title: Douching and endometritis: results from the PID evaluation and clinical health (PEACH) study.
abstract: BACKGROUND
  Douching has been related to risk of pelvic inflammatory disease (PID).
  
  
  OBJECTIVE
  To examine the association between douching and PID in a large, multicenter, clinical trial of PID after adjustment for race/ethnicity.
  
  
  METHODS
  Interviews were conducted with 654 women who had signs and symptoms of PID. Vaginal Gram stains and upper genital tract pathology/cultures were obtained from all the women. Women with evidence of plasma cell endometritis and/or gonococcal or chlamydial upper genital tract infections were compared with women who had neither endometritis nor upper genital tract infection.
  
  
  RESULTS
  Women with endometritis or upper genital tract infection were more likely to have douched more than once a month or within 6 days of enrollment than women who never douched. These associations remained after adjustment for confounding factors, after analysis of black women only; and among women with normal or intermediate vaginal flora but not bacterial vaginosis.
  
  
  CONCLUSIONS
  Among a predominantly black group of women with clinical PID, frequent and recent douching was associated with endometritis and upper genital tract infection.
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Pennsylvania 15261, USA. repro+@pitt.edu
authors.forename: R B
authors.initials: RB
authors.lastname: Ness
authors.forename: D E
authors.initials: DE
authors.lastname: Soper
authors.forename: R L
authors.initials: RL
authors.lastname: Holley
authors.forename: J
authors.initials: J
authors.lastname: Peipert
authors.forename: H
authors.initials: H
authors.lastname: Randall
authors.forename: R L
authors.initials: RL
authors.lastname: Sweet
authors.forename: S J
authors.initials: SJ
authors.lastname: Sondheimer
authors.forename: S L
authors.initials: SL
authors.lastname: Hendrix
authors.forename: S L
authors.initials: SL
authors.lastname: Hillier
authors.forename: A
authors.initials: A
authors.lastname: Amortegui
authors.forename: G
authors.initials: G
authors.lastname: Trucco
authors.forename: D C
authors.initials: DC
authors.lastname: Bass
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004716:Endometritis / Q000209:etiology*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D007507:Therapeutic Irrigation