Douching: a problem for adolescent girls and young women.
OBJECTIVE
To compile available published data on the prevalence of douching practices in adolescent girls and young women and the effects of douching on gynecologic health, including studies of gynecologic changes due to douching in adolescent girls and young women, surveys that demonstrated the prevalence of douching in the populations, and policy statements or lack thereof from professional and medical organizations with regard to the practice of douching.


METHODS
We did Internet searches, including a MEDLINE search, a literature review, and used the telephone, mail, and e-mail to contact professional organizations.


RESULTS
Douching has been found to be strongly associated with increased risk for pelvic inflammatory disease, bacterial vaginosis, and ectopic pregnancy, the former of which is especially prevalent in adolescent girls and young women. Douching is practiced by 15.5% of adolescent girls and young women in the United States, with significantly higher prevalences in certain groups in the population. We have not found any official position of professional and medical organizations on the practice of douching.


CONCLUSIONS
Because vaginal douching has been shown to be associated with bacterial vaginosis, pelvic inflammatory disease, and ectopic pregnancy, and because no benefits are conferred on those who practice it, douching should be discouraged among adolescent girls and young women. There is a great need for further studies, particularly prospective ones, to determine if there is evidence of a direct causative influence of douching on pelvic inflammatory disease, ectopic pregnancy, and/or bacterial vaginosis, and to determine why adolescent girls and young women douche.
Merchant
J S
JS
School of Public Health, University of Alabama at Birmingham, 35233, USA.
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K
K
Klerman
L V
LV
D005260:Female; D015438:Health Behavior; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000209:etiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000706:statistics & numerical data; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000209:etiology