
- Do not use if you have a gynecological exam in the next 24 to 48 hours.
- Do not douche more than two times a week.
Using a Bulb Syringe
- If necessary, use lukewarm water to dilute products.
- Start by either sitting on the toilet or standing in the shower.
- Gently insert the nozzle into your vagina about 3 inches.
- Apply gentle pressure to the bulb.
- Don't hold the vagina closed while you are douching. Let the solution enter gently, then let gravity do its job.
- Throw away disposable parts after use and clean reusable parts.
Using a Douche Bag
- Fill the bag with the warm solution.
- Laying in the tub with knees bent, raise the bag so that it is about one foot above your hips.
- Insert the nozzle about 1 1/2 inches into the vagina while aiming it up and back toward the small of your back.
- Release the clamp and let fluid enter the vagina until full.
- You can vary the rate of flow by adjusting the height of the bag slightly.
- Allow the fluid to remain in the vagina for 30 to 60 seconds, then let the fluid flow out.
- Repeat until bag is empty.
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Frequent Douching May Be Risky
In addition to disrupting the vagina's delicate chemical balance, frequent douching may increase the risk of:- Ectopic pregnancy (fetus develops outside uterus)
- Cervical cancer
- Pelvic Inflammatory Disease (PID), which can lead to sterility
- Salpingitis (inflammation of the fallopian tubes)
- Miscarriage in pregnant women
Know the Ingredients and the Effects
- Do not use if you are allergic to any ingredient in the product. Possibly troublesome ingredients include alum, benzalkonium chloride, benzocaine, boron compounds, nonoxynol-9, phenol compounds, and povidone-iodine.
- Douches should never be used as a method of contraception.
- Do not use if you are pregnant. You risk miscarriage, exposing the fetus to chemicals, and spreading a vaginal infection to the fetus.
- Using homemade douches such as carbonated soda increases the risk of gas bubbles entering the bloodstream and could cause a potentially fatal embolism.
- Use only approved, appropriate douche nozzles. The forceful stream created by an enema nozzle is damaging to delicate vaginal tissues. Using one nozzle for both douching and enemas risks spreading infection from your anus to your vagina.
- Some ingredients may potentially be harmful.
- Boron compounds can be poisonous in high concentrations.
- Edetate disodium and edetate sodium bind zinc can cause birth defects.
- Oxyquinoline citrate and oxyquinoline sulfate may cause cancer and genetic damage.
- Phenol and phenolate sodium are dangerous nerve poisons in high concentrations.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. Food & Drug Administration.Federal Register 2/3/94.
- 2. Covington, TR; RR Berardi, LL Young, SC Kendall, MJ Hickey.Handbook of Nonprescription Drugs. American Pharmaceutical Association, Washington DC, 1996.
- 3. Rinzler, CA.The Women'sHealth Products Handbook. Hunter House Inc. 1997.
- 4. Knodel, LC.Nonprescription Products: Formulations & Features '98-99. Americam Pharmaceutical Association. Washington DC 1998.
Find more books on health and wellness at  barnesandnoble.com.
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