Vaginal douching.
OBJECTIVE
To review current literature on vaginal douching.


METHODS
MEDLINE, CINAHL, and Cochrane databases from 1997 to 2001, using keywords douche or douching; 2001 Web sites of the Centers for Disease Control and Prevention; and Internet search engines for information about current retail sales of douches.


METHODS
MEDUNE included 67 records, CINAHL 18, and Cochrane 2. Abstracts of articles in English were reviewed, and those pertaining to vaginal douching practices were included. MEDLINE had 44 pertinent articles, CINAHL 11, and Cochrane 1. References from these articles were reviewed and included when appropriate.


METHODS
Articles were reviewed and summarized.


RESULTS
Vaginal douching is a common practice for women in the United States. Douching is associated with adverse reproductive and gynecologic outcomes including bacterial vaginosis, preterm birth, low-birth-weight infants, pelvic inflammatory disease, chlamydial infection, tubal pregnancy, higher rates of HIV transmission, and cervical cancer. Cultural beliefs and educational factors strongly influence douching practices.


CONCLUSIONS
Nursing assessment of women should include information on vaginal douching practices and beliefs. Nurses should use culturally appropriate educational strategies to discourage women of all ages from using vaginal douches as part of routine feminine hygiene because of the associated risks. Further research is needed on factors that influence women's beliefs and douching practices.
Cottrell
Barbara Hansen
BH
Florida State University School of Nursing, Tallahassee 32306-3051, USA. bcottrel@garnet.acns.fsu.edu
D001294:Attitude to Health / Q000208:ethnology; D005260:Female; D015658:HIV Infections / Q000209:etiology; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007246:Infertility / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000209:etiology; D000292:Pelvic Inflammatory Disease / Q000209:etiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D012307:Risk Factors; D015231:Sexually Transmitted Diseases, Bacterial / Q000209:etiology; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000451:nursing* / Q000523:psychology; D014481:United States; D014621:Vagina / Q000382:microbiology*; D016387:Women's Health