title: Cervicovaginal secretions protect from human papillomavirus infection: effects of vaginal douching.
abstract: OBJECTIVE
  Cervicovaginal secretions (CVSs) are reported to protect against human papillomavirus (HPV) infection. Although vaginal douching is known to clear both viral inoculants and CVSs, its effect on CVSs in women with HPV infection is unknown.
  
  
  METHODS
  The in vitro HPV pseudovirus infection system was used to test the protective activity of CVSs against HPV infection in samples collected before and after vaginal douching. To simulate different time points of vaginal douching in relation to viral exposure, the cell CVS reconstitute was washed after different viral exposure durations.
  
  
  RESULTS
  In the CVSs of premenopausal and postmenopausal women who did not perform douching, the CVSs inhibited HPV infection by 56.7 ± 1.8% and 53.6 ± 2.5%, respectively; in women who had performed douching, the CVSs inhibited HPV infection by only 31.2 ± 7.1%, which was significantly lower (p < 0.01). Cell washing effectively cleared 60-90% of the infectious load with the greatest activity occurring within 30 minutes after inoculation. In the presence of CVSs, a sustained inhibition of HPV infection existed for up to 8 hours after HPV exposure, and cell washing increased the clearance to up to 82-93% of the infectious load.
  
  
  CONCLUSIONS
  This study confirms the protective activity of CVSs against HPV infection regardless of age. In this in vitro study, the net effect of douching was found to be beneficial.
authors.affiliation: Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan. hidrchu@gmail.com
authors.forename: Tang-Yuan
authors.initials: TY
authors.lastname: Chu
authors.forename: Ying-Cheng
authors.initials: YC
authors.lastname: Chang
authors.forename: Dah-Ching
authors.initials: DC
authors.lastname: Ding
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism* / Q000821:virology; D005260:Female; D052162:Human papillomavirus 16 / Q000235:genetics / Q000254:growth & development*; D006801:Humans; D066298:In Vitro Techniques; D008593:Menopause; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D017698:Postmenopause; D017697:Premenopause; D014621:Vagina / Q000378:metabolism* / Q000821:virology; D044364:Vaginal Douching / Q000379:methods*
keywords: cervicovaginal secretion; human papillomavirus infection; vaginal douche